Using Ketamine to Overcome Substance Abuse

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Medically reviewed: Paloma Lehfeldt, MD
a woman walking and considering ketamine for substance abuse

Ketamine-Assisted Therapy Could Help Some People Overcome Addiction

People from all walks of life are struggling with addiction. Substance abuse continues to take its toll, whether it’s over-prescription of opioids, the proliferation of street drugs like methamphetamines, or increased dependence on alcohol due to the pandemic. In 2021 alone, drug overdose deaths reached an all-time high in the United States, with over 100,000 lives lost.(1)

The medical term for addiction is “substance use disorder.” Substance use disorder occurs an individual’s use of alcohol or another substance (such as recreational or prescription drugs) leads to health issues or problems at work, school, or home.

Despite its significant impact on society, few new treatments for substance abuse disorder have been developed in the last few decades. However, that is beginning to change with the advent of psychedelic-assisted therapies and ketamine. Medical providers and researchers have begun exploring the therapeutic use of ketamine as a new treatment option for substance use disorder. 

Ketamine is a short-acting anesthetic that has been used on people and animals since its introduction to the market in 1970.(2) Due to its hallucinogenic and dissociative properties, it also gained some notoriety as a “club drug.” (3) Today, however, ketamine is increasingly recognized as a successful treatment for several mental and physical ailments, including substance use disorder when used with proper dosing and administration.

What is Substance Use Disorder?

According to the Mayo Clinic, substance use disorder is a “disease that affects a person’s brain and behavior and leads to an inability to control the use of a legal or illegal drug or medication.”

In other words, when you reach the point that you can’t stop drinking, smoking, or using, you may have transitioned from a casual substance user to someone who may require treatment.

What are the Symptoms of Substance Abuse?The symptoms of addiction are vast and can vary depending on a person’s age or the substance they are abusing.(5) Generally speaking, some symptoms include:(6)

  • Hiding Substance Use From Loved Ones
  • Neglecting Responsibilities
  • Sudden Financial Problems
  • Abandonment of Hobbies
  • Withdrawal symptoms when not using (e.g., sweating, shaking, nausea, headaches, insomnia)

What Can Cause Addiction?Several factors contribute to substance use disorder, and each person’s journey into addiction is unique.(7) Mental illness, stress, environment, age, and occupation all seem to play a role. People sometimes abuse drugs as a means of escape or coping mechanism.(8)  More often than not, this affects the user’s mental and physical health.

The science behind the transition from casual use to addiction is relatively simple from a biological perspective. Many substances people abuse provide the brain with hits of a naturally-occurring chemical called dopamine, which plays a significant role in our brain’s reward system. Dopamine causes a pleasurable sensation in the body and mind. Not surprisingly, once people find a substance that supplies them with dopamine, they may use it repeatedly. 

Over time, however, the brain may build up a tolerance to these dopamine-inducing substances. Moreover, each time dopamine is depleted, the brain needs time to replenish its natural supplies, which causes users to ingest more of the substance with increasing frequency to get that same feel-good sensation. This is not to say that dopamine is the primary cause of addiction. Substance use disorder is complex and multifaceted, with many underlying factors outside the brain’s reward system. Some of those include age, genetics, environment, and brain chemistry. 

What is Ketamine Therapy for Substance Use Disorder?

So, what does ketamine have to do with all this? 

Our brains contain neurotransmitters, chemical messengers which allow different cells to communicate with each other. We talked about dopamine a moment ago. Dopamine is a neurotransmitter that allows our brains to experience pleasure.

Another neurotransmitter, glutamate, plays a significant role in learning and memory. Without glutamate, our brains would not function. When our glutamate levels get out of whack, we experience what scientists call “glutamatergic dysregulation.” Studies have shown that glutamatergic dysregulation is common in the brains of people with substance use disorders.(9)

That’s where ketamine comes in.
IV ketamine treatment for substance abuse

How Does Ketamine Therapy Work for Substance Abuse?

Ketamine does two distinct things that researchers think make it an effective tool for combating addiction. First, ketamine acts on the glutamate system, altering how it binds to the NMDA receptor. Research suggests that changing how this receptor interacts with neurotransmitters like glutamate (scientists call this “glutamate modulation”) effectively treats the severe depression associated with substance use disorder and addiction.(10)

Secondly, ketamine fosters neuroplasticity, which means that ketamine could help an addict’s brain break free from habitual and destructive conditioning.(11) In one study, researchers showed that ketamine could help retrain addiction responses in the brain. Helping it move away from constantly being in drug-seeking and pleasure-seeking mode to coping without the problematic addictive substance. 

Which Addictions Can Ketamine Therapy Help to Treat?So far, ketamine-assisted therapy has shown great promise in the treatment of:

Cocaine addiction(12)
Alcohol addiction(13)
Heroin addiction(14)

Learn More About Ketamine for Drug and Alcohol Use Disorder

The good news for substance use disorder patients is that ketamine therapy has already moved from the laboratory to Main Street, unlike other cutting-edge treatments for mental illness and substance abuse. Indeed, according to the National Library of Medicine, “ketamine is [currently] the only legal psychedelic medicine available to mental health providers for the treatment of emotional suffering.”(15)

If you’re interested in exploring ketamine therapy for treating addiction, there are a few available avenues. Many states have approved programs where patients are treated with a combination of ketamine and talk therapy in a clinical setting. However, if you can’t find one of these clinics in your immediate vicinity, “at-home” options can provide users with potentially effective relief from addiction. In either case, it’s a good idea to speak with your medical provider before deciding on an addiction treatment plan. 

Does Ketamine Work for Drug Abuse? Ketamine has shown great promise in the treatment of drug abuse. In one study involving cocaine addicts, for example, nearly 50% of patients treated with ketamine avoided using the drug over two weeks (as opposed to only 10% of patients in the control group who received other therapies). Individuals in the ketamine group were also less likely to relapse.(16)

Additionally, high-dose ketamine treatments have allowed some patients to abstain from using heroin for two years following therapy.(17) High-dose ketamine treatments also helped to reduce cravings and increase positive attitudes among former heroin addicts. Given the similarities between heroin and prescription opioids, these findings are encouraging for those struggling with addictions to fentanyl, oxycodone, and hydrocodone.

a ketamine therapy session for drug abuse

Does Ketamine Work for Alcohol Abuse?A study focused on ketamine’s ability to curb alcohol abuse found that ketamine therapy “significantly increased the likelihood of abstinence, delayed the time to relapse, and reduced the likelihood of heavy drinking days” compared with test subjects treated with Midazolam (a benzodiazepine similar to drugs like Xanax or Lorazepam).(18) This is exciting news, especially because nearly 15 million Americans currently suffer from Alcohol Use Disorder.(19)

How Safe is Ketamine for the Treatment of Substance Use Disorder?Psychiatrists and physicians are currently using ketamine to treat things like severe depression and suicidal ideation and addiction. Trials, such as those involving ketamine-assisted therapy for treatment-resistant depression, have shown the drug to be relatively safe and well-tolerated when used in a medical setting. However, further research is needed to establish broader safety claims.(20)

Given the promising results that ketamine has shown in treating substance use disorder, supervised, therapeutic use of ketamine is one of the most exciting options for people looking to overcome addiction. 

Could Ketamine Help You Overcome Addiction?Every person’s medical conditions and considerations are unique. Therefore, it is important that you talk to your doctor and the clinic doctors to determine whether you are ready to begin a ketamine-assisted substance use disorder program.

If you and your doctor agree that this is a viable treatment option for you, visit our list of therapeutic 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.