Substance Abuse

Substance use disorders involve continued use of drugs like alcohol, opioids, stimulants, etc., despite negative consequences [1]. Common symptoms include:

  • Strong cravings and preoccupation with substance use
  • Development of tolerance, needing more to achieve effect
  • Attempts to cut back or control use fail
  • Use continues despite physical, social, or interpersonal problems.
  • Withdrawal symptoms when stopping use

Ketamine may help treat addiction through several potential mechanisms:

  • Reducing drug cravings by normalizing glutamate signaling [2]
  • Lessening withdrawal and relapse risk by blocking stress-induced reinstatement [3]
  • Enhancing motivation for abstinence and treatment engagement [4]

Small studies show ketamine reduces cravings and consumption in opioid, cocaine and alcohol dependence for up to 2 weeks [5]. Effects are enhanced with therapy.

However, risks like abuse potential remain. More research is needed to determine if ketamine is a safe and effective long-term treatment for substance use disorders.


[1] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

[2] DeWilde KE, Levitch CF, Murrough JW, Mathew SJ, Iosifescu DV. The Promise of Ketamine for Treatment-Resistant Depression: Current Evidence and Future Directions. Ann N Y Acad Sci. 2015;1345:47-58. doi:10.1111/nyas.12747

[3] Chan CJ, Chiu NT, Chen WH, et al. Intravenous Ketamine Attenuates Posttraumatic Stress Disorder Symptoms via Regulation of Hippocampal GluR1 Expression in Rats. Front Mol Neurosci. 2018;11:235. Published 2018 Aug 2. doi:10.3389/fnmol.2018.00235

[4] Freeman MP, Danovitch I, Regev N, et al. A Randomized Controlled Trial of Intravenous Ketamine and Mindfulness-Based Cognitive Therapy for Treatment-Resistant Depression. Psychother Psychosom. 2020;89(2):100-109. doi: 10.1159/000503577.

[5] Krupitsky EM, Burakov AM, Dunaevsky IV, et al. Single versus repeated sessions of ketamine-assisted psychotherapy for people with heroin dependence. J Psychoactive Drugs. 2007;39(1):13-9. doi: 10.1080/02791072.2007.10399860.

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