Study shows abstinence from alcohol improved when ketamine and talk therapy were combined.
We’ve talked before about the benefits of ketamine to reduce the craving for cocaine and for alcohol use, as well. A substance use disorder is can be a prison with no way out. We’re going to talk about the work of researcher who works for relief and freedom for those with disorders like this, Elias Dakwar, M.D., and his study using ketamine plus motivation enhancement therapy. But first, Jackson’s story can give an idea about how much suffering can happen for those with this type of disorder.
Jackson wiped the sweat from his forehead, and told himself he could do this. He had an AA meeting in a few hours. Surely, he could make it till then.
He tried to focus on the TV, to get his mind off the yawning craving he felt for a drink. It had been three days since his last drink, and he knew if he started drinking again, he’d be right back at the crack house.
Nobody told him it was like this.
If he could stay away from crack, he might almost be able to get clean and stay clean. But he knew from experience that if he saw some on the table, there would be no avoiding it.
But what was really frustrating, was that drinking alcohol always led to his seeking out crack cocaine. He didn’t know why…but it just happened that way.
You know, when you’re partying with friends, or even just getting together for dinner… everyone’s always drinking. And you think Why not? Glass of wine or a beer… no big deal, right?
But one drink would lead to another… and another. And the next thing he knew he was waking up wasted. Hating himself.
Why oh why did he ever try cocaine the first time? It had wrecked his life. But he couldn’t blame it all on that. He knew that tendency to have one drink after another could be a problem, even if he hadn’t tried crack cocaine.
It definitely was not a well thought out, informed decision, by any stretch. It was sudden, impulsive, and fit right in with the fun he was having.
And it destroyed his life.
There was no way he realized at the time how it would put a ring in his nose and lead him around whether he liked it or not.
It was fun for awhile, but after some time he’d burned through his paychecks, his credit cards, and sold what he had just to get more. He’d stolen from his family, and betrayed everyone who mattered to him.
He wanted out.
But there was no getting out… it was like a vice clamped on his mind that wouldn’t let go.
Sheer Will is Often NOT Enough
So he’d stayed away from it for nearly a week, then went to dinner with friends. Of course, everyone had drinks, so he ordered one too. By dawn…he’d been using this stuff all night long. And had no idea what had happened to his car.
That happened over and over…and over.
He would have the best intentions, and ask his family to loan him money for his car payment, or help him buy a new car, so he could go to work and keep his job. And over and over again… he’d have a drink with friends and end up at the crack house.
So now. He had been going to Alcoholics Anonymous, and to Narcotics Anonymous. He was determined to win.
Then, his girlfriend just got fed up with it all and broke up with him. He NEEDED her. Why would she leave him now when he needed her the most??
He just needed something to help him relax…So he picked up a six pack of beer. Three days later he finally dragged himself out of that same awful flop house… and he was hating himself. Why couldn’t he find the willpower to stop drinking and stop using crack cocaine?
What Do You Do When You Can’t Stop?
If you suffer with substance use disorder or alcohol use disorder, the cravings can be so strong because of changes in your brain that cause them. But as far back as 2013, Elias Dakwar, M.D., published his research showing that IV ketamine can dramatically reduce these cravings.
Now, a research team led by Dr. Dakwar that includes shining stars like Sanjay Mathew, M.D., Frances Levin, M.D., and Carl Hart, M.D. has published another study that has taken this work a step further.
This new pair of studies shows that ketamine plus motivation enhancement increases abstinence for people with dependence.
In our story of Jackson above, we learned about his experience trying to abstain from both alcohol and cocaine. There are also those who struggle to abstain from either alcohol or cocaine individually.
People who fit in both of these categories can benefit from the work of Dr. Dakwar’s team.
They completed two studies in 2019 and 2020. One for alcohol use disorder and one for cocaine use disorder.
Cocaine Use Disorder
Dr. Dakwar’s team, including Sanjay Mathew, M.D., Frances Levin, M.D., and Carl Hart, M.D., has published another study that has taken this work a step further. These researchers were part of the team who conducted the 2013 study.
His early study included 8 volunteers and demonstrated how IV ketamine could reduce cravings for cocaine.
This new 2019 study included 55 cocaine dependent individuals who were admitted as inpatients for 5 days. During this study, they were randomly divided and one group received a single ketamine infusion and the other received a midazolam infusion. In addition, they began a 5 week course on mindfulness-based relapse prevention.
As it turned out, 48.2% of those who received ketamine with the mindfulness-based course maintained abstinence through the last 2 weeks of the treatment course, whereas only 10.7% of the midazolam group achieved the same.
So, this led to the study with alcohol use disorder.
Alcohol Use Disorder
It’s surprising to realize that death from alcohol use disorder accounts for a whopping 3.8% of all deaths globally.
And that’s just the deaths. It goes without saying that the impairment of life, the breakdown in families, the cost due to sick days related to alcohol use disorder is gargantuan and is an enormous social and economic problem in our society.
And while 12 step programs provide a valuable service, helping many to abstain and rebuild their lives, there are too many that fall through the cracks. Because of cravings.
Ketamine Plus Motivation Enhancement Therapy
So this team designed a study that involved more subjects than the earlier work, and that measured the impact of combining IV ketamine plus with motivation enhancement therapy in subjects with alcohol dependence.
These subjects were enrolled in motivation enhancement therapy, which had been determined to be only modestly effective by itself. They were given 6 sessions during a 5 week period, with a single ketamine infusion at week 2 then a motivational enhancement session 24 hours after that infusion.
Another group was given midazolam instead of ketamine infusions during week 2 with a motivation enhancement session 24 hours after the infusion.
As it turned out, the subjects who were given ketamine with the motivation enhancement therapy were able to abstain from alcohol longer than those given midazolam. 82% of them were still abstaining at the end of 3 weeks when the study completed. Of those given midazolam, only 65% were still abstaining.
And possibly one of the best outcomes of all, was that more of those given ketamine resumed abstinence if they relapsed than those given midazolam.
And this was with only one infusion.
Studies are conducted under strict controls, but imagine how much a full ketamine plus motivation enhancement therapy 24 hours after each infusion can do for you ability to stay sober and build the life you want to live.
Ketamine plus motivation enhancement therapy can be life-changing for you if you can relate to someone like Jackson.
At Innovative Psychiatry, we welcome the opportunity to collaborate with your therapist and the rest of your healthcare team to help you break the hold that cocaine or alcohol may have in your life.
There is evidence that talk therapy 24-48 hours after your ketamine infusions can be far more effective than talk therapy alone. One reason for this may be the neuroplasticity that ketamine stimulates. It makes it easier for your brain to change, think new and different thoughts…see things in a new way.
There is hope for Jackson, and there is hope for you. Don’t give up if substance use disorders have made you lose control of your life. Ketamine plus motivation enhancement or some form of relapse prevention therapy can give you back your life and your sense of control.
Of course, it will take work, but you don’t have to feel helpless. You can get your self respect, your dignity, and your joy back. You can rebuild those damaged relationships and build a rewarding life.
We want to see you whole and free.
To the restoration of your best self,
Lori Calabrese, M.D.