What Is Ketamine? Uses, Risks and Drug Testing

Ketamine can appear in two very different conversations. In a hospital, the discussion may be about anaesthesia or relief from pain. Outside medical care, it may be about someone who feels detached from their surroundings, becomes confused or struggles to move safely. Both conversations concern the same substance. Understanding it requires more than a label.

For people receiving treatment, clear information helps distinguish medical care from recreational use. For families, it helps explain risks without judgement. For professionals working in public safety and drug testing, it raises a practical question: does the information available actually cover the substances they need to understand?

What is ketamine?

Ketamine is a dissociative anaesthetic used in human and veterinary medicine. “Dissociative” describes its ability to create a feeling of separation from the body, pain or surroundings. It can also alter perception, awareness and memory. The US Drug Enforcement Administration’s ketamine factsheet explains both its medical role and these effects.

Ketamine is not an opioid, even though it can be used in pain management. Nor does describing it as a “party drug” capture its full significance.
Its medical value and the risks associated with non-medical use can both be real.

Why medical supervision changes the context

Medical use involves a known formulation, a clinical purpose and decisions about suitability, dose and monitoring.
Some specialist services also use ketamine to treat treatment-resistant depression. That treatment is more than the administration of a drug: it includes assessment, supervised treatment and follow-up.

For example, Oxford Health NHS Foundation Trust describes a ketamine treatment programme in which staff monitor patients during infusions, provide recovery time and give specific instructions about activities afterwards.

Recreational use does not provide those safeguards. The person may not know the composition of the substance or how it will interact with anything else they have taken.

This distinction also matters when interpreting a drug-test result. Detecting a substance does not, by itself, explain why it was taken. Medical history and the circumstances of exposure remain important.

What does ketamine do to the body?

Ketamine can change the way a person experiences their body and environment. Effects can include altered perception, reduced awareness of pain, confusion and memory disturbance. Someone may appear detached or have difficulty responding coherently. These effects are described in the DEA’s ketamine guidance.

Reduced awareness of pain can make injuries harder to notice. Changes in perception and movement also matter around traffic, machinery, stairs or water.

At more intense levels of dissociation, a person may experience what is commonly called a “K-hole”: profound detachment, sometimes accompanied by an inability to move. The UK drug-information service FRANK describes how frightening and physically limiting this experience can be.

Symptoms alone, however, cannot reliably identify which substance is involved. A confused or unresponsive person needs appropriate assessment, rather than an assumption based on appearance.

Ketamine and alcohol: why combinations deserve attention

Ketamine use may involve more than one substance. Alcohol, opioid medicines and benzodiazepines are especially important combinations to understand.

The prescribing information for KETALAR, a ketamine medicine, warns that combining ketamine with these central nervous system depressants can cause deep sedation, dangerously reduced breathing, coma and death.

For professionals assessing an incident, identifying one substance may therefore leave part of the picture unexplained. The possibility of additional substances deserves attention.

If someone loses consciousness or has serious difficulty breathing after taking drugs, seek emergency help immediately. The NHS guidance on poisoning identifies these as emergency signs. Obtaining a test result should never delay urgent care.

The harms that can continue after intoxication ends

Some ketamine-related problems develop over time.
Repeated, intensive use can damage the bladder and urinary tract. Symptoms may include pain when urinating, needing to urinate frequently or urgently, and blood in the urine. North London NHS drug and alcohol services describe potentially serious bladder complications alongside other health risks.

Ketamine can also lead to dependence. Regular users may develop tolerance and take more to obtain the effects they previously experienced. FRANK’s ketamine guidance explains this pattern.

Increasing use, difficulty cutting down or continuing despite health problems are reasons to seek professional support. Painful urinary symptoms deserve medical attention, rather than being accepted as an unavoidable part of using the drug.

An informed conversation can help someone recognise a problem earlier. Shame rarely makes that conversation easier.

Why ketamine is receiving more attention in Europe

Ketamine remains less widely used than several better-known illicit drugs, but European monitoring shows reasons to pay closer attention.
The European Union Drugs Agency’s European Drug Report 2026 reports that the number of people entering specialised treatment for ketamine-related problems rose from 413 in 2019 to approximately 1,796 in 2024.

The same report notes that ketamine residues increased in 40 of the 66 European cities with comparable wastewater data for 2024 and 2025.

These indicators measure different things. Treatment figures describe people seeking help; wastewater analysis provides information at population level. Neither tells us what a particular person has taken.

Together, however, they support a practical inference: ketamine deserves consideration when organisations review their monitoring priorities and testing panels.

Can ketamine be detected in saliva?

Yes.
Research has demonstrated the detection and measurement of ketamine and its metabolite, norketamine, in oral fluid using analytical methods.

A study published in 2025 involving drivers in northeastern France examined samples from 3,364 drivers who had already tested positive in roadside screening for other drug groups. Subsequent mass-spectrometry analysis detected ketamine in 88 drivers.

Most of those ketamine-positive drivers also had another drug detected.

This was a selected group, not a representative sample of all drivers. The findings should not be treated as a general prevalence estimate. Their practical relevance is that analysis for additional substances can provide information beyond the initial screening result.

The researchers recommended considering ketamine and norketamine in oral-fluid testing for drug-impaired driving.
That does not mean every saliva test detects ketamine. Coverage depends on the substances included in the specific test and the performance established for that method.

What ketamine means for on-site drug testing

For organisations choosing a testing system, ketamine illustrates why the substance panel deserves careful attention.

A useful discussion starts with the intended application: which substances matter, what information is needed and how the result will support the next decision.

Speed is valuable when the analysis answers the relevant question. Substance identification and concentration measurements can add information, while interpretation still requires the circumstances of the case.

At SafePAS, this is the thinking behind Drug Hunter: portable analysis that identifies and quantifies selected drugs in saliva, bringing substance-specific information closer to operational settings.

As testing needs evolve, any proposed expansion of a panel should be supported by research and validation for the intended application. Ketamine provides a timely reason to keep that work moving.

Behind every sample is a person. Better information should help professionals respond more thoughtfully, use resources more effectively and make decisions grounded in evidence.

Frequently asked questions

Is ketamine an opioid?

No.
Ketamine is a dissociative anaesthetic. Its use in pain management does not make it an opioid.

Does every drug test check for ketamine?

No.
Drug tests have different substance panels. Ketamine coverage must be confirmed for the particular method being used.

Want to discuss the substances your organisation needs to test for?
Contact the SafePAS team to explore Drug Hunter’s current substance panel and your on-site testing requirements.