Can Ketamine Help with Drug Addiction?

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Medically reviewed: Paloma Lehfeldt, MD
a man struggling with drug addiction and contemplating ketamine-assisted therapy

Ketamine-Assisted Therapy Could Help Combat Drug Abuse

Drug addiction (clinically known as substance use disorder) is a significant concern in the United States. One out of every ten Americans will experience drug use disorder at some time in their lives. This means 23 million people are impacted. However, 75% will never receive any treatment.(1) Of those that do seek help, 40% to 60% of individuals struggling with a substance use disorder will relapse.(2)

Thankfully, research into an established dissociative anesthetic, ketamine, could be the key to developing new ways to treat drug abuse. Early studies and trials involving the use of ketamine to treat drug addiction have shown interesting and potentially significant results. While ketamine has not yet received FDA approval to treat substance abuse, it is commonly used off-label (other than its FDA-approved usage). If you or a loved one are struggling with addiction and drug use, ketamine could be a viable step on a path to healing. 

What is Drug Addiction?

Drug addiction is the uncontrolled use of an intoxicating substance, even when it causes harm and clinically significant impairment to the individual’s life.(3) In certain individuals and situations, misuse of a given substance can spiral out of control, causing users to damage, or even lose, their careers, friends, and families. 

What are the Symptoms of Drug Addiction?Drug addiction presents in many forms. Symptoms can be physical, behavioral, and psychological.
They can include:(4)

  • Extreme Risk-taking
  • Neglecting Obligations
  • Disorderly Conduct or Theft 
  • Shallow or Fast Breathing
  • Bloodshot Eyes
  • Loss of Appetite and Weight Loss
  • Changes to Sleeping Patterns
  • Changes to Friends and Activities
  • Paranoia or Severe Anxiety
  • Severe Mood Swings

What are Some Commonly Abused Drugs?

Some commonly abused drugs include:(5)

  • Cocaine
  • Prescription Opioids
  • Heroin
  • Methamphetamines
It should be noted that ketamine, when used outside of a therapeutic setting, can also be abused. Ketamine therapy typically involves low-dose ketamine administered by a health practitioner who may provide adjacent talk therapy during the session or integration counseling post-session.

Can Ketamine Help with Opioid and Opiate Addiction?

The opioid epidemic in the United States has become a public health emergency. In many cases, individuals begin by using both non-prescription drugs and prescription painkillers such as oxycontin, Vicodin, or Percocet. Over time, some users may become addicted to those prescription medications or move from abusing prescription drugs to heroin or other opiates.(6,7)

Fortunately, researchers have found that ketamine may provide a new tool for combating drug addiction and abuse. This promising research suggests that ketamine is a viable solution for those struggling with opioid addiction.
a couple discussing ketamine treatment for opioid addiction

Ketamine and Cocaine Use DisorderKetamine may also work to help individuals with addiction to cocaine. A study was done on eight individuals dependent on the drug. The participants were divided into three different groups: two ketamine groups, one low-dose (0.41mg/kg) and one high-dose (0.71 mg/kg), and a placebo group (IV Lorazepam). The results showed that the group with the low-dose infusion of ketamine had a greater motivation to quit using cocaine than the placebo group. Additionally, those that received low-dose ketamine significantly reduced the number of days they used cocaine (22 out of 28 days before treatment was reduced to five out of 28 days following treatment, four weeks later).(8)

What Causes Addiction?Addiction is a complex condition that can have a range of underlying causes.(9) Age, stress, environment, occupation, and mental health are contributing factors. In many cases, these stressors can cause people to seek a means of escape or reprieve. This need for release and escapism may cause some individuals to seek out substances that make them feel good or allow them to temporarily avoid the problems that are causing them stress and pain, whether emotional or physical.(10) 

This “feel-good” sensation is largely due to a neurotransmitter called dopamine. Dopamine is released when we’re engaged in activities we enjoy and is produced in greater amounts when users ingest certain drugs, such as narcotics, amphetamines, and opioids. Specifically, drugs that work as dopamine agonists (meaning it activates and binds to dopamine receptors). Over time, users need greater amounts of dopamine to feel good. This never-ending drive to re-experience the initial dopamine rush is one of the key factors in addiction.

What is Ketamine Therapy for Drug Addiction?Ketamine has the potential to help people struggling with drug addiction by reducing their cravings. Once someone has this aspect of their condition under control, they may begin taking other steps to help them continue their recovery. Ketamine therapy is not a cure-all, but early trials are very promising. 

How Does Ketamine-Assisted Therapy Work for Drug Addiction

To understand how ketamine therapy treats drug addiction, we first need to understand how the brain works. In addition to dopamine, our brains possess over 100 types of neurotransmitters.(11) Neurotransmitters are tiny messengers that allow the cells in our brains to communicate. Dopamine, as noted, is one of many chemicals that tell our brains to experience pleasure. 

One of the primary neurotransmitters involved in drug addiction and recovery is glutamate. Glutamate, among other things, allows our brains to learn and remember. Glutamate is so important that without it, we would have a hard time functioning at all. 

When our glutamate levels are disrupted, we experience something called “glutamatergic dysregulation.” Scientists are beginning to discover that glutamatergic dysregulation plays a part in substance abuse and addiction.(12) Ketamine also affects how glutamate works in the brain through its action at one of glutamate’s receptors. First, ketamine causes “glutamate modulation,” which is the opposite of glutamatergic dysregulation. In other words, ketamine can help the glutamate system return to a state closer to equilibrium.(13,14)

Is Ketamine for Drug Addiction Effective?

Early studies indicate ketamine could be a highly effective treatment for drug addiction. For example, in one study involving individuals with cocaine use disorder, nearly half of the patients treated with ketamine avoided using cocaine for over two weeks (as opposed to only 10% of patients who received the control drug, midazolam).(15)

Some recent trials have shown that high-dose ketamine treatments and ketamine-assisted psychotherapy may successfully treat opioid addictions, particularly heroin abuse. High-dose ketamine therapy produced a significantly greater rate of abstinence in heroin addicts within the first two years of follow-up, a greater and longer-lasting reduction in craving for heroin, and more positive change in nonverbal unconscious emotional attitudes than low-dose ketamine therapy did.(16) They also experienced fewer cravings and increased positive attitudes.
Ketamine Assisted Therapy - IV Bag

How Safe is Ketamine for Drug Abuse?The good news about ketamine is that it is being studied widely. The results of preliminary studies indicate ketamine may effectively combat drug and alcohol addictions and overcome conditions like depression and anxiety. Significantly, the drug has shown to be relatively safe and well-tolerated throughout these various trials.(17,18)

Given its relative safety and apparent efficacy when used in therapeutic settings, ketamine could be a promising option for individuals struggling with drug addiction.

Could Ketamine Help You Overcome Drug Addiction?Ketamine, like any treatment for drug addiction, should be discussed with your physician, psychologist, or other health care provider. Ketamine therapy could be a good treatment option for drug addiction and substance use disorder. If you and your doctor believe ketamine is the appropriate treatment for you, you can explore ketamine clinics in your area.

Where to Find
Ketamine TreatmentLocate outpatient ketamine clinics and at-home ketamine service providers in the U.S. that offer care for pain, depression, anxiety, PTSD, OCD, and addiction.