Can Ketamine Treatment Help With Alcohol Abuse?
The simple answer is: Possibly, and it’s Promising.
According to the United States National Survey on Drug Use and Health, 14.4 million adults ages 18 and older had alcohol use disorder in 2018. Alcohol use is the third leading cause of preventable deaths in the United States. Pathological alcohol use totals an estimated 3.8% globally. Those most affected people with alcohol use disorder are not in treatment, and of those that are in treatment, a large number do not respond to their treatments. Since traditional treatment often doesn’t work, can ketamine be used as a non-traditional treatment?
Researchers Studied both the Patient and the Effects of Ketamine:
Researchers studied alcohol-dependent patients to examine the amount of days patients were abstinent (i.e. alcohol-free) over the study period, any reduction in heavy drinking days, and time to relapse in those who received motivation enhancement therapy with either ketamine or the control drug, midazolam.
The hypothesis about combining the two aspects (ketamine and motivational therapy) was that ketamine enhances motivation, which the researchers could take advantage of 24 hours post-infusion. Previous trials on the benefits of the motivational therapy showed only modest efficacy, but the researchers hoped those benefits would be amplified with a ketamine infusion.
The Study:
Out of forty patients selected, 17 received a ketamine infusion and 23 received the control. Those who received ketamine were administered a single dose by weight (0.6mg/kg) over 52 minutes. Those who received midazolam were also treated for 52 minutes; Midazolam was chosen as the active control because it alters consciousness without any known effect on alcohol dependence.
The participants were engaged in motivational enhancement therapy twice a week, with the exception of the week that the patient underwent their infusion (week 2). During that week, they met with a psychiatrist for three consecutive days. During the study weeks, the sessions were audiotaped and supervised by a psychiatrist.
The Researcher’s Results was Very Surprising:
For a brief period after the treatment, there were high rates of alcohol abstinence regardless of which medication participants were treated with. That led researchers to conclude that midazolam plus motivational enhancement therapy might provide some relief for alcohol withdrawal or cravings. However, it was not as powerful as ketamine over time.
Ketamine Treatment’s Promising Study:
Ketamine treatment showed promising and significant relief for those receiving treatment with motivational enhancement therapy. The findings suggested that ketamine provided protection against constant relapse and dropout. Ketamine minimized individuals losing hope after using and consequently relapsing or disengaging from treatment. The study suggests new usefulness of ketamine in facilitating addiction treatment and reducing the risk of relapse by helping maintain motivation for sobriety even when dealing with challenges and stressors.
It is hypothesized that ketamine can help reduce relapse by modulating the connectivity between neurons in the prefrontal cortex, however, we believe ketamine’s therapeutic activity likely extends beyond this neurologic biologic level. Whatever the case may be, the researchers concluded that compared to the control group, the ketamine group had a significantly lower proportion of drinking days over time.
The Study May have been too Limiting for a Substantial Outcome:
Of course, there were limitations to the study such as the need for more frequent assessments to test the efficacy of ketamine over time and dropouts in the control group. We look to the future for a larger study with a longer assessment time, more frequent assessments, analysis of the effect of multiple ketamine infusions, and more rigorous examination of the synergy between ketamine and behavioral treatment.
The Results of Using Ketamine Treatment:
In spite of the limiting aspects of the study, the findings are promising for the use of ketamine in treating those with alcohol use disorder, and perhaps other types of substance use disorders. In summary, pairing one single ketamine infusion with five weeks of motivational enhancement therapy, researchers saw significant results in participants and their drinking behaviors.