Does Ketamine Therapy Get You High?
- Dr. Aubrey Verdun
- Nov 19
- 5 min read
When considering ketamine therapy for anxiety, depression, or other mental health conditions, many patients naturally wonder: does ketamine therapy get you high? This question reflects an important concern about what to expect during treatment and whether the therapeutic benefits depend on psychoactive effects.
The straightforward answer is that ketamine therapy can produce altered states of consciousness, but medical ketamine treatment is fundamentally different from recreational ketamine use. Understanding these differences is crucial for anyone considering this innovative mental health treatment.
What Is Ketamine and How Does It Work?
Ketamine is a dissociative anesthetic that was originally developed in the 1970s for surgical procedures. Unlike traditional antidepressants that target serotonin pathways, ketamine works through a completely different mechanism in the brain. It blocks NMDA receptors and can reduce activity in the Default Mode Network—a brain network that becomes overactive in individuals with Major Depressive Disorder.
This unique mechanism of action allows ketamine to produce rapid antidepressant effects, often within hours or days rather than the weeks or months required by conventional medications. In 2019, the FDA approved esketamine (Spravato), a nasal spray form of ketamine, specifically for treatment-resistant depression.
Understanding the "High": Dose Makes the Difference
Does ketamine therapy get you high? The answer depends largely on the dosage and treatment approach used. Ketamine exists on a spectrum of effects based on the amount administered:
Most clinical ketamine therapy uses what researchers call "sub-psychedelic doses". At these therapeutic levels, patients may experience:
Mild sedation and relaxation
Slight dissociation or feeling "detached"
Minimal to no hallucinations
Maintained awareness and communication ability
According to medical experts, patients with depression and PTSD generally benefit from low ketamine doses that typically don't cause hallucinations. This approach focuses on ketamine's neuroplasticity benefits rather than psychoactive experiences.
Higher-Dose Psychedelic Approaches
Some treatment centers use moderate to higher doses that can produce more pronounced dissociative effects, including:
Vivid visual experiences
Out-of-body sensations
Altered perception of time and space
Profound introspective experiences
Research suggests that "psychedelic effects at higher ketamine doses can cause intense visuals and out-of-body experiences", but these effects are still carefully controlled in medical settings.
Different Models of Ketamine Therapy
The medical community has developed several approaches to ketamine treatment, each with different philosophies about the role of psychoactive effects:
The Medical Model
Many clinics, particularly those run by anesthesiologists, minimize the dissociative effects. As one treatment center explains, "the best part about how ketamine infusion therapy works is that it does not rely on a psychedelic or spiritual journey to find relief". This approach treats ketamine as a medication where the therapeutic benefit comes from its neurobiological effects, not the subjective experience.
The Psychedelic-Assisted Therapy Model
Other providers embrace ketamine's consciousness-altering properties, using "moderate to high doses of ketamine in an effort to occasion a non-ordinary state of consciousness that is meant to promote deeper psychological, or psycho-spiritual, transformation". This model often includes intensive psychotherapy integration.
The Relational Model
A third approach uses lower doses of ketamine within ongoing therapy sessions, allowing patients to remain more grounded while still experiencing some dissociative effects that can facilitate therapeutic breakthroughs.
Safety and Medical Supervision
Whether ketamine therapy gets you high or not, all legitimate medical ketamine treatment occurs under strict medical supervision. The DEA classifies ketamine as a controlled substance because it "can induce a state of sedation, relief from pain, and amnesia" and "is abused for the dissociative sensations and hallucinogenic effects".
In clinical settings, ketamine therapy includes:
Comprehensive medical screening
Supervised administration by trained healthcare providers
Continuous monitoring during treatment
Structured integration and follow-up care
Medical supervision ensures safety and maximizes therapeutic benefit while minimizing risks. As research continues, "we better understand that it is the ketamine treatment, and not the experience, that provides the lasting antidepressant effect".
The Therapeutic Experience vs. Getting High
Does ketamine therapy get you high? While ketamine can produce altered states, the therapeutic context fundamentally changes the experience. Medical ketamine therapy aims to:
Promote neuroplasticity and new neural connections
Facilitate psychological insights and emotional processing
Support lasting mental health improvements
The controlled medical environment, therapeutic preparation, and integration support distinguish treatment from recreational use. Patients describe the experience as potentially transformative rather than simply intoxicating.
Research on Subjective Effects and Outcomes
Scientific research on whether the psychoactive effects are necessary for therapeutic benefit shows mixed results. A recent meta-analysis found "some evidence that the subjective effects of ketamine and other psychedelics like psilocybin are crucial for their therapeutic outcomes" in treating depression and substance use disorders.
However, other studies suggest that ketamine's antidepressant effects can occur independently of significant subjective experiences. The relationship between consciousness-altering effects and therapeutic outcomes remains an active area of research.
What to Expect During Treatment
If you're considering ketamine therapy, understanding what to expect can reduce anxiety about the experience:
Before Treatment
Comprehensive medical and psychiatric evaluation
Discussion of treatment goals and expectations
Preparation for potential dissociative effects
Clear explanation of the specific protocol being used
During Treatment
Comfortable, supervised clinical environment
Continuous monitoring by medical staff
Duration typically ranges from 40 minutes to 2 hours
Effects usually peak within 30-60 minutes and gradually subside
After Treatment
Observation period until effects fully wear off
Integration discussion with healthcare provider
Follow-up assessment of symptoms and side effects
Planning for subsequent treatments if appropriate
Important Considerations and Contraindications
While ketamine therapy shows remarkable promise, it's not appropriate for everyone. People with certain medical conditions, substance abuse history, or psychiatric conditions may not be good candidates. The treatment requires careful evaluation by qualified healthcare providers who can assess individual suitability and monitor outcomes.
The Bottom Line: Treatment vs. Recreation
Does ketamine therapy get you high? The answer is nuanced. Medical ketamine therapy can produce dissociative effects ranging from mild to profound, depending on the dosage and treatment model. However, these effects occur within a therapeutic framework designed to promote healing and mental health improvement.
The key distinctions between therapeutic and recreational ketamine use include:
Medical supervision and safety protocols
Controlled dosing and administration
Therapeutic preparation and integration
Focus on long-term mental health outcomes
Legal and regulated treatment environment
For individuals struggling with treatment-resistant depression, anxiety, PTSD, or other mental health conditions, ketamine therapy represents a potentially transformative treatment option. The question isn't whether it produces altered states of consciousness, but whether those effects, when properly managed, can facilitate meaningful healing and recovery.
If you're considering ketamine therapy, discuss your questions and concerns openly with qualified healthcare providers who can explain their specific approach and help you understand what to expect from treatment. The goal is always your mental health and wellbeing, whether that journey includes psychoactive experiences or not.
