Why Recreational Ketamine Use Is Rising: APA 2026 Data
TL;DR
- Recreational ketamine use among US adults has risen sharply — past-year use went from 0.08% in 2008 to 0.46% in 2024, roughly a 5–6x increase. Among adolescents, however, use has declined (from 2.6% to 0.9% over the same period).
- Among adults who go to NYC nightclubs, past-year ketamine use is approximately 18% (weighted) as of 2025 — up from about 7% in 2017.
- Illegal ketamine seizures are at record highs: 6,549 seizures by U.S. labs in 2025, up from ~2,000 in 2018. Customs and Border Protection seized 13,756 pounds in 2022 alone.
- Pharmaceutical diversion is rising: 230 incidents of ketamine being diverted from legal supply chains in 2023, up from ~20 in 2008.
- Ketamine-involved deaths are mostly fentanyl deaths. 912 deaths involving ketamine 2019-2023; only 2.6% involved ketamine alone. The rest involved fentanyl, methamphetamine, or cocaine.
- This matters for medical patients. Rising recreational use increases scrutiny of legitimate ketamine therapy. Patients in legal programs are not the source of this trend, but the public conversation often conflates them.
This is part of a series of patient-facing posts translating what was discussed at the American Psychiatric Association's 2026 Annual Meeting.
The session
The talk — "Shifting Landscapes: Epidemiology of Ketamine, LSD, and Psilocybin Use Amid Psychiatry's Psychedelic Renaissance" — was led by three substance-use researchers:
- Joseph Palamar, PhD (Professor, NYU Langone Health) — the leading U.S. researcher on recreational ketamine epidemiology
- Brian Barnett, MD (Cleveland Clinic) — LSD use trends
- Andrew Yockey, PhD — psilocybin use patterns
The honest framing: as therapeutic interest in these substances grows, recreational use is rising in parallel — and many patients are conflating the two. The session was less about discouraging medical use and more about giving clinicians an accurate picture of what's actually happening in their patients' lives.
The headline numbers on ketamine
Dr. Palamar's portion focused specifically on ketamine — particularly the gap between adolescent and adult use trends, which has implications for how the conversation is framed.
Past-year ketamine use, US adults aged 18+
The trend across nearly two decades of survey data (National Surveys on Drug Use and Health):
| Year | % of US adults reporting past-year ketamine use |
|---|---|
| 2008 | 0.04% |
| 2014 | 0.08% |
| 2019 | 0.20% |
| 2022 | 0.27% |
| 2024 | 0.46% |
That's an 11x increase from 2008 to 2024, with most of the growth concentrated in the last 5 years.
Past-year ketamine use, US 12th graders
The teenage trend goes the opposite direction:
| Year | % of US 12th graders reporting past-year ketamine use |
|---|---|
| 2000 | 2.6% |
| 2007 | 1.3% |
| 2018 | 0.7% |
| 2024 | 0.9% |
Adolescent use has declined to roughly one-third of its 2000 peak. This is consistent with broader declines in adolescent substance use over the same period.
The implication: this isn't a story about ketamine entering youth culture. It's a story about adults adopting ketamine — many of whom are simultaneously exposed to a therapeutic framing of it as a depression treatment.
Past-year ketamine use among NYC nightclub attendees
Where Palamar's data gets striking: among adults attending NYC nightclubs (a venue where ketamine has a stronger cultural presence than in the general population):
| Year | Unweighted past-year use | Weighted estimate |
|---|---|---|
| 2017 | 17.2% | 7.5% |
| 2019 | 21.0% | 16.0% |
| 2022 | 18.7% | 11.7% |
| 2025 | 38.8% | 18.0% |
That weighted estimate (18% past-year) is comparable to alcohol use in some cohorts. In this specific subculture, ketamine has become a regularly-used recreational drug.
Supply-side data
The trends in legal exposure (poisoning reports, seizures, diversions) tell the same story:
Illicit ketamine seizures by U.S. forensic labs (NFLIS)
- 2007: ~2,698 seizures
- 2018: ~2,000
- 2025: 6,549 — a record high
Customs and Border Protection seizures of illicit ketamine
- 2019: ~1,000 lbs
- 2022: 13,756 lbs (peak)
- 2026 (through April): 8,598 lbs
Pharmaceutical ketamine diversion in the US (FOIA data via DEA)
- 2008: ~25 diversion incidents
- 2016: ~205
- 2023: 230 incidents (record)
These metrics aren't perfect — they reflect law enforcement activity as much as actual drug movement — but the trend across multiple independent data sources is unambiguous: the recreational ketamine market is bigger than it has been in decades.
How recreational ketamine is sold
Dr. Palamar showed images of the actual products being seized:
- Pharmaceutical-grade veterinary vials (Ketaset)
- Liquid ketamine hidden in hand-sanitizer-style pump bottles
- Foreign-manufactured vials (KTM-100, others) imported through gray markets
- Veterinary-labeled boxes from Mexican manufacturers (Ttokkyo)
- Bulk powdered ketamine (Hong Kong police seized 13 tons in one record bust)
The point: this isn't homemade. It's diverted pharmaceutical product flowing through international gray markets. The supply quality varies wildly. A patient buying ketamine on the street has no idea what they're actually getting.
