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

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.