Is Ketamine an Opioid? Clarifying Common Confusions in Pain Management

Ketamine is used for pain management and as a general anesthetic. However, ”Is ketamine an opioid?” is a question that pops up often, especially when we talk about managing pain in hospitals or clinical settings. Understanding what kind of drug is ketamine, and whether or not it's an opioid, is important. Why? Knowing the difference helps us understand how it works for pain and why doctors might choose it over other medicines. 

So, if you're curious about “Is Ketamine considered an opioid?” and want to learn more about its role in pain management, keep reading to discover the facts.

Is Ketamine An Opioid?

No, ketamine is not an opioid. It's a dissociative anesthetic that can make you feel detached from your pain and the environment around you, for instance, sort of like being in a dream. Health providers use it to relieve pain and help patients get some relaxation before undergoing surgery.  

Let's compare Ketamine vs opioids and learn the major differences between both of them

Ketamine and opioids both work and are used differently. Ketamine is one of the best opioid alternatives for pain relief management without any addiction risk.

Also Read: Ketamine Infusions: How It Works And What Are The Benefits

Types of Ketamine and Their Uses

Many people ask, "Does ketamine come in pill form?" Yes, ketamine can come in different forms including pills, although it's more commonly given in other ways in hospitals or clinics. Each form of ketamine has its specific use and benefits, depending on what it's being used for.

• Intravenous IV Ketamine: The most common form that is given directly into your veins and works quickly to relieve pain or to sedate you before surgery. It's fast-acting, which makes it useful in emergencies or when immediate pain relief is needed.

• Nasal Spray: Used for treating severe depression and certain pain conditions. It's easier to use than IV ketamine and can be administered under supervision outside of a hospital setting.

• Pill Form: The pills are used mainly for pain management and are usually considered when other forms of ketamine are not suitable. The effect of the pill form can take longer to feel because the ketamine needs to pass through your digestive system first.

Now, when we talk about ketamine, it's also important to mention that two types of ketamine have different effects on the brain and are used for different research purposes and treatment plans.

• Racemic Ketamine: This is the most common type, a mix of two mirror-image molecules. It's used in most medical treatments and research because of its effective pain relief and antidepressant properties.

• Esketamine: This is one of the two types of ketamine, specifically the "S" molecule. It's used mainly in nasal spray form for treating depression and has been the subject of a lot of recent medical research.

Understanding these two types of ketamine is crucial for medical research and determining the most effective treatment plans for pain and depression. 

Also Read: Is Ketamine Addictive: Symtpoms, Works And Side Effects

Ketamine's Use in Pain Management

How is ketamine used? Its primary function as a N-methyl-D-aspartate NMDA receptor antagonist sets it apart from opioids, which primarily affect the brain’s opioid receptors.

Here’s how ketamine manages pain:

• Blocks NMDA Receptor: Blocks NMDA receptors in the brain & spinal cord which are responsible for pain transmission.

• Lowers Pain Sensitivity: Decreases the sensitivity of the brain to pain signals by blocking NMDA receptors, thus, offering analgesic effects.

• Regulates Neurotransmitter: Impacts glutamate ( type of neurotransmitter) that helps normalize the brain's pain signaling pathways.

• Acts on Central Nervous System: Works on the body's central nervous system which changes the pain perception in the brain.

Also Read: Navigating the Journey: What To Expect During Ketamine Therapy Sessions

The Recreational Use of Ketamine and Its Effects

While many know ketamine for its medical application in pain management, others use it recreationally – raising concerns among health professionals who argue that there are risks involved without proper guidance from a doctor.

Recreational Use of Ketamine:

• Psychoactive Effects: Induces feelings of detachment from the body and environment.

• "K-hole" Experience: At high doses, gives a "K-hole" experience, a state of extreme disconnection from the body and reality.

• Euphoria & Hallucinations: Gives feelings of euphoria (intense happiness), visual or auditory hallucinations, and altered time and space perception.

Despite these effects that some might find appealing, it’s important to note that using ketamine recreationally can also cause confusion, disorientation, and loss of coordination which could be dangerous.

Risks Associated with Non-medical Use of Ketamine:

Using ketamine without medical guidance poses risks. Frequent or high doses can cause issues like:

• Ketamine bladder syndrome, resulting in pain and difficulty urinating. 

• Impaired memory, leading to dependency and increased risk of mental health issues like depression and anxiety

Hence, driving or operating heavy machinery under the influence of this substance can be particularly dangerous because of its dissociative effects that impair motor functions.

Understanding Recreational vs. Therapeutic Use

To make informed health decisions regarding ketamine use, it’s important to differentiate between recreational and therapeutic use. 

Legal status of Ketamine in the United States

• In 1970, ketamine was introduced as an injectable and short-acting anesthetic for human as well as animal use.

• In 1999, under the the Controlled Substances Act, ketamine, its isomers, salts, and salts of isomers were categorized as "Schedule III non-narcotic substance".

• In 2019, the esketamine nasal spray version (Spravato) was FDA-approved for treatment-resistant depression only in clinical and hospital settings.

• However, ketamine can be abused, leading to high psychological dependence or low or moderate physical dependency.

Future of Ketamine in Medicine

Researchers are uncovering new ways this drug could help with mental health conditions like depression and PTSD (Post-Traumatic Stress Disorder), offering hope to many who haven't found relief with traditional treatments. Let's explore what the future might hold for ketamine's role in treating these challenging conditions.

• Treating Depression

Ketamine steps in as a promising alternative to traditional antidepressants for treating depression. Unlike most antidepressants that take weeks to start working, ketamine can lift mood in hours or even minutes. It works differently, targeting the NMDA receptors in the brain, leading to rapid changes in mood and thought patterns.

• Managing PTSD (Post-traumatic stress disorder)

PTSD can develop after a person has experienced a terrifying event, leaving them with ongoing severe anxiety and flashbacks. Studies suggest that ketamine may help lessen the symptoms of PTSD by creating new pathways in the brain, allowing patients to form new, positive memories and reduce the impact of traumatic ones. 

• Beyond Pain Management

Ketamine's journey from a pain management drug to a potential breakthrough in mental health treatment is remarkable. Its ability to act quickly and differently from traditional medications opens up new avenues for research and treatment strategies. 

As we understand more about how ketamine works, we could see it being used for a broader range of conditions, possibly including anxiety disorders, addiction, and even obsessive-compulsive disorder OCD.

Connection Between Ketamine Use and Matthew Perry's Death

• As per the reports of the County of Los Angeles medical examiners, “acute effects of ketamine” were the reason behind Matthew Perry's unfortunate death on October 28, 2023.

• Other factors contributing to his death were drowning, buprenorphine effects (was used for opioid use disorder), and coronary artery disease and it was an accidental death.

• The medical examiners also found that the amount of the last ketamine dose used by Matthew Perry was the same as the dose prescribed by his doctor.

• The professional team stated that ketamine use contributed to cardiovascular “overstimulation & respiratory depression".

This shows that the therapeutic use of ketamine can also lead to severe effects. Hence, proper medical supervision is important, and self-administered or misused should be avoided. 

Also Read: Is Ketamine Therapy Right For You? A Guide To Ketamine Treatment Eligibility

Final Thoughts

The question Is ketamine an opioid? is a common one among patients exploring pain management options. The answer is no, ketamine is not an opioid. Its use in pain management represents a significant shift in how doctors approach the treatment of chronic pain. By targeting pain through a different mechanism, ketamine offers benefits that traditional opioids cannot, such as a lower risk of addiction and the ability to treat certain types of pain more effectively.