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Beyond the High: A Narrative Review of the Chronic Complications of Recreational Ketamine Use.

Karen L Erskine, Paul I Dargan, David M Wood

British journal of hospital medicine (London, England : 2005) May 18, 2026 Peer reviewed DOI: 10.31083/bjhm53976 via PubMed

Summary

Chronic, high-dose recreational use of ketamine can lead to dependence and various long-term complications affecting multiple organ systems, including urological, neurological, neuropsychiatric, and hepatobiliary issues. Clinicians need to be aware of these potential complications to facilitate early identification and management in affected individuals.

Study at a glance

Design narrative review
Population individuals with long-term ketamine use
Key finding Long-term ketamine use is associated with dependence and significant complications across multiple organ systems.

Abstract

Ketamine, initially developed as a dissociative anaesthetic, has seen expanding therapeutic applications, in managing treatment-resistant depression and chronic pain. However, its psychoactive properties have also been associated with a significant rise in recreational use globally. Chronic, high-dose recreational ketamine use is associated with dependence potential and a spectrum of long-term complications affecting multiple organ systems. This narrative review details the major chronic urological, neurological, neuropsychiatric and hepatobiliary complications that clinicians may encounter in individuals with long-term ketamine use, along with an overview of the potential risk of dependence. This review highlights the importance of heightened awareness among clinicians of the issues related to long-term ketamine use, enabling early identification and prompt, appropriate investigation and management.

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