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Ketamine’s Potential: A New Frontier in Addiction and Depression Treatment

September 12, 2023

Alcohol and drug misuse is a growing global health issue. In 2010, about 10% of people worldwide had problems with alcohol or drugs. Opioid use, in particular, has led to many deaths, especially in the U.S., where opioid-related deaths increased by 88% yearly from 2013 to 2016.

People with substance use issues face challenges like cravings, risky behavior, and withdrawal symptoms. Stopping alcohol after heavy use can cause dangerous seizures and extreme anxiety. Stopping opioids can lead to severe physical symptoms like nausea and sleeplessness. Many people fear these withdrawal symptoms, which can be a hurdle to getting treatment.

There aren’t many effective drug treatments for these issues. Some approved drugs can help reduce heavy drinking, but their effects are modest. For opioid addiction, there are drugs that act on opioid receptors to help. However, there are no approved treatments for cannabis and stimulant addiction. So, doctors sometimes use other non-approved drugs, either alone or with behavioral therapy.

Research has shown that addiction and depression might be linked to changes in brain regions related to the chemical glutamate. Ketamine, a drug used in anesthesia, affects these glutamate pathways. Recent studies have found that ketamine can quickly reduce severe depression and suicidal thoughts. This effect might be because ketamine helps balance glutamate in the brain, leading to better brain connections. This could help people learn new behaviors and might be useful for treating addiction. We aim to review recent studies on ketamine’s role in treating addiction.

Published in the National Library of Medicine: Efficacy of Ketamine in the Treatment of Substance Use Disorders: A Systematic Review

“We conducted a thorough search of the PubMed/MEDLINE, Scopus, and clinicaltrials.gov databases from January 1, 1996, to January 1, 2018. For PubMed, we used the MESH terms “Substance-Related Disorders” and “Ketamine/therapeutic use.” In Scopus, we combined the term “ketamine” with keywords like “cocaine,” “alcohol,” “marijuana,” “methamphetamine,” and others. We only considered human studies in English with full texts. We excluded case reports. For clinicaltrials.gov, we simply used “ketamine” to find active studies. Our focus was on studies that assessed ketamine’s effectiveness in treating substance use disorders (SUD) or withdrawal symptoms. For a detailed breakdown of our study methods, refer to Figure 1.”

Cocaine

Two studies looked at how effective ketamine is for treating cocaine addiction.

In the first study by Dakwar and team, they tested two doses of ketamine against a control drug (lorazepam) on eight people who used cocaine but weren’t trying to quit. They found that after getting the lower dose of ketamine, people felt more motivated to stop using cocaine and had fewer cravings when shown cocaine-related cues. This effect was stronger than what was seen with the control drug. Interestingly, when people got ketamine first and then the control drug, the motivation to quit remained high. This suggests that the effects of ketamine can last for some time. Also, after the study, participants reported using cocaine less frequently and spending less money on it.

In a second study by the same team, they tested a higher dose of ketamine against another control drug (midazolam) on 20 people who used cocaine. During their stay in the hospital, participants could choose to either take cocaine or get money. After getting ketamine, people chose cocaine 66% less often than before, while there was no change in the control group.

In simple terms, these studies suggest that ketamine might help reduce cocaine use and cravings in people who are addicted to cocaine.

Opioid Addiction

Two studies looked at how well ketamine works for treating opioid addiction.

In the first study by Krupitsky’s team, they tested two doses of ketamine on 70 people addicted to heroin. They found that the higher dose of ketamine helped more people stay off heroin. After one month, 85% of people who got the higher dose were not using heroin, compared to 55% who got the lower dose. After a year, 24% of the high-dose group were still off heroin, compared to 6% in the low-dose group. People who got the higher dose also had less craving for heroin. In another study by the same team, they found that giving ketamine treatments multiple times worked better than just once. Half of the people who got multiple treatments were not using heroin after a year, compared to 22% who got just one treatment.

In the second study by Jovaiša’s team, they gave people either a saltwater placebo or ketamine before a treatment to quickly stop the effects of opioids. They found that ketamine helped reduce the body’s reaction to stopping opioids, like lower blood pressure and heart rate. However, after four months, there wasn’t a big difference between the two groups in terms of how many people were still off opioids or how they felt about their health and relationships. This might be because both groups got another treatment to block opioids or because they got ketamine while they were asleep.

Alcohol Problems

Krupitsky’s team studied people with alcohol problems who had treatment in a facility. After 3 months, they compared those who had an extra ketamine therapy session to those who didn’t. After a year, about 66% of the ketamine group stayed off alcohol, compared to 24% of the other group. But, this study didn’t randomly pick who got ketamine, and there wasn’t a proper control group.

Wong’s team looked back at 23 patients in the hospital for severe alcohol withdrawal. These patients got ketamine along with the usual treatment. The results hinted that these patients might have needed fewer standard medications after getting ketamine, but it wasn’t a strong finding.

In Conclusion

Research suggests that ketamine might help people quit drugs and alcohol. Studies have shown that ketamine can reduce cravings for cocaine and help people stay off alcohol and heroin after long treatments. It might also help ease the tough symptoms people feel when they stop using opioids.

However, these studies have some issues. For example, they had small groups of participants, and some didn’t have a proper comparison group. Also, the people in the studies were different. Some were actively trying to quit, while others weren’t. Interestingly, even those who weren’t trying to quit cocaine sometimes stopped using it after getting ketamine.

There are still many questions. For instance, does a person’s motivation to quit affect how well ketamine works? Does ketamine work the same for everyone, or do factors like gender or background play a role?

Ketamine might also help with withdrawal symptoms, which can be severe and even life-threatening for some drugs. Some reports say ketamine has helped people with opioid withdrawal symptoms. More research is needed to see if ketamine can help with alcohol withdrawal too.

Another area to explore is combining ketamine with therapy. Some believe that the two together might work better than either alone.

Ketamine can cause some mind-altering effects. While there’s concern that people might misuse ketamine because of this, some researchers think these effects might be part of why ketamine helps with addiction.

Lastly, we need to figure out the best dose of ketamine and how often to give it. Some studies used a dose that’s been tested for depression, but others used different amounts. There’s also interest in giving ketamine as a nasal spray, which could make treatment more accessible.

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Luminous Health

Luminous Health provides tailored programs that seamlessly incorporate Ketamine treatments, specifically designed to complement the practices of rehab centers, counselors, and psychiatrists. By addressing conditions like depression, ADHD, anxiety, and grief, we aim to revolutionize the approach to mental health challenges, addiction, and substance abuse through our collaborative efforts.

The insights shared in this blog aim to enrich your understanding and appreciation of psychedelic therapy, though they are not substitutes for professional medical or therapeutic advice. It's essential to consult with qualified healthcare providers to tailor a safe and effective treatment plan to your individual needs. By nurturing a collaborative dialogue with professionals, you can explore the therapeutic potentials of psychedelics within a safe and informed framework.

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