Is ketamine addictive when used for depression at Mana Recovery in Maui, Hawaii?

When used in a properly supervised medical context (such as for treatment‑resistant depression at Mana Recovery in Maui, Hawaii) the risk of addiction to ketamine is extremely low. The clinic uses small, carefully measured doses under supervision and monitors patients to reduce risks. However, misuse or recreational use can lead to dependence.

What is the difference between medical ketamine use and recreational ketamine use in Maui, Hawaii?

At the Maui facility of Mana Recovery, medical ketamine use is administered by trained clinicians in a controlled environment, in small, precise doses, and with careful monitoring. In contrast, recreational ketamine use is unsupervised, often involves higher doses, and carries greater risks of harm, addiction, and physical/psychological damage.

Can someone develop dependence on ketamine at the Maui, Hawaii clinic if they follow the treatment protocol?

When following the treatment protocol at the Maui clinic, the likelihood of dependence is very low. The article notes that in medical settings risk is minimal because dosing schedules and treatment are structured to avoid tolerance and misuse.

What are the signs of ketamine misuse or abuse that we monitor in Maui, Hawaii?

Some red flags for misuse include using ketamine outside of prescribed sessions, increasing dose without approval, craving ketamine or thinking about it frequently, neglecting responsibilities or relationships due to ketamine use, feeling detached or emotionally flat between doses, developing tolerance or needing more frequent treatments. These are the behavioural cues monitored at the Maui centre.

What are the long‑term mental and physical effects of excessive ketamine use, according to the Maui, Hawaii centre?

The Maui article notes that long‑term or excessive ketamine use (especially recreationally) may lead to memory problems or cognitive impairment, dissociation, depression or anxiety when not using; physically it may lead to ‘ketamine bladder’ (bladder inflammation or pain), urinary tract issues, liver damage (rarely), high blood pressure or cardiovascular strain.

How does Mana Recovery in Maui ensure ketamine therapy is delivered safely?

At the Maui, Hawaii location, Mana Recovery ensures safety through a comprehensive evaluation before treatment, supervised administration by licensed professionals, monitoring during sessions (vitals, mood, physical reactions), post‑treatment follow‑up, and integrating ketamine therapy with psychotherapy and wellness practices to promote long‑term emotional stability.

Are there alternative or complementary treatments to ketamine at the Maui facility?

Yes — the Maui centre emphasizes that while ketamine can be valuable for treatment‑resistant depression, alternatives and complementary approaches include cognitive behavioural therapy (CBT), medication management, transcranial magnetic stimulation (TMS), mindfulness and meditation, lifestyle changes, and holistic therapies like yoga or art therapy.

Addiction vs. Dependence: Understanding the Key Differences

By Carmen Cook, LMFT | November 24th, 2025

treatment for drug addiction

Addiction is a complex brain disorder that goes far beyond simply using a substance. It involves a compulsive need to seek and use drugs or alcohol despite harmful consequences.

When someone struggles with addiction, their substance use is no longer voluntary. It becomes driven by cravings and reinforced by how the brain’s dopamine pathways react to the drug. Even when the individual recognizes the negative impact on their health, relationships, or professional life, they may feel unable to stop.

At Mana Recovery in Maui, we see addiction as both a medical and social condition. Many people we serve come from complex backgrounds that may include justice involvement, housing instability, or long-term substance use. Through compassionate, evidence-based support and personalized treatment programs, we help individuals reconnect to community, purpose, and long-term stability.

What is Physical Dependence?

While addiction refers to a behavioral and psychological condition, physical dependence occurs when the body adapts to the presence of a substance after prolonged use. Over time, the brain and nervous system adjust to function with that substance present. If the person suddenly stops using, they experience withdrawal symptoms, which can range from mild discomfort to life-threatening complications.

Physical dependence can develop with both addictive substances and even non-addictive medications, such as antidepressants or steroids. For example, someone taking prescription opioids for chronic pain may become physically dependent on them even if they use the medication as directed and do not display addictive behaviors.

Dependence, therefore, is a physiological process, not necessarily an indicator of addiction. However, when dependence is combined with cravings, loss of control, and compulsive use, it becomes part of the addiction cycle.

How Addiction and Dependence Are Related

Addiction and dependence often overlap but are not synonymous. Dependence can occur without addiction, but addiction almost always includes some level of dependence.

