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ConditionsDISS

Ketamine & Dissociative Use Disorder

Ketamine, DXM (cough syrup), and PCP — drugs that produce detachment from the body and surroundings. Recreational ketamine in particular has become far more common.

What to know. Ranges from mild to severe. Heavy ketamine use can seriously damage the bladder and urinary tract; PCP can cause agitation and psychosis.

First-line care
No FDA-approved medication; structured behavioral treatment with off-label support

What major medical bodies recommend first when this condition is the focus of care.

Off-label medications can be used in addition to behavioral therapy.


Symptoms

How clinicians think about it.

The DSM-5 lists eleven signs grouped into four areas. The number that fit in the past year suggests a severity — not a verdict.

LOSS OF CONTROL · 4
  • ·Using more than meant to
  • ·Wanting to cut down
  • ·Time spent using
  • ·Cravings
SOCIAL IMPACT · 3
  • ·Trouble at work / school
  • ·Relationship strain
  • ·Giving up activities
RISKY USE · 2
  • ·Risky situations
  • ·Using despite harm
PHYSICAL · 2
  • ·Tolerance
  • ·Withdrawal

Risks worth knowing

Plainly: what makes this condition dangerous.

High concern

Ketamine-induced bladder and urinary-tract damage (cystitis)

High concern

Agitation, psychosis, and injury — especially with PCP

Moderate concern

Confusion and accidents while intoxicated


Treatment options

What's offered, and what we usually start with.

FIRST-LINE — RECOMMENDED FIRST
01
Off-label medicationFirst-line

Used to manage cravings, mood, and sleep. There is no FDA-approved medication specific to dissociatives.

02
Cognitive behavioral therapy

Addresses triggers, patterns of use, and relapse prevention.

03
Urology referral when bladder symptoms appear

Heavy ketamine use can injure the bladder; we coordinate care when it's needed.


Common questions

Asked often, answered briefly.

Ketamine and esketamine are used under close medical supervision for depression. That's different from frequent recreational use, which can become hard to control and can damage the bladder. Both things are true.

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This is not a diagnosis. These tools are for reflection and conversation. A clinician's evaluation is the only way to confirm a substance use disorder. If you are in crisis, call or text 988.
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