New Research
A Single Ketamine Infusion Combined With Mindfulness-Based Behavioral Modification to Treat Cocaine Dependence
: A Randomized Clinical Trial
Elias Dakwar , M.D., Edward V. Nunes , M.D., Carl L. Hart , Ph.D., Richard W. Foltin , Ph.D., Sanjay J. Mathew , M.D., Kenneth M. Carpenter , Ph.D., C.J. “Jean” Choi , M.S., Cale N. Basaraba , M.P.H., Martina Pavlicova , Ph.D., Frances R. Levin , M.D.
Published Onlin Jun 2019[doi.org]
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Abstract
Objective:
Research has suggested that subanesthetic doses of ketamine may work to improve cocaine-related vulnerabilities and facilitate efforts at behavioral modification. The purpose of this trial was to test whether a single ketamine infusion improved treatment outcomes in cocaine-dependent adults engaged in mindfulness-based relapse prevention.

Methods:
Fifty-five cocaine-dependent individuals were randomly assigned to receive a 40-minute intravenous infusion of ketamine (0.5 mg/kg) or midazolam (the control condition) during a 5-day inpatient stay, during which they also initiated a 5-week course of mindfulness-based relapse prevention. Cocaine use was assessed through self-report and urine toxicology. The primary outcomes were end-of-study abstinence and time to relapse (defined as first use or dropout).

Results:
Overall, 48.2% of individuals in the ketamine group maintained abstinence over the last 2 weeks of the trial, compared with 10.7% in the midazolam group (intent-to-treat analysis). The ketamine group was 53% less likely (hazard ratio=0.47; 95% CI=0.24, 0.92) to relapse (dropout or use cocaine) compared with the midazolam group, and craving scores were 58.1% lower in the ketamine group throughout the trial (95% CI=18.6, 78.6); both differences were statistically significant. Infusions were well tolerated, and no participants were removed from the study as a result of adverse events.

Conclusions:
A single ketamine infusion improved a range of important treatment outcomes in cocaine-dependent adults engaged in mindfulness-based behavioral modification, including promoting abstinence, diminishing craving, and reducing risk of relapse. Further research is needed to replicate these promising results in a larger sample.

My resident drug guru said, this is well known among users. Good to see clinical evidence now.
The critical garndma says; but won't you then have an addiction to ketamine?
No, says the guru. You cannot get addicted to Ketamine.
Ha, ha, ha , says the grandma.