Trends and Characteristics in Ketamine Use Among US Adults with and Without Depression, 2015-2022

Overview

Journal J Affect Disord

Date 2025 Jan 2

PMID 39746553

Authors

Kevin H Yang

Wayne Kepner

Charles M Cleland

Joseph J Palamar

Affiliations

Soon will be listed here.

Abstract

Background: Ketamine's potential for treating depression has drawn increased clinical interest in recent years. However, despite growing therapeutic use, recreational use among individuals with depression remain underexplored.

Methods: We analyzed data from the 2015-2022 National Survey on Drug Use and Health focusing on adults in the US. Trends in past-year ketamine use, overall and by depression status, were estimated separately for 2015-2019 and 2021-2022 due to methodological changes in the survey. We also delineated correlates of ketamine use in each period, focusing on depression, sociodemographic characteristics, and other past-year drug use.

Results: Overall ketamine use prevalence increased from 2015 to 2019 (from 0.11 % to 0.20 %, an 81.8 % increase, p < 0.01) and from 2021 to 2022 (from 0.20 % to 0.28 %, a 40.0 % increase, p < 0.05). From 2015 to 2019, use increased among adults with and without depression (by 139.3 % [p < 0.05] and 66.7 % [p < 0.05], respectively), while from 2021 to 2022, an increase occurred only among those without depression (by 38.9 %, p < 0.05). Multivariable models revealed that depression was associated with increased odds of ketamine use in 2015-2019 (aOR = 1.80, 95 % CI: 1.12-2.89) but not in later years. New sociodemographic correlates emerged in 2021-2022, including adults aged 26-34 and those with a college degree being at higher odds for use. Various drugs (especially ecstasy/MDMA and gamma-hydroxybutyrate) were consistently associated with higher odds of use.

Conclusion: We identified differential patterns and correlates of ketamine use over time. Shifts may be related to the evolving ketamine landscape and/or changing survey methodology. Monitoring of use patterns is crucial to inform prevention and harm reduction strategies.

References

Price O, Man N, Sutherland R, Bruno R, Dietze P, Salom C . Disruption to Australian heroin, methamphetamine, cocaine and ecstasy markets with the COVID-19 pandemic and associated restrictions. Int J Drug Policy. 2023; 113:103976. PMC: 9932690. DOI: 10.1016/j.drugpo.2023.103976. View

Hurst K, Vogeley A, Greenstein D, Durland L, Makel S, Wang P . Long-term follow-up of participants in ketamine clinical trials for mood disorders. J Affect Disord. 2024; 357:134-137. PMC: 11134418. DOI: 10.1016/j.jad.2024.04.062. View

Rogers A, Shepherd J, Garey L, Zvolensky M . Psychological factors associated with substance use initiation during the COVID-19 pandemic. Psychiatry Res. 2020; 293:113407. PMC: 7434361. DOI: 10.1016/j.psychres.2020.113407. View

Sanacora G, Frye M, McDonald W, Mathew S, Turner M, Schatzberg A . A Consensus Statement on the Use of Ketamine in the Treatment of Mood Disorders. JAMA Psychiatry. 2017; 74(4):399-405. DOI: 10.1001/jamapsychiatry.2017.0080. View

Wilkinson S, Palamar J, Sanacora G . The Rapidly Shifting Ketamine Landscape in the US. JAMA Psychiatry. 2024; 81(3):221-222. DOI: 10.1001/jamapsychiatry.2023.4945. View

Bendau A, Viohl L, Petzold M, Helbig J, Reiche S, Marek R . No party, no drugs? Use of stimulants, dissociative drugs, and GHB/GBL during the early COVID-19 pandemic. Int J Drug Policy. 2022; 102:103582. PMC: 8730379. DOI: 10.1016/j.drugpo.2022.103582. View

Palamar J, Rutherford C, Keyes K . Trends in Ketamine Use, Exposures, and Seizures in the United States up to 2019. Am J Public Health. 2021; 111(11):2046-2049. PMC: 8630483. DOI: 10.2105/AJPH.2021.306486. View