Addiction adds psychological and behavioral elements to physical dependence, such as craving, compulsion, and continued use despite negative consequences. For instance, a person dependent on opioids may experience withdrawal when stopping use. But if they’re not obsessively seeking the drug or losing control over their use, they may not meet the criteria for addiction.

At Mana Recovery, our clinical team carefully assesses both physical dependence and addictive behaviors to determine the most appropriate level of care, whether it’s Partial Hospitalization (PHP), Intensive Outpatient (IOP), or a standard Outpatient Program (OP).

Behavioral Signs of Addiction

Recognizing addiction often begins with noticing subtle but progressive changes in a person’s behavior. These shifts can appear long before physical symptoms or health complications emerge, and they often indicate that substance use has begun to interfere with the person’s life.

Some of the most common behavioral signs include:

Loss of control: Being unable to stop or cut back on use despite wanting to. Someone may make repeated promises to quit, only to return to use after a short time.
Neglecting responsibilities: Missing work, school, or family obligations becomes more frequent as substance use consumes time and energy. Bills, hygiene, and household duties may also be neglected.
Continued use despite harm: Persisting in use even when it causes financial strain, damaged relationships, or health issues. The person may downplay the severity of these problems or justify their behavior.
Social withdrawal: Avoiding loved ones or replacing friendships with those with others who use substances. This isolation can deepen feelings of shame, depression, and disconnection from their community.
Compulsive seeking: Spending significant time and energy obtaining, using, or recovering from substance use. This behavior often leads to secrecy, risk-taking, or involvement in illegal activity.

Addiction often reshapes a person’s priorities and personality. What once mattered (relationships, career, hobbies, and health) may fall away as the substance becomes central to daily life. Over time, this behavioral shift reinforces the cycle of addiction, creating emotional instability and loss of self-identity.

Physical Symptoms of Dependence

Physical dependence reveals itself through tolerance and withdrawal, two indicators that the body has adapted to the continued presence of a substance. Over time, the brain and nervous system adjust their chemistry to accommodate drugs or alcohol. Suddenly stopping or reducing use disrupts this delicate balance, so the body reacts.

These symptoms vary by substance but often include:

Shaking or tremors: Common with alcohol and benzodiazepine withdrawal, indicating that the nervous system is overstimulated after being dampened by external substances.
Sweating and chills: The body struggles to regulate temperature as it adjusts to functioning without the substance.
Nausea, vomiting, or stomach cramps: The digestive system may feel unstable during detox when correcting for the lack of substance.
Muscle aches or fatigue: As the body works to eliminate toxins, inflammation and dehydration can lead to exhaustion and discomfort.
Insomnia: Disrupted sleep is common as the brain’s natural sleep-wake cycles attempt to recalibrate.
Irritability and anxiety: Emotional instability often accompanies physical withdrawal as the body attempts to correct its levels of dopamine and other substances.

The severity of these symptoms depends on the substance used, duration of use, and individual health factors. Some people may experience mild flu-like discomfort, while others face serious medical complications like hallucinations.

Because withdrawal can be dangerous, medical supervision is critical. Mana Recovery offers safe, supportive care for individuals transitioning through detox and into structured treatment. Our clinicians monitor vital signs, manage symptoms with appropriate medications, and provide emotional support throughout the process.

Once withdrawal symptoms subside and the body begins to restore balance, individuals can more effectively engage in therapy, group work, and our Recover Strong program. This combination of medical care and active healing helps rebuild physical strength, restore mental clarity, and prepare each individual for long-term success in recovery.

Common Misconceptions About Addiction and Dependence

Many people misunderstand addiction and dependence, which can delay treatment or cause stigma. Common misconceptions may include:

“Dependence means you’re addicted.” Not always. Dependence can happen with prescribed medications used responsibly.
“Addiction is just a lack of willpower.” Addiction is a brain disease influenced by genetics, environment, and mental health, not moral weakness.
“You can quit anytime if you really want to.” Withdrawal symptoms and brain changes make quitting extremely difficult without help.
“If I’m not physically dependent, I’m not addicted.” Some addictions, such as gambling or cocaine use, can develop with minimal physical dependence but severe psychological symptoms.

Breaking down these myths helps people seek the right type of support and reduces the shame often associated with asking for help.

Psychological vs. Physical Dependence: Key Differences

The distinction between psychological and physical dependence helps explain why addiction is more than just a chemical process.

Physical dependence involves the body’s adaptation to a substance, leading to tolerance and withdrawal.
Psychological dependence refers to the emotional and cognitive attachment to substance use. This may include cravings or feelings of anxiety and depression when not using.

