Efficacy of Ketamine in the Treatment of Substance Use Disorders: A Systematic Review

Summary & key facts

Researchers reviewed seven completed studies testing ketamine as a treatment for problems with alcohol, cocaine, or opioids. The studies found signs that ketamine helped reduce craving and use of cocaine and that people given ketamine had higher rates of staying abstinent from alcohol or opioids. However, the studies were small, sometimes looked at similar kinds of people, and some important comparisons (like placebo control) were missing. Overall, the evidence is promising but still early, and researchers say more and better studies are needed.

Key facts:

• The review found seven completed studies: two on alcohol problems, two on cocaine problems, and three on opioid problems.
• Both cocaine studies reported that ketamine reduced craving, increased motivation to stop, and lowered cocaine use rates.
• Studies of alcohol and opioid problems found higher abstinence rates in people given ketamine, with some studies reporting effects lasting up to about two years after a single infusion.
• The alcohol and opioid studies that showed long-lasting effects did not include placebo (inactive) comparison groups.
• The cocaine studies were limited by small numbers of participants, similar types of participants (a homogeneous group), and short follow-up times.
• At the time of the review, there were six more ongoing studies testing ketamine for alcohol, cocaine, cannabis, and opioid problems.

Abstract

Seven completed studies were identified. Two studies focused on alcohol use disorder, two focused on cocaine use disorder, and three focused on opioid use disorder. Both cocaine studies found improvements in craving, motivation, and decreased cocaine use rates, although studies were limited by small sample sizes, a homogeneous population and short follow-up. Studies of alcohol and opioid use disorders found improvement in abstinence rates in the ketamine group, with significant between-group effects noted for up to two years following a single infusion, although these were not placebo-controlled trials. These results suggest that ketamine may facilitate abstinence across multiple substances of abuse and warrants broader investigation in addiction treatment. We conclude with an overview of the six ongoing studies of ketamine in the treatment of alcohol, cocaine, cannabis, and opioid use disorders and discuss future directions in this emerging area of research.

Topics

Neurotransmitter Receptor Influence on Behavior Treatment of Major Depression Tryptophan and brain disorders

Categories

Health Sciences Medicine Pharmacology

Tags

Abstinence Acamprosate Addiction Cannabis Clinical psychology Craving Environmental health Internal medicine Ketamine Medicine Meta-analysis Naltrexone Opioid Population Psychiatry Receptor Substance abuse

Substances

Cannabis Ketamine

Conditions & symptoms

Addiction Addiction or harmful habbits