Inside Ketamine’s Strange Comeback As A “Lifestyle” Drug

HAMBURG — Oh, a line of coke, thought Markus S. and his best friend when they were offered a powdery substance at a house party. They gratefully accepted and snorted it. But the energy boost they were expecting never came. Instead, they ended up in a K-hole, caused by what they had actually taken: ketamine.

“We sat on the floor for half an hour and had no idea what was going on,” Markus says, describing the paralyzing sensation of no longer being in his own body. The K-hole, or ketamine hole, is a dissociative state that can result from ketamine use, where people feel disconnected from their body and surroundings. His girlfriend swore off ketamine afterward. But he liked the experience and wanted more.

Markus is clearly not alone in this. For several years now, ketamine has been gaining ground as a party drug. But the substance, first synthesized in 1962 and already circulating in party scenes by the 1970s, is not just on the rise in nightclubs. Clinical psychologists have also been exploring whether ketamine can help treat mental illnesses, especially depression. Meanwhile, more and more people appear to be using ketamine in everyday life, and this is exactly where experts see the greatest risk.

Markus had his first experience with ketamine about 15 years ago. Since then, he’s used it on and off. Now in his mid-40s, he has a successful marketing career in Berlin’s creative industry. These days, he says he snorts the substance two or three times a month. At parties, he more often takes ecstasy, which usually contains MDMA. That gives him a lift and boosts his mood, while ketamine has a more dissociative effect. “I just feel happy,” Markus says, adding that it changes how he experiences music in clubs. “It feels like the music has a physical presence.”

The tracking question

It’s hard to say exactly how many more people are using ketamine today than in the past. Authorities and researchers can usually only estimate what drugs are being used in a country, and how extensively. There’s no central database or registry. Instead, they rely on wastewater residue analysis or police reports from drug busts. Still, there are signs that ketamine use is on the rise.

The 2025 European Drug Report states: “There are indications that ketamine appears to be increasingly available on the EU pharmaceutical market.” However, it also notes that tracking ketamine is “challenging,” partly because its legal status varies across EU countries. Ketamine is not banned everywhere. In Germany, for instance, possession is not illegal, but its distribution and supply are, unless they happen in a medical setting.

In addition to the European report, the German Federal Drug Crime Report 2023 also notes “an increased seizure volume of ketamine, particularly in mail and parcel shipments, can be observed in Germany.” The substance is most commonly purchased online, through dark web shops or specific Telegram groups.

Ketamine is rarely taken by itself at parties. It’s usually mixed with other substances.

For this article, Die Zeit contacted eight drug counseling centers across Germany to ask whether they’ve noticed more people using ketamine. The response was quite consistent: according to the centers, ketamine use has gone up in recent years.

Felix Betzler, a psychiatrist and psychotherapist who leads a research group and a special clinic for patients with substance use disorders at Charité in Berlin, agrees. In 2019, he published a study in which he and a research team in Berlin surveyed partygoers, mostly online, about their drug use; 32% of respondents said they had used ketamine in the past 30 days. Among the most common substances, ketamine came in seventh, behind alcohol, cannabis, and cocaine. “My guess,” says Betzler today, “is that ketamine use has grown a lot since then.”

He believes a key reason for the growing appeal of ketamine is how well it’s tolerated at first. “The aftereffects are barely noticeable,” he says. There’s no hangover, unlike with many other drugs. Most users feel fine the next morning.

The “final stretch” drug

Ketamine has been used in hospitals for decades, mostly as an anesthetic and pain reliever. Many also know it from veterinary medicine, where it’s used as a horse tranquilizer. It blocks NMDA receptors in the brain, which can induce a hypnotic state or unconsciousness. It also affects opioid receptors, likely explaining its pain-relieving effect. On top of that, it opens up the bronchi, making it a common emergency treatment, as it lowers the risk of suffocation while unconscious.

