Trends in poisonings involving ketamine in the United States, 2019-2023.
Joseph J Palamar, Jennifer S Jewell, Omar El-Shahawy, Joshua C Black
Drug and alcohol dependence March 1, 2025 DOI: 10.1016/j.drugalcdep.2025.112549 via PubMed
Summary
AI-generated from the abstractReported ketamine poisonings in the US rose from 205 in 2019 to 414 in 2023, the highest in reporting history. Most cases involved ingestion (57.2%) and misuse or abuse (36.2%). The proportion of cases involving suspected suicide attempts doubled from 12.7% to 25.9%, and ingestion increased from 46.0% to 65.2%. Cases with major effects or death decreased from 23.4% to 15.6%. Overall, 18.6% of cases experienced a major event or death, but prevalence was lower for those who inhaled ketamine compared to those who did not. Both medical and recreational use and related adverse events need monitoring, especially as off-label prescribing of take-home oral formulations appears to be increasing.
Study at a glance
| Characteristics | Observational cohort Peer reviewed |
|---|---|
| Sample size | 1,519 |
| Population | Ketamine-related poisonings reported to US Poison Centers |
| Duration | 2019-2023 |
| Topics | Ketamine |
| Keywords | Poisonings Polydrug use Drug-safety Substance-abuse Ketamine-poisoning |
| Citations | 9 |
| Key finding | Reported ketamine poisonings in the US increased from 205 in 2019 to 414 in 2023, with a doubling of suspected suicide attempts and a decrease in cases involving major effects or death. |
Abstract
Off-label prescribing of ketamine to treat psychiatric disorders has been increasing, as has recreational use and availability of illicit ketamine. It is important to examine trends in ketamine-related poisonings to inform public health efforts. We examined data from poisonings (exposures) involving ketamine reported to Poison Centers in the US between 2019 and 2023 (n = 1519). Annual trends were examined for number of exposures and characteristics of exposures, and we delineated correlates of major (life-threatening) adverse effects and death compared to less severe outcomes. The number of reported ketamine exposures increased from 205 in 2019 to 414 in 2023. Most cases involved ketamine ingestion (57.2 %), and a plurality involved misuse or "abuse" (36.2 %) and moderate effects (44.8 %). The percentage of cases involving suspected suicide attempts doubled from 12.7 % in 2019 to 25.9 % (a 103.9 % increase; P < 0.001); ingestion use increased from 46.0 % to 65.2 % (a 41.7 % increase; P < 0.001), and cases involving ketamine in liquid form decreased from 65.1 % to 41.2 % (a 36.7 % decrease; P < 0.001). Cases with major effects or death decreased from 23.4 % in 2019 to 15.6 % in 2023 (a 33.2 % decrease; P = 0.039). A major event or death was experienced by 18.6 % of cases, but prevalence was lower for those who inhaled ketamine (aPR=0.49, 95 % CI:0.29-0.85) compared to those who did not inhale. Poisonings involving ketamine are at their highest in reporting history. Both medical and recreational ketamine use and related adverse events need to be monitored, especially as off-label prescribing of take-home oral formulations appears to be increasing.