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Associations between substance use treatment and ketamine use: A hypothesis-generating analysis.

Fares Qeadan, Shanti O'Neil

Addictive behaviors reports June 1, 2026 DOI: 10.1016/j.abrep.2025.100650 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Cross-sectional survey analysis Peer reviewed
Sample size 173,808
Population U.S. residents aged 12 and older who reported substance use
Topics Addiction Ketamine Esketamine
Keywords Drug treatment Hallucinogens Prescription misuse Public health policy
Citations 1
Key findings Past-year substance use disorder treatment was associated with higher odds of past-year ketamine use across multiple substance domains, including alcohol, marijuana, inhalant, methamphetamine, pain reliever, and opioid use disorders.

Abstract

Ketamine is increasingly used in clinical settings for mental health and pain management, yet its misuse poses public health risks. While prior studies have examined ketamine trends, few have explored its use among individuals receiving treatment for substance use disorders (SUD). Using 2021-2023 data from the National Survey on Drug Use and Health (NSDUH), we analyzed the association between past-year ketamine use and receipt of SUD treatment among U.S. residents aged 12 and older. Stratified analyses by substance type and use category (use, misuse, and disorder) were conducted using adjusted logistic regression models. Among 173,808 participants who reported substance use, 3.19 % received past-year treatment and 0.26 % reported past-year ketamine use. Ketamine use was more common among those in treatment (1.39 %) than not (0.22 %). Across SUD strata, treatment was associated with higher odds of ketamine use, including alcohol SUD (aOR = 2.73; 95 % CI: 1.58-4.71), marijuana SUD (2.32; 1.34-4.02), inhalant SUD (5.22; 1.96-13.94), methamphetamine SUD (5.10; 2.08-12.48), pain reliever SUD (2.62; 1.16-5.90), and opioid SUD (2.76; 1.23-6.18). Among misuse strata, associations included pain relievers (2.69; 1.40-5.16), opioids (3.13; 1.71-5.74), and psychotherapeutics (2.09; 1.21-3.62). Among use strata, treatment was associated with higher odds for cigarettes, alcohol, marijuana, heroin, PCP, DMT/AMT/FOXY, methamphetamine, pain relievers, tranquilizers, and stimulants. Past-year treatment is a marker of elevated ketamine exposure across multiple substance domains. Findings are hypothesis-generating and underscore the need for clinical screening, patient education on unsupervised ketamine risks, and research clarifying timing, intent, and outcomes of ketamine use in SUD populations.

In the evidence

This study is part of the evidence base for a synthesis in the library. Here is how each one recorded it.

  • Past-year substance use disorder treatment was associated with higher odds of past-year ketamine use across multiple substance domains, including alcohol, opioid, and methamphetamine use disorders.

    Synthesized

Comparable studies

Other cross-sectional and survey studies on ketamine for addiction, most cited first.

Study Year Design Participants
Self-reported prevalence of dependence of MDMA compared to cocaine, mephedrone and ketamine among a sample of recreational poly-drug users Global non-treatment-seeking sample of last year users of MDMA, cocaine, mephedrone,... 2014 Cross-sectional survey
Differences between users' and addiction medicine experts' harm and benefit assessments of licit and illicit psychoactive drugs: Input for psychoeducation and legalization/restriction debates. German substance-dependent adults seeking inpatient detoxification or rehabilitation... 2022 Cross-sectional comparative study n = 117
Recreational Ketamine Use among Individuals with Opioid Use Disorder: Demographics, Motivations, and Polysubstance Use. Treatment-seeking individuals with opioid use disorder 2025 Cross-sectional survey n = 301
Mental Health Facilities With Ketamine Infusion Therapy in the United States in 2020: Co-Location of Dual Diagnosis Mental Health and Substance Use Disorder Treatment U.S. mental health treatment facilities that provide ketamine infusion therapy 2024 Cross-sectional survey n = 134
Ketamine Dependence: Clinical Characteristics of an Inpatient Detoxification Population With Complex Physical Health Needs Patients admitted for ketamine detoxification at the Chapman Barker Unit, a regional... 2026 Retrospective cross-sectional study n = 59

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