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How Does Ketamine Treat Substance Use Disorder?

September 7, 2022

You had a friend in college who lived to drink – who skipped classes just for a shot of his favorite alcohol – but then one day woke up and decided enough was enough. He basically went cold turkey, abstaining from drinking wine, beer, or alcohol, and went on with his life without thinking twice about what happened before. Could that strategy work for you? Maybe, or maybe not. There are many ways to treat substance use, including ketamine infusion therapy from a specialty clinic.

What is Ketamine?

Ketamine is a medicine that originated as a surgical anesthetic in the early 1960s. Early studies found it had psychoactive properties, including creating an out-of-body sensation and feeling of unreality – making it a potential solution for anxiety, chronic pain, substance use disorder, and many other physical and psychiatric illnesses. More than 50 years would pass before a version of ketamine would receive approval from the U.S. Food and Drug Administration as therapy for treatment-resistant depression.

What is Substance Use Disorder?

Substance use disorder, also called drug addiction, is an illness that affects your brain and renders you incapable of controlling the use of a legal or illegal substance like nicotine, alcohol, cocaine, or others. It can have severe consequences, leading to illegal or risky behavior, spending all your money and time on getting the substance you’re addicted to, and other physical and mental health problems.

Ketamine as a Treatment for Substance Use Disorder

In addition to being used as a pre- and post-surgical anesthetic, ketamine has also gained a foothold as a sedative and for treating symptoms of mental and physical illness, including depression, chronic pain, and problems related to substance use disorder. As is the case with many forms of treatment, no one is 100% certain as to how ketamine works, but there are many educated guesses.

At the basic level, ketamine is believed to strengthen or repair damaged or weakened neurotransmitters in the brain, like glutamate and serotonin. These chemical messengers are responsible for transmitting and receiving signs flowing between the central nervous system and the rest of the body. If glutamate and other messengers don’t work the way they should, parts of the brain responsible for controlling reward, learning based on rewards, and how we respond to pain, pleasure, and distress stop working. When that happens, people can become more susceptible to addiction and substance use disorder.

Specific areas of the brain related to addiction on which ketamine can have a positive effect include:

  • The basal ganglia, responsible for constructive forms of motivation, like the pleasure you get from eating, hanging out with friends, and physical relationships, is needed for positive habits and routines in daily life. Ketamine’s effects on the basal ganglia are still being investigated in non-human test subjects.
  • The extended amygdala influences anxiety, irritability, and nervousness, which may happen after you stop using an addictive substance. Afterward, feelings of elation subside – forcing you to find and use the drug again. Someone who’s addicted may react negatively in emotionally charged situations, and it’s believed that ketamine may reduce negative consequences related to amygdala function.
  • The prefrontal cortex is the brain’s main hub for decision-making, planning, self-control, solving problems, and thinking. It’s believed that ketamine’s fast-acting anti-depressive effects can positively impact neurotransmitter function in the prefrontal cortex.

Though more research is needed, it appears that ketamine infusion therapy, when combined with psychotherapy, has a positive effect on people who abuse certain substances. In one trial for people with a cocaine addiction, a single dose of ketamine produced a number of significant treatment outcomes in adults undergoing mindfulness-based behavioral adjustment, like endorsing abstinence, diminishing craving, and lowering the chance of relapse.

Another study of participants with alcohol dependence also showed promising results. In this case, treatment with three ketamine infusions was well tolerated in patients and was linked to more days of abstaining from alcohol at a 6-month check-up. “The findings suggest a possible beneficial effect of adding psychological therapy alongside ketamine treatment.”

Find a Specialty Clinic Near You

If you’ve been living with substance use disorder and finally received a formal diagnosis, you know the challenge of beating addiction and regaining control of your life will be hard – but not impossible. Your healthcare provider may recommend combining different forms of treatment, like psychotherapy and certain medicine, or diet and lifestyle changes. Another option? Ask about ketamine infusion therapy, normally available at specialty clinics nationwide.

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