Why Mixing Ketamine and Alcohol Is Dangerous + Overdose Response Guide

Bleach and ammonia. Hydrogen peroxide and vinegar. Ketamine and alcohol. What do these combinations have in common? They’re all deadly. Just like mixing household cleaning supplies, mixing ketamine and alcohol creates a lethal cocktail that poses serious health risks.

Why is it so dangerous, and what should you do if you or someone else mixes alcohol and ketamine? Here’s what you need to know.

Why Alcohol and Ketamine Don’t Mix

Ketamine is a sedative and dissociative anesthetic.Alcohol is also a sedative. Using either substance by itself has significant effects on the body and poses health risks, but using ketamine with alcohol exponentially increases these effects and the dangers involved.

Basically, the body can’t handle the effects of both ketamine and alcohol at once. These substances affect the brain, heart, lungs and other organs.

When the cardiovascular and central nervous systems are hit with both ketamine and alcohol, the chances of overdose significantly increase. Breathing can slow to a stop, heart rate can become erratic and cognition can falter, so the person isn’t able to process what’s happening or seek help.

The result? Overdose, cardiac arrest, coma and death are all possible. There were over 1500 ketamine poisonings in the U.S. between 2019 and 2023. The CDC reports that a majority of drug overdoses involve the use of more than one substance, such as mixing ketamine and alcohol.

What Is Ketamine?

Ketamine is a dissociative anesthetic, or hallucinogen. This means it blocks certain receptors in the brain. Its dissociative and aesthetic effects make ketamine an effective medication for certain situations.

Medically, ketamine is used as an anesthetic for surgery or pain management. Doctors have also prescribed ketamine therapy in small doses for depression.

However, because ketamine intoxication makes people feel detached (dissociated) from their surroundings, some people misuse this drug recreationally to experience these mind- altering effects.

This abuse includes taking ketamine as a powder, in pill form or through injection. Often, this misuse also includes the mixing of alcohol, THC/marijuana or cocaine with ketamine.

Short-Term Effects of Ketamine

The hallucinogenic experience caused by ketamine use is often described as a K-hole. It is typically described as feeling separated from your body (dissociation) and includes psychological effects such as panic, confusion, paranoia and changes in sensory perception.

Physical effects may include nausea, dizziness, poor coordination and alterations in heart rate and blood pressure. Individuals in a k-hole may feel numb, making it hard to move or communicate. When combined with alcohol, these effects are even more severe, increasing the chance of fatal overdose.

Free Download: Ketamine Overdose Response Playbook

Mixing ketamine and alcohol can turn deadly in minutes. Don’t wait until it’s too late. 

The free Ketamine Overdose Response Playbook provides a clear, step by step guide to recognizing the symptoms and taking life saving action.

Download the Playbook Now

Keep this resource on your phone, share it with friends, or print it out, because knowing what to do in an emergency could save a life.

How Ketamine Works in the Brain

Ketamine blocks NMDA (N-methyl-D-aspartate) receptors in the brain. NMDA receptors play a role in regulating the central nervous system as well as learning and memory.

So, for those who ask, does ketamine damage memory? Yes, it can.Researchers have discovered that ketamine use affects both the structure and function of the brain and is associated with reduced brain matter, memory impairment and impaired higher level cognitive functioning. The dissociation it causes alters the brain, disrupts memory and impairs future learning and cognitive abilities.

Mixing ketamine with depressants like alcohol amplifies these risks, because alcohol can have similar long term effects on the body.

What Is Alcohol’s Effect on the Body?

Alcohol impacts all the organs of the body. As a depressant, alcohol’s effects include slowed brain activity and impaired coordination. Alcohol also alters the levels of various chemicals in the brain, affecting mood.

Because the body can only process a certain amount of alcohol per hour, based on absorption and metabolism, drinking large amounts in one sitting increases the toxic effects of alcohol.

The liver can’t rid the body of the alcohol content quickly enough, so the person becomes intoxicated, experiencing even more severe physical and mental symptoms.

Alcohol and Ketamine Interactions: Why the Combo Is So Deadly

Both ketamine and alcohol affect the body’s GABA and glutamate systems. These are communicators in the body that tell systems to slow down or speed up. Because alcohol and ketamine are both sedatives/depressants, they both slow breathing and heart rate.

When these effects overlap, the body may slow down too much. The result of ketamine and alcohol interactions can result in cardiac arrest or fatal respiratory depression. The person is at increased risk of unconsciousness, coma, overdose and death.

Ketamine mixed with alcohol also impairs judgment. The person is unable to think clearly, which delays them from seeking critical help.

Ketamine and alcohol interactions also increase the risk of accidents, injury and risky behavior. The combination of impaired judgment, hallucinations and severe physical and psychological effects makes it more likely that the person under the influence of these substances will do something harmful to themselves or others.

Organ Damage Risks

Ketamine use causes detrimental effects to major organs of the body, so does alcohol use. Mixing ketamine and alcohol heightens these effects, putting the organs at even higher risk.

• Brain: Risks of ketamine and alcohol use on the brain include memory loss, hallucinations and seizures.
• Lungs: Because ketamine and alcohol both sedate the body, there is a risk of slowed or ceased breathing.
• Heart: Ketamine and alcohol use can cause arrhythmia (irregular heartbeats), high blood pressure, stroke or heart attack.
• Bladder & Kidneys: Ketamine is known to cause lower urinary tract issues, including ketamine bladder syndrome.
  • Bladder issues can include blood in urine, frequent urination, incontinence and irreversible damage.
• Liver: The liver is in charge of filtering and removing toxins and waste from the body.
  • When a person combines ketamine and alcohol, this creates a significant metabolic burden on the liver.
  • The strain of filtering so many toxins leads can lead to long term liver damage.

