By Dr. Lisa Parker, DNP, APRN, NP — Owner & Clinical Director, Parker Neuroscience, Omaha, Nebraska

“Will I get addicted?”

I hear this question in almost every consultation, and I want to answer it the same way here that I answer it in my office: directly, without minimizing why you’re asking.

The short answer: when ketamine is administered in a clinical setting, at therapeutic doses, on a defined schedule, with proper screening and monitoring, the research shows the addiction risk is very low. Thousands of patients have completed medically supervised ketamine therapy without developing dependence.

But I’m not going to leave it at “trust me.” You deserve to understand why the risk is low, what we do at Parker Neuroscience to keep it that way, and, just as importantly, when I tell a patient that ketamine may not be the right choice for them.

Why you’re right to ask

Ketamine has a reputation, and the reputation isn’t invented. Ketamine is misused recreationally, and recreational misuse can absolutely lead to serious harm, including dependence. If you searched this question before your consultation, you were doing exactly what a careful patient should do.

Here’s what I want you to understand: recreational ketamine use and clinical ketamine treatment share a molecule and almost nothing else. The difference isn’t a technicality — it’s the entire mechanism by which addiction develops.

How addiction actually develops — and why the clinical setting interrupts it

Addiction is driven by a reinforcement loop. A person uses a substance to escape something or to chase a high. The relief is immediate, the effect fades, and the brain learns to seek the substance again, sooner, and often at higher doses. Access is unlimited, use is self-directed, and the loop tightens.

Now look at what treatment in my clinic actually involves:

You come in for a scheduled treatment. You receive a therapeutic dose, calibrated to you, administered by us, in a monitored medical setting. Then you go home. You are not using ketamine daily. You are not deciding your own doses. You are not escalating outside a protocol. You don’t have take-home access at all.

There is no reinforcement loop, because every element that builds the loop, unlimited access, self-directed use, dose escalation, chasing the effect, is structurally absent. You aren’t chasing anything in my treatment room except your own healing.

What we screen for before you ever receive treatment

At Parker Neuroscience, addiction risk isn’t something we reassure you about, it’s something we screen for. During your intake evaluation, we review your full history, including any history of substance use or dependence, before any treatment is offered.

If you have a history of substance dependence, that doesn’t automatically disqualify you. It means we have an honest conversation about whether medical ketamine is safe for you, and whether a different option is the better path. Sometimes it is. I have told patients that ketamine is not the right treatment for them, and I consider that conversation as much a part of good care as any infusion I administer.

That is the difference between a medical psychiatric practice and a volume clinic. My job is not to treat everyone who walks in. My job is to treat the patients for whom treatment is safe and appropriate, and to be straight with everyone else.

What ongoing monitoring looks like

Screening doesn’t end at intake. Throughout your treatment series, we track your symptoms and your response. You attend scheduled sessions, a typical induction series is six treatments over two to three weeks, followed by a personalized maintenance plan based on your response, not a standing subscription. Every session happens under direct clinical supervision with defined discharge criteria before you leave.

If anything in your response pattern concerned me, including how you were relating to the treatment itself, we would address it directly. That is what monitoring means.

The bottom line

Used recreationally, without oversight, ketamine carries real risks, including dependence. Used clinically, screened, scheduled, dosed therapeutically, monitored, and integrated into a broader treatment plan, the addiction risk is very low, and the research consistently reflects that.

If this question is the thing standing between you and a consultation, bring it with you. Ask me directly. I would rather spend your entire first appointment on this question than have you carry it silently through treatment, or let it stop you from exploring an option that could genuinely help.

Questions related to this one

Can I become dependent on the feeling of the treatment itself? The dissociative experience during treatment fades within hours, and because sessions are scheduled and clinic-administered, there’s no mechanism for seeking it between visits. If a patient’s relationship to the treatment experience ever concerned us clinically, that becomes part of the monitoring conversation, that’s what oversight is for.

Does a family history of addiction rule me out? No. It’s part of your intake evaluation and risk discussion, not an automatic disqualifier. What matters is your complete picture, your history, your current health, and your treatment goals, reviewed honestly before any treatment is offered.

Is Spravato different from IV ketamine for addiction risk? Spravato (esketamine) follows a strict FDA REMS protocol: it’s administered only in a certified clinical setting with a minimum two-hour monitored observation period, and there is no take-home supply. Structurally, the same protections against a reinforcement loop apply.

What happens if you decide ketamine isn’t safe for me? Then I tell you that, and we talk about what might serve you better, whether that’s a different treatment approach, coordination with your existing providers, or a referral. A “no” from us comes with a direction, not a dead end.

If you or someone you love is struggling with substance use, help is available: SAMHSA National Helpline, 1-800-662-4357. If you are in crisis, call or text 988 (Suicide & Crisis Lifeline) or go to your nearest emergency room.

This article is for informational purposes only and does not constitute medical advice or establish a patient-provider relationship. Ketamine and Spravato carry potential risks; individual candidacy is determined through clinical evaluation by Dr. Parker.

Parker Neuroscience, LLC · 179 Welch Plaza, Suite 106, Omaha, NE 68135 · (402) 915-1862