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  • Ketamine for Addiction: What to Know

    What Is Ketamine? Ketamine , also known as Special K or Super K, is a short-acting  anesthetic  drug with hallucinogenic effects. It can change how you perceive sights and sounds, make you feel like you’re not in control, and make you feel detached from the world around you or any  pain  you’re feeling. Scientists created ketamine to be an anesthetic and a pain reliever. It’s approved by the FDA for these purposes. But this “club drug” is often misused. However, researchers are now looking at whether there might be some benefits in the fight against  addiction . Ketamine was linked with better outcomes when used along with behavioral and motivational  therapy  in two  clinical trials  on substance misuse treatment. How Ketamine Works Ketamine triggers activity of a neurotransmitter called glutamate in the frontal cortex of  your brain . It also allows more synapses, which allow information to flow inside your brain, to form in the same area. Ketamine comes in several forms. It may be a powder or a liquid. People who use it illegally often snort, smoke, or inject it, or mix it into drinks. Doctor usually inject it as an  intravenous  (IV) infusion. The effects start quickly. After a few minutes, your  heart rate  speeds up and your  blood pressure begins to go down. You may not respond to things in the world around you. Different amounts of ketamine will give different “highs.” A medicinal dose is usually around 1 to 2 milligrams for each kilogram of  body weight . But a fraction of that amount can lead to a high. A low dose will create a mellow high with mild visual  hallucinations , heightened senses, and numbness. A higher dose might cause vivid  hallucinations , trouble moving, short-term  memory loss , and feeling like you’re having an “out-of-body” experience. This could lead to: Uncontrolled  eye  movement Tears Dilated pupils More  saliva Stiffened muscles Nausea An  overdose  of ketamine can cause unconsciousness or slowed  breathing , which is very dangerous. In a medical setting, doctors give low doses of ketamine over a longer period of time. This way, they avoid a potentially addictive high. Addictions are very rare under a doctor’s care. Ketamine and Addiction Treatment Two  clinical trials  — one looking at  cocaine  addiction and the other at  alcohol  dependency — showed that people who were prescribed ketamine, alongside  therapy , had a better outcome than those who had therapy without ketamine treatment. The people who had cocaine addictions got ketamine through an IV for 5 days, in addition to 5 weeks of mindfulness relapse prevention therapy. The people who were dependent on alcohol got ketamine through an IV during the second week of a 5-week motivational enhancement therapy session.  In both studies, the researchers concluded that ketamine lowered the chances of restarting or relapsing into addiction. More research on how ketamine affects addiction is needed, but it may change how your brain deals with cravings, motivation to quit a drug, and controlling behavioral reactions. Ketamine treatment might also make behavioral therapy more effective, which is a big part of overcoming addiction. For ketamine to be helpful in addiction treatment, it must be used under the close care of medical professionals. Recreational use could lead to addiction and other dangerous effects. https://www.webmd.com/mental-health/addiction/ketamine-for-addiction-what-to-know Ketamine for the treatment of addiction: Evidence and potential mechanisms Ketamine is a dissociative anaesthetic drug which acts on the central nervous system chiefly through antagonism of the n-methyl-d-aspartate (NMDA) receptor. Recently, ketamine has attracted attention as a rapid-acting anti-depressant but other studies have also reported its efficacy in reducing problematic alcohol and drug use. This review explores the preclinical and clinical research into ketamine’s ability to treat addiction. Despite methodological limitations and the relative infancy of the field, results thus far are promising. Ketamine has been shown to effectively prolong abstinence from alcohol and heroin in detoxified alcoholics and heroin dependent individuals, respectively. Moreover, ketamine reduced craving for and self-administration of cocaine in non-treatment seeking cocaine users. However, further randomised controlled trials are urgently needed to confirm ketamine’s efficacy. Possible mechanisms by which ketamine may work within addiction include: enhancement of neuroplasticity and neurogenesis, disruption of relevant functional neural networks, treating depressive symptoms, blocking reconsolidation of drug-related memories, provoking mystical experiences and enhancing psychological therapy efficacy. Identifying the mechanisms by which ketamine exerts its therapeutic effects in addiction, from the many possible candidates, is crucial for advancing this treatment and may have broader implications understanding other psychedelic therapies. In conclusion, ketamine shows great promise as a treatment for various addictions, but well-controlled research is urgently needed.  https://pubmed.ncbi.nlm.nih.gov/29339294/ Efficacy of Ketamine in the Treatment of Substance Use Disorders: A Systematic Review Background: Despite advances in behavioral and pharmacotherapy interventions, substance use disorders (SUDs) are frequently refractory to treatment. Glutamatergic dysregulation has received increasing attention as one common neuropathology across multiple substances of abuse. Ketamine is a potent N-methyl-D-aspartate (NMDA) glutamatergic receptor antagonist which has been found to be effective in the treatment of severe depression. Here we review the literature on the efficacy of ketamine in the treatment of SUDs. Ketamine in AUD 2022 – Adjunctive Ketamine With Relapse Prevention–Based Psychological Therapy in the Treatment of Alcohol Use Disorder Early evidence suggests that ketamine may be an effective treatment to sustain abstinence from alcohol. The authors investigated the safety and efficacy of ketamine compared with placebo in increasing abstinence in patients with alcohol use disorder. An additional aim was to pilot ketamine combined with mindfulness-based relapse prevention therapy compared with ketamine and alcohol education as a therapy control.

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