Mixing Other Drugs With Ketamine

What about mixing cocaine and ketamine? Or mixing marijuana and ketamine? As with alcohol, mixing other drugs with ketamine is extremely dangerous. Polydrug use is the leading factor in ketamine related deaths. Each combination poses serious health risks.

Mixing ketamine and cocaine increases the risk of heart attack and stroke. Using marijuana and ketamine or THC and ketamine worsens confusion and paranoia as well as sedative effects. Again, these increased risks mean situations such as overdose, coma or death are more likely to occur.

Can You Overdose on Ketamine?

Yes. It is possible to overdose on ketamine, and it is much more likely when ketamine is mixed with other substances such as alcohol.

A ketamine lethal dose varies based on whether alcohol or other drugs are also used simultaneously, as well as the individual’s health, weight, metabolism and other physical factors.

Ketamine overdose symptoms include:

• Unconsciousness
• Clammy skin
• Seizures
• Irregular heartbeat
• Dangerously slowed breathing
• Collapse
• Coma

If you suspect someone is experiencing an overdose, seek immediate treatment for ketamine overdose. Steps to take:

• Call 911
• Administer CPR
• Provide airway support
• Seek hospitalized hospital care

Warning Signs of Alcohol and Ketamine Overdose

While ketamine intoxication on its own can cause overdose, ketamine mixed with alcohol increases the risk of lethal overdose.

If someone is using both substances, watch for these symptoms of ketamine overdose:

• Confusion
• Slowed breathing
• Hallucinations
• Clammy skin
• Vomiting
• Collapse

If these symptoms occur, take the following immediate action steps:

1. Stop substance use
2. Don’t leave the person alone
3. Call emergency services
4. Monitor respirations and pulse, begin CPR if necessary

Long Term Risks of Alcohol and Ketamine Use Disorder

The use of these addictive substances can lead to dependence and dual substance use disorder. The risks of ketamine and alcohol use disorder include significant physical damage to the body, as well as psychological effects.

Common long term risks of ketamine and alcohol addiction include:

• Memory loss
• Brain damage
• Depression
• Anxiety
• Psychosis
• Alcohol related cirrhosis
• Cancer
• Cardiovascular disease
• Advanced ketamine bladder syndrome/bladder removal surgery

Treatment for Alcohol and Ketamine Addiction

Fortunately, if you or someone you know is experiencing dependence or addiction, ketamine and alcohol addiction treatments are available in a variety of formats.

• Detox: Inpatient detox offers medical supervision for ketamine detox and alcohol withdrawal.
  • Clinicians oversee the withdrawal process and provide treatment to mitigate symptoms, prevent serious side effects and reduce health risks.
• Residential Rehab: Participants in residential or inpatient rehab live on site at the facility and receive 24/7 monitoring and support.
  • This structured setting includes individual and group counseling as well as other therapy methods to teach coping skills and prevent relapse.
• Outpatient Care: At this level of treatment, individuals live at home and attend therapy sessions one or more times per week.
  • Medication management may also be provided, as well as other types of ongoing support and aftercare.

An important aspect of treatment at any of these levels of care is dual diagnosis support. This type of treatment addresses both mental health and substance use disorders concurrently.

Because these disorders are often interwoven and have a significant influence on each other, it is crucial that treatment offers support for both.

Alcohol and Ketamine in Medical Settings: What About Therapy?

Ketamine is sometimes prescribed for treatment-resistant depression (TRD). Patients receive supervised infusion treatments of controlled doses of ketamine to address depressive symptoms.

In these situations, it is important to avoid alcohol use before and after taking ketamine. Due to the effects of alcohol and ketamine on the body, alcohol and ketamine therapy do not mix.

Alcohol intake before or after a ketamine infusion can reduce ketamine’s therapeutic effects. It can also increase side effects, which pose significant health risks. The bottom line: Clinical guidelines instruct patients to abstain from alcohol use when receiving ketamine therapy.

Ketamine and Alcohol FAQs

Downloadable Resource: Ketamine Overdose Response Playbook

If you’re not familiar with the symptoms of ketamine overdose, it may be hard to determine if someone is in danger and needs help. Or if you do recognize ketamine overdose symptoms, you may not be sure what to do next.

This free one page guide walks you through the exact steps to take if someone is overdosing on ketamine and alcohol. It highlights the most common ketamine overdose symptoms, explains when to call 911, and provides a clear step by step emergency response that anyone can follow.

Download the Ketamine Overdose Response Playbook

What’s Inside

The Ketamine Overdose Response Playbook offers:

• Fast reference list of ketamine overdose symptoms
• Step by step response protocol (airway, breathing, circulation)
• The recovery position explained with visuals
• “What not to do” during a ketamine overdose
• Quick checklist for emergency situations

How to Use This Playbook

Here are three ways you can use this resource to help people identify ketamine overdose symptoms and prevent ketamine related death.

1. Print it. Keep it visible in community spaces, dorms or clinics.
2. Share it. Share digitally with friends, family or coworkers who may encounter ketamine and alcohol use.
3. Use it. This is a helpful safety resource alongside addiction education and prevention materials.

Get Help for Ketamine and Alcohol Addiction

If you or someone you know is experiencing ketamine and alcohol addiction, recovery is possible. Treatment centers are available nationwide to address substance use disorder and co-occurring mental health disorders.

Get support today:

• Find a detox center: Search for Detox Centers By State on the Detox.com Directory.
• Call 800-996-6135(Sponsored) to speak with someone who can help.
• Call 800-996-6135 to locate detox centers in your area.
• Call the national addiction support hotline: 1-800-662-HELP.

If overdose symptoms appear, take urgent action. Call 911 to prevent a lethal overdose.