What does "recreational ketamine use" look like?
A study of 2,439 NYC nightclub attendees surveyed in 2024-2025 found:
- 48.8% had used ketamine at some point in their life
- 36.9% had used in the past year
- 23.4% in the past month
- 11.8% in the past 48 hours
- 9.3% in the past 24 hours
When asked the context of their ketamine use:
- 94.8% — recreational only
- 3.9% — recreational AND medical
- 1.3% — medical only
The vast majority of recreational ketamine use in this population is happening outside of any clinical context. Despite the cultural overlap between "I'm getting ketamine therapy" and "I'm using ketamine recreationally," the data suggests these are largely separate populations.
Why deaths involve ketamine but rarely are caused by ketamine
A widely-cited 2024 MMWR report (CDC) examined 912 overdose deaths involving ketamine in the US from July 2019 to June 2023:
| Co-detected substance | % of cases |
|---|---|
| Fentanyl | 59% |
| Fentanyl AND/OR methamphetamine OR cocaine | 82% |
| Ketamine alone | 2.6% |
In other words: the deaths labeled as "involving ketamine" are almost always actually fentanyl deaths where ketamine happened to also be detected. Pure ketamine fatalities are extremely rare.
This doesn't mean ketamine is safe in all contexts — high-dose recreational use carries real risks. But it does mean the headline "ketamine-related deaths are rising" needs context. The deaths are tracking the fentanyl crisis, not a ketamine crisis.
What about poisoning reports?
Calls to U.S. poison control centers involving ketamine have risen substantially:
- 2008: ~115
- 2014: ~310
- 2024: 663 (record)
Roughly 4% of these involve children aged 0-12, which suggests inadvertent exposure (likely from adults with the drug at home). This is a real concern that scales with recreational use.
Why this matters for medical ketamine patients
If you're considering or already receiving ketamine therapy through a legitimate medical channel, several practical implications:
1. Increased scrutiny, but you're not the problem
As recreational ketamine use rises, medical ketamine providers face increased regulatory and reputational scrutiny. This affects how providers operate but generally doesn't affect patient access in legal programs. The DEA periodically tightens diversion-monitoring requirements.
Patients in physician-supervised programs are not contributing to the recreational use trend. The pharmaceutical industry's quality-controlled supply chain is largely separate from the gray market for recreational ketamine.
2. Be careful what you say to whom
A patient saying "I do ketamine therapy" and a patient saying "I do ketamine" can sound similar to non-clinicians. Insurance, employers, drug tests, and immigration contexts may not make the distinction your provider would.
Practical advice:
- Keep your prescription documentation
- Know your medical record details
- See does ketamine show up on a drug test for the testing landscape
3. The rising recreational use is itself a reason patients seek therapy
A significant portion of patients who come to ketamine therapy programs have had recreational experiences before — sometimes positive ones that led them to wonder if there could be a structured way to get the same kind of benefit safely. The therapeutic and recreational worlds aren't completely separate.
That recreational history is not a disqualification from medical treatment. It's information your provider should know about, because it affects:
- Starting dose
- Expectations for the session
- What you might want to work on in integration
- Tolerance considerations
A provider who treats prior recreational use as evidence of bad character is one to avoid. A provider who treats it as relevant medical history is one to work with.
How to think about this
Three honest framings:
- Recreational use is rising. This isn't a moral panic — it's data. Multiple independent measurement systems agree.
- The medical use track is distinct, but politically intertwined. Even though the populations are largely separate, the public conversation lumps them together. Patients in legal medical programs may need to navigate this in their professional and family lives.
- The "ketamine deaths" headlines deserve scrutiny. Most are fentanyl deaths with ketamine detected. The underlying ketamine safety profile in medical use remains favorable.
For someone considering ketamine therapy, the practical takeaway: work with a physician-led program that operates within the legal pharmaceutical supply chain, takes patient history seriously, and has clear protocols around safety. The risks of recreational use don't translate directly to the supervised therapeutic context, but they explain why some clinicians are appropriately cautious about how this work is delivered.
Sources cited
- Palamar JJ. International Journal of Drug Policy 2025 — Trends in ketamine use among nightclub attendees in NYC, 2017-2024
- Palamar JJ, Rutherford C, Keyes KM. JAMA 2025 — Diversion of undistributed pharmaceutical ketamine in the US
- Palamar JJ et al. Drug and Alcohol Dependence 2025 — Trends in poisonings involving ketamine in the United States, 2019-2023
- Vivolo-Kantor AM et al. MMWR 2024 — Notes from the Field: Ketamine Detection and Involvement in Drug Overdose Deaths, July 2019-June 2023
- Miech RA et al. Monitoring the Future 2025 — Annual survey of secondary school drug use
- National Surveys on Drug Use and Health, 2006-2024 — Federal substance use prevalence data
- Office of National Statistics (UK). Drug Misuse in England and Wales 2025
Related Articles
- APA 2026 Annual Meeting Recap
- What Can Cause a False Positive for Ketamine?
- Does Ketamine Show Up on a 12-Panel Drug Test?
- Volkow on Psychedelics for Addiction: APA 2026 Notes
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