Recreational Ketamine Use among Individuals with Opioid Use Disorder: Demographics, Motivations, and Polysubstance Use

Background: Data show that recreational ketamine use appears to be increasing. This study aimed to understand how ketamine fits into broader polysubstance use in individuals with opioid use disorder (OUD). Methods: Survey data were collected from a sample of treatment-seeking individuals with OUD in March 2022. Results: Of 301 respondents, 28.6% reported lifetime ketamine use. Ketamine use was more frequently reported among males (61.9% vs. 37%; p < 0.001) and less frequently reported among individuals in rural locations (33.6% vs 15.7%; p < 0.002). Most respondents (70.9%) used ketamine to achieve a desired psychoactive effect, and 46.4% used to self-treat a physical or mental health problem, including mental distress symptoms and mitigating opioid withdrawal symptoms or cravings. Polysubstance use involving ketamine was prevalent (70.7%) and included marijuana (64.9%), alcohol (61.4%), cocaine (36.8%), MDMA (36.8%), hallucinogens (31.6%), prescription opioids (29.8%), and illicit opioids (29.8%). Negative experiences while using ketamine were reported by 32.1% and included central nervous system complications and mental distress. Conclusions: Among this sample of individuals with OUD, motivations for ketamine use are varied and polysubstance use is common. Such behaviors, even when attempting to self-treat OUD or other health problems may place individuals at risk for psychiatric or physical health conditions, including overdose or death.