Ketamine, also known as Special K, Kit-Kat, or K, belongs to a class of drugs called dissociative anesthetics or hallucinogens. These induce a dissociative, out-of-body state and often alter perceptions of space and time.
Ketamine is often abused in party settings such as raves and music festivals for its “spacey” or “out of body” effects that make users feel dissociated and euphoric. However, this can cause users to lose complete control or awareness of their environment, also known as a K-Hole.
K-holeing is a scary and distressing experience that can increase the risk of medical complications and accidental injuries. Read on to learn more about what it is and how to recognise the signs of a K-hole.
What Exactly Is a K-Hole?
A K-hole refers to a hallucinogenic dissociative state induced by high doses of ketamine, a dissociative anesthetic. Users report experiencing complete detachment from their body and surroundings, often described as an out-of-body or near-death sensation.
During this episode, users often struggle to move and speak, and can feel like they are melting into their environment. It can also cause vivid hallucinations and altered perceptions of time and space, usually lasting 5 to 30 minutes.
Some users seek out a K-hole as a spiritual experience and transformative effects, but often it’s caused by an accidental overdose. Some users report enjoying a K-hole experience, and others find it extremely frightening. The experience of a K-hole can vary, based on factors such as how much you take, if you mix it with alcohol or other drugs, and your environment [1].
What Does A K-Hole Feel Like?
Ketamine users describe a K-hole as an out-of-body experience, meaning they feel intensely separated from their body. Others report feeling as if they are “melting” into their surroundings, unable to move and literally “glued” to the couch.
Users often experience physical effects such as numbness, being spaced out, dizzy, and even nauseous. The psychological effects of a K-hole can include [1]:
- Anxiety or panic
- Paranoia
- Hallucinations
- Changes in sensory perceptions
- Feeling detached from yourself or your surroundings
- Confusion/mental disorientation
How Quickly Does It Work and How Long Does A K-Hole Last?
How fast ketamine kicks in depends on the method of use and other individual factors such as tolerance, body weight, and metabolism. Most often, it is sold in powder form and snorted, but can also be injected or taken orally. The general onset of effects for ketamine includes [2]:
- Injected: 1 minute
- Snorted: 5 to 15 minutes
- Ingested: up to 30 minutes
A K-hole can last anywhere from a few minutes to several hours, although most report that intense symptoms peak within 30 minutes to 1 hour. Drinking alcohol, mixing with other drugs, and individual factors can all affect how long the effects last.
Difference Between Typical Dissociative Effects of Ketamine vs. a “K-hole”
When taking ketamine, even under medical supervision, it’s normal to feel detached from the body and surroundings, feel foggy, and have an altered sense of time and space. However, users are still aware of their environment and can often respond to people who are still conscious of themselves, where they are, and who they are with.
Following an experience on ketamine, users often are able to reflect on the experience and are not stuck in a state of disorientation.
A K-hole is a near-complete disconnection from the physical world. Users experiencing a K-hole often cannot move or speak, lose their sense of self and identity, and are often not aware of their surroundings at all. Following a K-hole, users often feel confused, disoriented, and cannot reflect on their experience.
| Feature | Typical Ketamine Dissociation | K-Hole |
| Awareness/Control | Partial | Very little or absent |
| Mobility | Yes, slight movements are possible | Often completely impaired |
| Risk Level | Lower risk | Higher risk of accidents, medical injury, cardiac arrest |
What Happens During A K-hole In The Brain?
A K-hole is thought to occur in the brain due to ketamine’s action as an antagonist of NMDA receptors, which disrupts glutamate signaling and leads to widespread dissociation in high doses.
At these levels, typically over 150-200 mg for recreational users, ketamine inhibits the thalamus, a relay station for sensory and motor signals, severing the connection between perception, movement, and consciousness.
It is also thought to trigger intense gamma waves and delta wave “down states” that mimic a temporary shutdown of the brain, and why some users compare this to a near-death experience [3].
Why Do Some People Experience K-Holes?
Not everyone who uses ketamine has or will experience the intensity of a K-hole. However, there are several factors that are thought to increase the risk of experiencing one. These include [3][4]:
- Dose: Users taking higher amounts of ketamine, exceeding 150-200 mg recreationally, to achieve stronger effects often experience K-holeing at these high doses.
- Tolerance buildup: Repeated use reduces responsiveness, encouraging frequent users to chase intensified sensations and enter K-hole territory.
- Body weight: Larger individuals may require higher doses for similar effects, increasing the risk of intense dissociative states.
- Metabolism: Variations in how quickly the body processes ketamine influence peak blood levels and intensity.
- Genetic differences: Some people have higher concentrations of NMDA receptors, increasing ketamine’s blocking effects at lower doses.
- Liver enzymes (CYP3A4): Genetic variations slow or speed ketamine breakdown, making certain individuals more susceptible to profound dissociation even at moderate amounts.
Can You Die From A K-Hole?
Death directly from a K-hole itself is extremely rare, and ketamine alone rarely causes fatality. However, risks such as accidents, cardiovascular strain, risk of seizures, and polydrug use can greatly increase the risk.
Mixing ketamine with alcohol or opioids can lead to overdose and labored breathing. Mixing ketamine with other hallucinogenic party drugs such as MDMA or LSD can strain the heart and increase the risk of severe cardiac episodes.
When To Seek Emergency Help
Being in a K-hole is an intense and scary experience. You might not know if it is a K-hole alone, or an overdose from polydrug use, nonetheless, it’s better to seek medical attention and be on the side of caution if you notice any of the following signs:
- Vomiting/choking
- Irregular heartbeat
- High blood pressure
- Chest pain
- Seizures
- Loss of consciousness
- Intense or vivid hallucinations
Ketamine Therapy at Maple Mountain
At Maple Mountain Mental Health and Wellness, our compassionate team of clinical psychiatrists and experienced therapists provides advanced ketamine therapy for treatment-resistant depression and other chronic mental health cases. Connect with our team to get evaluated and find out if you meet the criteria to receive ketamine therapy. Our licensed mental health team prioritizes your well-being and safety throughout the therapeutic process.
Through a holistic, blended approach, we address each aspect of your health and recovery needs to support long-term healing. Reach out today for an evaluation.
Sources
[1] Neuroglow. 2025. What is K-Hole, Its effects & What it feels like?
[2] Drug Arm. 2025. Ketamine Fact Sheet.
[3] Schoevers, M. et al. (2022). Brain Changes Associated With Long-Term Ketamine Abuse, A Systematic Review. Frontiers in neuroanatomy, 16, 795231.
[4] Qian, J. et al. (2023). The variability in CYP3A4 activity determines the metabolic kinetic characteristics of ketamine. Toxicology, 500, 153682.