K-Hole: Ketamine Use Risks
A ‘K-hole’ is an intense, unpleasant experience caused by a high dose of the anesthetic ketamine, characterized by severe dissociation and hallucinations.
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What Is a K-Hole?
A “K-Hole” is a series of hallucinations that happen when you take more ketamine than your body can handle. You might experience changes in your sensory perception, loss of bodily control, or even paralysis.
A K-hole typically lasts between 15 and 45 minutes, although some ketamine experiences can last for several hours.
Everyone experiences a K-hole differently, but many people compare it to a terrifying “near-death experience.”
People often describe the following sensations after leaving a k-hole:
- Vivid nightmare-like state
- Feeling “outside” of your body
- Intense anxiety, agitation, or paranoia
- Feeling like time “slows down”
What Causes a K-Hole?
Ketamine blocks receptors in your brain that control memory, pain, and learning. It also interferes with minerals that enable your brain cells to communicate with each other. This breakdown in your neural network can make you feel detached from your body.
Animal studies have found that ketamine can make brainwaves fluctuate or even stop activity in the cortex, the part of the brain that controls consciousness and emotions.
These combined effects are thought to cause a k-hole’s scary “blackout” effects.
Why Do People Go Into K-Holes?
Some people may enjoy the “oblivion” of a k-hole and cause it on purpose. Others may accidentally go into k-holes when taking a ketamine dose that’s too high for their body weight or tolerance level.
Other factors that may increase the risk of a k-hole include the following:
- Injecting ketamine instead of snorting or ingesting it
- Consuming more concentrated or pure ketamine
- Taking repeated doses of ketamine
Is a K-Hole Dangerous?
Yes. A k-hole can make you feel terrified, agitated, or paranoid, leading to irrational behaviors that may hurt yourself or others.
Being paralyzed or losing control of your body could cause falls or leave you unable to help yourself in dangerous situations. For example, former Friends star Matthew Perry drowned in a hot tub due to the effects of ketamine.
Taking high doses of ketamine can also cause overdoses, especially if you combine it with other drugs. According to the Centers for Disease Control and Prevention (CDC), most ketamine overdose deaths also involve opioids or stimulants.
Short-Term Effects of a K-Hole
During a K-hole, you might feel chest or stomach pain along with the distressing mental effects. Ketamine can also impair your judgment and thinking abilities up to 24 hours after use.
Some of the most common symptoms associated with short-term ketamine use include the following:
- Confusion and disorientation
- Visual or auditory hallucinations
- Loss of motor control
- High blood pressure
- Heart palpitations and chest pain
- Sedation or loss of consciousness
- Paranoia or anxiety
- Abdominal pain and tenderness
- Nausea and vomiting
Long-Term Risks of Repeated K-Hole Episodes
Repeated ketamine use can cause long-term physical or mental changes. For example, taking chronic, high doses of ketamine can alter your brain’s structure and function.
Other potential long-term effects of ketamine use include the following:
- Hallucinogen Persisting Perception Disorder (HPPD)
- Bladder cysts or other urological complications
- Kidney problems
- Increased risk of addiction
- Poor work or academic performance
- Trouble thinking clearly or remembering
- Anxiety, depression, or psychosis
How to Recover From a K-Hole Experience
Ketamine overdoses can cause dangerous side effects like heart attacks or seizures, especially when combined with other substances.
Meanwhile, a k-hole experience can be intense and scary, especially if it was accidental.
Ideally, you should have someone monitor you for one to two hours after “coming down” to ensure you don’t experience any complications.
You can help yourself calm down from the experience through the following steps:
- Drink water
- Control your breathing
- Move to a quiet environment
- Seek emotional support from friends or family
You should seek medical attention for a k-hole if you or someone you know has trouble breathing or passes out. If the emotional impact of a k-hole lingers, you may want to talk it over with a counselor or therapist.
K-Holes and Ketamine Addiction
Not everyone who takes ketamine recreationally is addicted. However, repeatedly going into k-holes can cause you to develop a psychological dependence on ketamine, where you crave the experience, even at the expense of other aspects of your life.
Some of the warning signs of a ketamine addiction can include the following:
- Craving ketamine or spending a lot of time trying to get ketamine
- Building a tolerance, or needing higher doses to get the same effects
- Experiencing withdrawal symptoms without taking ketamine
- Prioritizing ketamine use over other responsibilities or activities
- Worsening academic or professional performance
- Breakdown of relationships with friends and family
If you recognize any of the above symptoms in yourself or a loved one, resources are available to treat addictions and get your life back on track.
Get Help for Ketamine Misuse and Addiction
While ketamine and k-holes may feel like an inescapable trap, resources like medical detox and rehab can help you address the physical and psychological roots of addiction so that you can step into a life without ketamine.
Ask your healthcare provider about addiction treatment resources in your area, or visit the Substance Abuse and Mental Health Services Administration (SAMHSA)’s online treatment locator.
FAQs About K-Holes
How long does a K-hole last?
The effects of Ketamine often last between 15 and 45 minutes, depending on the dosage and a person’s individual tolerance.
Can you die from entering a K-hole?
K-Holes require a larger amount of ketamine to experience, which may lead to overdoses. However, it’s rare to overdose on ketamine alone, and most people who die from ketamine overdoses also have other substances in their system, like opioids.
What does being in a K-hole feel like?
The experience is different for everyone. Some people may feel like they’re having vivid nightmares, while others may feel intense anxiety and paranoia.
Is a K-hole the same as a ketamine overdose?
No. While a k-hole can cause a person to black out, it’s not the same thing as an overdose. Think of it like “being drunk” on ketamine.
However, the high dose of ketamine required to induce a k-hole can lead to an overdose in some people, similar to the way that drinking too much alcohol can lead to alcohol poisoning.
How can I tell if someone needs help for ketamine use?
If someone’s ketamine use begins dominating their life and impacts their career, relationships, or other pursuits, they may need treatment for ketamine addiction. See our guide on staging an intervention for tips to help a ketamine addict.
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