Call your local emergency number now. An unresponsive person after taking ketamine may have severe poisoning, coma, dangerously slow breathing, or another life-threatening problem. Do not wait for them to “sleep it off.” Stay with them, check breathing, and follow the dispatcher’s instructions.
If the person is unconscious but breathing normally, place them on their side to help keep the airway clear. If they are not breathing normally, tell the dispatcher immediately and follow instructions for rescue breathing or cardiopulmonary resuscitation (CPR). In the United States, Poison Control (1-800-222-1222) can provide poison advice, but an unresponsive person needs emergency services first.
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Why unresponsiveness after ketamine is an emergency
Ketamine can cause profound sedation and loss of consciousness. A large amount can depress the central nervous system, leading to coma, slowed breathing, or death. The danger is greater when ketamine is combined with alcohol, opioids, benzodiazepines, sleep medicines, or other central-nervous-system depressants. Health Canada warns that these combinations can cause respiratory depression or stop breathing completely. Official Australian medicine information likewise identifies respiratory depression after overdose or excessively rapid administration and describes assisted ventilation as supportive treatment.
You cannot safely determine at home whether someone is merely deeply sedated, has stopped protecting their airway, has taken another drug, or has a different medical emergency such as a seizure, head injury, stroke, or dangerously low blood sugar. Treat unresponsiveness as an emergency even if you know the person intended to take ketamine or believe the dose was small.
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What to do in the first minutes
- Call emergency services immediately. Use your local emergency number (911 in the United States and Canada, 999 or 112 in many other locations). Put the phone on speaker so you can work while the dispatcher talks you through the response. Do not delay the call to search for packaging, calculate a dose, or wait for a friend to arrive.
- Check for a response. Call the person’s name loudly and tap their shoulder. Do not shake them violently. Tell the dispatcher whether they respond to your voice or gentle touch.
- Check breathing for no more than 10 seconds. Look for normal chest movement, listen for breathing, and feel for air. Occasional gasps, snorting, or irregular “agonal” breaths are not normal breathing. Report exactly what you see.
- Follow the dispatcher’s instructions. The dispatcher may direct you to start CPR, provide rescue breaths, use an automated external defibrillator (AED), or continue monitoring. Follow those directions even if you are uncertain about what was taken.
- Stay with the person. Keep watching their breathing and responsiveness until trained help takes over. If another sober adult is present, ask them to meet paramedics and gather medication or substance information while you remain at the person’s side.
Position and breathing: choose the right response
| What you observe | What to do |
|---|---|
| Unresponsive but breathing normally | Place the person in the recovery position on their side, with the upper knee bent and the face angled downward. Keep the airway open, continue monitoring, and follow the dispatcher’s directions. |
| Not breathing normally, only gasping, or you cannot tell | Tell the dispatcher immediately. Begin CPR or rescue breathing exactly as instructed. Use an AED if one is available and the dispatcher advises it. |
| Breathing becomes slow, shallow, noisy, or stops | Report the change at once and follow emergency instructions for ventilation or CPR. Do not leave to look for information or supplies. |
| Vomiting while unconscious | Turn the person onto their side and clear only visible material from the mouth. Do not put your fingers deep into the throat and do not give anything by mouth. |
The recovery position reduces the chance that vomit or saliva will block the airway, but it is not treatment for poisoning. Keep checking breathing because a person who is breathing now can deteriorate.
Can ketamine make someone stop breathing?
Yes. Severe ketamine poisoning can slow or stop breathing. The risk rises when ketamine is mixed with alcohol, opioids, or other sedating medicines. A person who is difficult to wake, breathing fewer than normal breaths, making gurgling sounds, turning blue or gray, or showing pauses between breaths needs immediate emergency care.
Do not assume that loud snoring means the person is safely asleep. Snoring, choking, or rattling can indicate partial airway obstruction. Reposition the person on their side if they are breathing, tell the dispatcher, and keep watching for changes.
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Naloxone (Narcan): when it may help and when it will not
Naloxone reverses opioid effects; it does not reverse ketamine intoxication. Giving naloxone will not wake someone whose unresponsiveness is solely from ketamine, and a lack of response does not make the emergency less serious.
If an opioid may also have been taken, the substance is unknown, or counterfeit tablets or powders are possible, give available naloxone according to the product instructions while emergency services are being called. Do not wait to see whether naloxone works before calling. Continue rescue breathing or CPR if directed. More than one naloxone dose may be needed for some opioids, and a person who wakes after naloxone can become unresponsive again as the medicine wears off; they still require medical evaluation.