“Unless you choke on your vomit,” Betzler points out. That’s one of the risks of using ketamine at parties, especially when an overdose leads to unconsciousness. There are also dangers from mixing it with other substances. “Patients often tell me they take various drugs one after another,” he says. First alcohol, then MDMA, then cocaine. And finally ketamine, to ride out the last hours of the party. The short-term effects of combining drugs like this are hard for users to judge. With cocaine, for instance, those effects can range from psychotic episodes to heart failure, as a 2020 study shows.

And passing out from using is apparently not that rare. “Some people take it daily and eventually collapse,” says a spokesperson for the Cologne Drug Help Center. Counseling centers also noted that ketamine is rarely taken by itself at parties. It’s usually mixed with other substances.

Some combinations even have their own street names. Ketamine and coke is called “Keffel” or CK. Ketamine and MDMA go by “MK-Ultra.” And mixing amphetamines with ketamine and psilocybin mushrooms has been dubbed the “Elon Flip” — a nod to a New York Times report claiming Elon Musk uses just that combination. So ketamine misuse has now even worked its way into pop culture vocabulary.

Life-coping effects

But it’s not the party use that worries experts most. It’s something less obvious. “People usually encounter ketamine for the first time at parties,” says Betzler. Often, it starts like it did for Markus: Users think they’re snorting something else. “Then they take it now and then, but the gaps between uses get shorter,” says Betzler. “Eventually, it becomes part of everyday life.” Ketamine leaves the party scene and becomes a so-called lifestyle drug, taken before or during work, used to get through the day.

Even outside parties, ketamine can initially have a very pleasant effect, though a very different one. Martin Walter, head of the University Clinic for Psychiatry and Psychotherapy in Jena, studies this life-coping use of ketamine. He’s currently leading a study on ketamine-augmented psychotherapy, where subjects receive low doses of the drug. “Our patients become more open, less anxious, and sleep better,” Walter says.

These are people with chronic, treatment-resistant depression who haven’t responded to either psychotherapy or standard antidepressants. But ketamine gives Walter some hope.

“In depression, the brain’s synaptic plasticity is impaired, which limits learning capacity,” Walter explains. Ketamine aims to change that. It boosts plasticity, making therapy more effective. Patients take ketamine 24 hours before a session, always under a doctor’s supervision.

The drug is never handed out. “The goal is to enable patients to participate in therapy again and actually apply what they’ve learned,” Walter says. Just 12 to 14 hours after a dose, symptoms of depression begin to ease. Mood lifts, anxiety fades, and motivation returns. “The effect usually lasts two to three days,” he says.

While it’s rarely physically addictive, it can be psychologically habit-forming.

So ketamine can be very useful in this strictly supervised medical setting. Research into its antidepressant and anti-anxiety effects has been ongoing for years, and many studies have confirmed its benefits.

But ketamine, despite its medical promise, also has its downsides. While it’s rarely physically addictive, it can be psychologically habit-forming. This risk is especially high when people start using it on their own to deal with daily life. When ketamine is used to boost mood or fight anxiety, it becomes a way to manage emotions.

“I have it under control”

Ketamine has an oddly positive image even beyond medical circles. Many users assume that if it’s used in therapy, it can’t be all that bad. Especially since there’s no hangover, no ill feeling afterward. In fact, some even feel better. But even low-dose misuse can cause long-term harm. The bladder, in particular, is at risk. Symptoms include a strong urge to urinate, pain, and blood in the urine.

The long-term effects of using ketamine as a lifestyle drug have not been fully studied. So far, research has focused mostly on its recreational abuse and medical use.

“I think more and more people will start using small doses of ketamine in their daily lives,” Walter says.

Markus no longer limits his ketamine use to parties. More and more often, he prefers to take it at home. He gets a designer version of the drug from the Netherlands, a particularly strong ketamine derivative. He describes the experience as a kind of self-discovery journey.

“It feels like all the strands in my brain are connecting. I start to see patterns in my life that I wouldn’t notice otherwise,” he says. But he doesn’t think his behavior is a problem. He’s in therapy and can talk to his therapist about his use. “I have it under control.”