Psychological dependence alone can sometimes drive relapse. Even after detox, the brain’s reward system can continue to crave the drug’s effects. This is why evidence-based therapy, such as Cognitive Behavioral Therapy (CBT) and Matrix Model Therapy, is essential. These therapies help individuals identify triggers, change thought patterns, and build resilience to stress and cravings.

The Role of Tolerance in Substance Use

Physical tolerance occurs when the body becomes less responsive to a substance, requiring higher doses to achieve the same effect. While tolerance alone isn’t addiction, it’s a warning sign that the body is adapting to the drug.

Over time, tolerance can accelerate dependence and raise the risk of overdose, especially with alcohol or opioid addiction. Many people begin using higher doses without realizing how close they are to dangerous levels.

Mana Recovery clinicians regularly assess individuals for signs of tolerance and dependence during treatment. Through structured programs like PHPs and IOPs, individuals receive close monitoring, medical support, and therapy to prevent escalation.

The Risks of Ignoring Dependence or Addiction

Ignoring the signs of dependence or addiction can have devastating consequences, including:

Increased risk of overdose or severe withdrawal
Permanent organ damage or cognitive decline
Strained family and community relationships
Legal and financial issues
Worsening mental health or aggravation of existing mental health conditions

For justice-involved or houseless individuals, these risks are often compounded by social and environmental challenges. Mana Recovery’s mission is to provide accessible, community-based care that meets people where they are. Through collaboration with courts, Medicaid, and community partners, we help individuals build lasting recovery and reintegration.

Treatment Approaches for Addiction vs. Dependence

Because addiction and dependence manifest differently, treatment approaches must be individualized. For physical dependence, the focus is on safely managing withdrawal and restoring the body’s balance. For addiction, treatment addresses behavioral, emotional, and cognitive components that drive compulsive use.

Mana Recovery’s comprehensive programs combine both medical and therapeutic approaches to ensure individuals receive well-rounded care. Our treatment offerings include:

Partial Hospitalization (PHP): Intensive daytime programming with structured therapy, group work, and exercise-based healing.
Intensive Outpatient (IOP): Flexible care for those who need support while reintegrating into daily life.
Standard Outpatient (OP): Ongoing therapy and accountability for maintaining sobriety.

Every individual’s journey is unique, which is why our admissions team carefully evaluates each person’s substance use history, mental health needs, and social supports to recommend the most appropriate path forward.

Medical Detox and Therapy Options

Detoxification is the first step in addressing physical dependence, allowing the body to safely eliminate substances while minimizing withdrawal symptoms. Mana Recovery partners with trusted detox facilities and coordinates transitions into structured outpatient treatment once individuals are medically stable.

Therapeutic care at Mana Recovery integrates several evidence-based modalities, including:

Individual therapy: One-on-one sessions to explore trauma, triggers, and goals.
Group therapy: Building accountability and community support.
Family therapy: Healing relationships and fostering understanding.
Cognitive Behavioral Therapy (CBT): Reframing negative thought patterns and developing coping skills.
Matrix Model Therapy: Combining education, relapse prevention, and behavioral support for long-term sobriety.
Recover Strong: Our signature neuroscience-informed fitness program that enhances mood, reduces cravings, and rebuilds confidence through movement.

Together, these methods address both the body’s dependence and the mind’s addiction, offering a balanced path toward recovery.

Preventing Relapse: Understanding Your Risk Factors

Even after treatment, relapse remains a challenge for many individuals. Recognizing personal risk factors can greatly improve long-term outcomes. Common triggers may include:

High stress or emotional distress
Exposure to old environments or peers who use substances
Lack of structure or support systems
Untreated co-occurring mental health issues
Physical illness or chronic pain

At Mana Recovery, relapse prevention is an ongoing process. We emphasize consistency, connection, and physical wellness through continued participation in therapy and Recover Strong sessions. By helping individuals build routines, set goals, and strengthen social bonds, we reduce relapse risk and promote independence.

Finding Lasting Recovery at Mana Recovery

Addiction and dependence are not life sentences. They are treatable conditions that require compassion, structure, and community. At Mana Recovery, we provide evidence-based care and holistic healing rooted in connection and resilience.

Whether you are struggling with physical dependence, behavioral addiction, or both, our Maui treatment center offers a supportive environment to help you rebuild your life. Contact Mana Recovery today to verify your insurance, learn more about our programs, and take the first step toward lasting recovery.