Ketamine, a hallucinogenic drug that has already shown promise as a treatment for brain disorders such as depression, may also be effective at treating alcoholism, according to researchers at Columbia University. In combination with psychotherapy, the drug appears to help patients control their problem drinking behavior for weeks at a time. It may also help patients to recover when they experience a relapse of their problem drinking behavior.

One Dose at a Time

In the study, the researchers administered a single dose of ketamine to participants under controlled circumstances. Afterward, the participants also received motivational therapy on an outpatient basis. A control group of participants received a dose of midazolam, a drug used to treat alcohol withdrawal symptoms, rather than ketamine.

Three weeks after the administration of the drugs, 82% of the participants who received ketamine were still abstaining from drinking, as compared to only 65% of the midazolam group. Overall, those in the ketamine group were less likely to experience a relapse, less likely to have heavy-drinking days, and more likely to return to abstinence after a relapse.

The reason for ketamine’s effectiveness is not clear. One theory is that it helps patients to respond to motivational therapy, a therapeutic approach that is not typically effective in treating alcoholism.

“One possibility is that ketamine addresses addiction-related vulnerabilities, like low motivation and low resilience, that contribute to problematic use. This may create a window where they can benefit more from behavioral treatment and lay the groundwork to meet their goals,” says Elias Dakwar, MD, the study’s lead author.

A striking effect of ketamine is that it seems to have made participants better able to handle the inevitable setbacks in their quest for improvement.

“In our participants, ketamine appears to have increased resilience and reduced demoralization after a lapse,” says Dakwar. “Participants may have been better able to bounce back after slipping, and they may have been more motivated to resume the work of recovery. In the midazolam group, on the other hand, there was a higher likelihood of escalating use after slipping and either relapsing or dropping out.”

A New Class of Treatments

The possibility of ketamine as a treatment for alcoholism fits into a body of recent research that is revealing the therapeutic effects of psychoactive drugs. This class of drugs, which also includes MDMA and psilocybin, may be able to significantly alter behavior in patients with a wide range of brain disorders, particularly when combined with psychotherapy. The Columbia team undertook the study on alcoholism after conducting a similar study that showed ketamine to be effective at treating cocaine addiction.

The scientists at Columbia are continuing to research ketamine’s use as a treatment for alcoholism. Further research will attempt to determine if multiple doses of the drug will produce even better results than a single dose.

Columbia University, Single Dose of Ketamine Plus Talk Therapy May Reduce Alcohol Use
The American Journal of Psychiatry, A Single Ketamine Infusion Combined With Motivational Enhancement Therapy for Alcohol Use Disorder: A Randomized Midazolam-Controlled Pilot Trial

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