Grigsby T, Howard J . Prescription opioid misuse and comorbid substance use: Past 30-day prevalence, correlates and co-occurring behavioral indicators in the 2016 National Survey on Drug Use and Health. Am J Addict. 2019; 28(2):111-118. DOI: 10.1111/ajad.12866. View

Roberts A, Rogers J, Mason R, Siriwardena A, Hogue T, Whitley G . Alcohol and other substance use during the COVID-19 pandemic: A systematic review. Drug Alcohol Depend. 2021; 229(Pt A):109150. PMC: 8559994. DOI: 10.1016/j.drugalcdep.2021.109150. View

10.

Xu C, Wang S, Su B, Ozuna K, Mao C, Dai Z . Associations of adolescent substance use and depressive symptoms with adult major depressive disorder in the United States: NSDUH 2016-2019. J Affect Disord. 2023; 344:397-406. DOI: 10.1016/j.jad.2023.10.066. View

11.

Palamar J, Kumar S, Yang K, Han B . Ketamine use in relation to depressive symptoms among high school seniors. Am J Addict. 2022; 31(2):100-107. PMC: 8901529. DOI: 10.1111/ajad.13259. View

12.

Eidbo S, Kropp Lopez A, Hagedorn J, Mathew V, Kaufman D, Nichols S . Declines and regional variation in opioid distribution by U.S. hospitals. Pain. 2021; 163(6):1186-1192. DOI: 10.1097/j.pain.0000000000002473. View

13.

Wilkinson S, Toprak M, Turner M, Levine S, Katz R, Sanacora G . A Survey of the Clinical, Off-Label Use of Ketamine as a Treatment for Psychiatric Disorders. Am J Psychiatry. 2017; 174(7):695-696. PMC: 5549850. DOI: 10.1176/appi.ajp.2017.17020239. View

14.

Swainson J, McGirr A, Blier P, Brietzke E, Richard-Devantoy S, Ravindran N . The Canadian Network for Mood and Anxiety Treatments (CANMAT) Task Force Recommendations for the Use of Racemic Ketamine in Adults with Major Depressive Disorder: Recommandations Du Groupe De Travail Du Réseau Canadien Pour Les Traitements De.... Can J Psychiatry. 2020; 66(2):113-125. PMC: 7918868. DOI: 10.1177/0706743720970860. View

15.

Palamar J, Salomone A, Rutherford C, Keyes K . Extensive Underreported Exposure to Ketamine Among Electronic Dance Music Party Attendees. J Gen Intern Med. 2020; 36(1):235-237. PMC: 7858731. DOI: 10.1007/s11606-020-05672-x. View

16.

Kennedy S, Lam R, McIntyre R, Tourjman S, Bhat V, Blier P . Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 3. Pharmacological Treatments. Can J Psychiatry. 2016; 61(9):540-60. PMC: 4994790. DOI: 10.1177/0706743716659417. View

17.

Walsh C, Livne O, Shmulewitz D, Stohl M, Hasin D . Use of plant-based hallucinogens and dissociative agents: U.S. Time Trends, 2002-2019. Addict Behav Rep. 2022; 16:100454. PMC: 9471967. DOI: 10.1016/j.abrep.2022.100454. View

18.

Sassano-Higgins S, Baron D, Juarez G, Esmaili N, Gold M . A REVIEW OF KETAMINE ABUSE AND DIVERSION. Depress Anxiety. 2016; 33(8):718-27. DOI: 10.1002/da.22536. View

19.

Yockey R . Past-Year Ketamine Use: Evidence from a United States Population, 2015-2019. J Psychoactive Drugs. 2022; 55(2):134-140. DOI: 10.1080/02791072.2022.2058896. View

20.

Halkitis P, Palamar J, Mukherjee P . Poly-club-drug use among gay and bisexual men: a longitudinal analysis. Drug Alcohol Depend. 2007; 89(2-3):153-60. PMC: 1945225. DOI: 10.1016/j.drugalcdep.2006.12.028. View