Is Ketamine an Opioid Drug? No.

Ketamine belongs to a class of drugs called, “dissociative anesthetics” and is not an opioid drug.  

At Ketamine Wellness Clinic of Orange County, we occasionally hear from physicians and clinicians who want to refer a patient for ketamine IV therapy, but they are concerned that ketamine is an opioid drug. Simply put, ketamine is not an opioid drug. Let’s review current literature on ketamine to clear up any misconceptions. We fully understand that many patients who suffer from mood disorders also have a history of addiction which is why it’s important to understand the pharmacology of ketamine.

Ketamine belongs to a class of drugs called, “dissociative anesthetics.” The confusion generally happens because ketamine has some of the anesthetic properties of opioids. In contrast to opioids, recently published research found that ketamine had the ability to reduce problematic alcohol and drug use in patients with addiction.¹ Although the research in this area is promising, additional randomized controlled trials need to be conducted given this research is still in its infancy.

So, then, what exactly is ketamine? Ketamine is a glutamate N-methyl-d-aspartate (NMDA) receptor antagonist that has been used broadly as an anesthetic for both children and adults in operating rooms since the 1960s.²

In sub-anesthetic doses, ketamine intravenous therapy can produce rapid, profound, and sustained improvement in patients with debilitating psychiatric and pain conditions. Ketamine has also been shown to restore damaged brain pathways known to cause mood disorders.³ The rapid antidepressant effect is noteworthy. Suicidal ideation tends to subside within hours of ketamine IV therapy for many patients.⁴

If you have a patient who has been diagnosed with a treatment-resistant mood disorder such as depression, post-traumatic stress disorder (PTSD), suicidal ideation, or bipolar, ketamine IV therapy may be a great next step.

1. Ezquerra-Romano, I. & Lawn, W., et. al. Ketamine for the treatment of addiction: Evidence and potential mechanisms. Neuropharmacology. 2018 Nov;142:72-82. doi: 10.1016/j.neuropharm.2018.01.017. Epub 2018 Jan 12.   https://doi.org/10.1016/j.neuropharm.2018.01.017
2. Linda, L. & Vlisides, P. Ketamine: 50 Years of Modulating the Mind. Front Hum Neurosci. 2016; 10: 612. Published online 2016 Nov 2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5126726
3. Gao, M., Rejaiei, D., Liu, H. Ketamine use in Current Clinical Practice. Acta Pharmacol Sin. 2016 Jul; 37(7): 865–872. Published online 2016 Mar 28.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4933765
4. Costi, S., Van Dam, N., Murrough, J. Current Status of Ketamine and Related Therapies for Mood and Anxiety Disorders.Curr Behav Neurosci Rep. 2015 Dec; 2(4): 216–225. Published online 2015 Oct 1.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4714563/