A temporary response to naloxone does not prove that ketamine was not involved. Mixed-drug poisoning, additional doses, alcohol, injuries, and other medical causes remain possible.
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What information to give the dispatcher and paramedics
Share what you know without delaying the emergency call. Useful details include:
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- The person’s age, approximate size, and medical conditions if known.
- What substance was taken, whether it was prescribed, and its form or route (for example, swallowed, snorted, injected, or administered medically).
- The estimated amount and the time it was taken. Say when the person was last known to be awake and when you found them.
- Any alcohol, opioids, benzodiazepines, sleep medicines, stimulants, or other drugs taken at the same time.
- Whether the person has vomited, had a seizure, fallen, hit their head, or has abnormal movements.
- Whether they respond to voice or touch and whether breathing is normal, slow, irregular, or absent.
Keep containers, prescription labels, or remaining substances for responders if they are safely available. Do not taste, smell, or handle unknown powders, and do not put yourself at risk to retrieve them. Be honest about drug use; accurate information helps clinicians choose airway support, monitoring, and testing.
What not to do
- Do not let the person “sleep it off.” Unresponsiveness can progress to respiratory arrest without warning.
- Do not give food, drinks, coffee, or other medicines. An unconscious person can choke or aspirate liquid, and stimulants do not reverse poisoning.
- Do not induce vomiting. It can cause choking and does not remove a reliably known amount of ketamine.
- Do not put the person in a cold shower or make them walk. These actions do not restore safe breathing and can cause falls, hypothermia, or injury.
- Do not leave them alone to find a phone, drugs, or transportation. Call first and ask another person to retrieve items or meet responders.
- Do not assume a normal-looking pulse means the danger has passed. Breathing and airway problems can develop while the heart is still beating.
When the person wakes up
Waking is not the end of the emergency. Keep the person seated or on their side, quiet, and supervised. Do not allow them to drive, take more substances, drink alcohol, or go to sleep alone. Tell paramedics exactly what happened, including any naloxone given and whether the person briefly stopped breathing.
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Ketamine effects can outlast the period of obvious unconsciousness, and mixed substances can be absorbed at different rates. A person who appears alert may still have impaired coordination, confusion, vomiting, or recurrent sedation. Accept medical evaluation even if they insist they feel fine.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.If you are not sure whether the person is breathing
Uncertainty is itself a reason to call. Put the phone on speaker and tell the dispatcher that you cannot confirm normal breathing. Follow the dispatcher’s assessment rather than relying on a consumer pulse oximeter, smartwatch, or another device. Such devices can give delayed or inaccurate readings and must not postpone CPR or emergency transport.
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If you are alone, call emergency services before leaving the person. If you have a mobile phone, use its emergency-call feature and keep the line open. Dispatchers can often provide step-by-step instructions even when you have never performed CPR.
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Poison-control and jurisdiction guidance
United States
For poison questions, call Poison Control at 1-800-222-1222 or use webPOISONCONTROL. For an unresponsive person, call 911 first; Poison Control is an additional source of guidance, not a substitute for emergency care.
Canada
Call 911 or your local emergency number for an unresponsive person. Health Canada notes that the Good Samaritan Drug Overdose Act can provide certain legal protections to people who call for help during an overdose, but the details and limits are specific to Canadian law and should not be generalized to other countries.
Other countries
Use the local emergency number and ask the dispatcher for the regional poison centre if needed. Numbers, responder procedures, and legal protections differ by country. If you travel, do not assume that the United States Poison Control number or Canadian protections apply where you are.
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Emergency clinicians focus first on airway, breathing, circulation, oxygenation, temperature, and injuries. They may provide oxygen or assisted ventilation, monitor heart rhythm and blood pressure, check blood glucose, treat seizures or agitation, and investigate co-ingestants. There is no home antidote that reverses ketamine itself; treatment is supportive and depends on the person’s condition and what else may have been taken.
Tell clinicians about prescribed ketamine treatment as well as nonmedical use. The route, formulation, dose, timing, and combination with other medicines affect observation and treatment decisions.
Quick Recap
Key decisions at a glance
- Does the person respond? If not, call emergency services immediately.
- Is breathing normal? If no, or if you are unsure, tell the dispatcher and begin the instructed resuscitation steps.
- Could opioids be involved? Give naloxone if available and appropriate, but never delay the emergency call or breathing support.
- Are you in the United States? Poison Control is 1-800-222-1222 for additional poison guidance; emergency services remain the priority.
- Are you elsewhere? Use the local emergency number and regional poison service; legal protections and procedures vary.
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