Some evidence suggests ketamine may help reduce withdrawal symptoms and may promote neuroplasticity, but controversy exists on whether the risks of ketamine outweigh its potential benefits.

Ketamine is a drug originally developed for use in anesthetic and pain management. It’s considered a dissociative anesthetic, which means it creates a sense of detachment from your senses and surroundings in order to generate pain relief, amnesia, and sedation.

While ketamine is primarily used to induce general anesthesia for medical procedures, it’s gaining ground as a therapeutic agent for several other health conditions. One area where it appears to hold promise is in the treatment of opioid use disorder (OUD).

OUD — a pattern of chronic opioid use that causes significant distress and impairment — is a type of substance use disorder (SUD) that affects an estimated 16 million people around the world.

Ketamine doesn’t directly counteract opioid use, but it may aid in the treatment of OUD for some people.

According to a systematic review from 2018, ketamine can help reduce symptoms of opioid withdrawal, like cravings, and may help relieve co-occurring psychological symptoms like depression. Also, the anesthetic properties of ketamine may help with some of the physical discomfort experienced during opioid withdrawal.

Ketamine does this by affecting neurotransmitters like glutamate and dopamine, which guides communication between neurons in your brain. A review from 2020 indicates ketamine may also improve how well your brain neurons form, connect, and interact (a trait called neuroplasticity).

According to the review authors, ketamine’s ability to enhance dopamine signaling could also help fix deficits in neuron signaling created by opioid misuse.

Want to get involved?

If you’d like to help researchers understand how ketamine may be able to help relieve OUD or its symptoms, you may be able to join a clinical trial.

Check out ClinicalTrials.gov to see if you meet the requirements for any currently open studies, but make sure to discuss participation with a primary healthcare professional beforehand.

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The use of ketamine for OUD is still controversial.

Despite potential therapeutic benefits, ketamine comes with a long list of potential side effects and risks. As a potentially addictive substance on its own, ketamine also has the capacity for misuse and abuse.

Possible side effects from ketamine treatments are numerous and can develop throughout a variety of systems in your body.

Common experiences include:

Ketamine therapy isn’t recommended for use with certain cardiovascular conditions, in people who are pregnant, or for anyone living with schizophrenia.

In some people, ketamine can cause potentially life threatening side effects like respiratory failure or cardiac arrest. During ketamine-assisted therapy, your healthcare team will monitor your mental and physical health for any side effects.

Access to ketamine therapy for OUD is another potential difficulty for many people. Because it’s a substance controlled by the Drug Enforcement Agency (DEA), the possession, distribution, and production of ketamine is regulated by federal law.

What’s more, ketamine isn’t currently approved for use in the treatment of OUD or any mental health condition, which means adding it to a treatment regime can become complicated by regulatory concerns.

Not all healthcare professionals will be able or willing to use ketamine off-label for a purpose other than what it’s approved for by the Food and Drug Administration (FDA). According to the FDA, ketamine hasn’t been proven safe or effective for any mental health condition, which includes OUD.

Due to the off-label nature of using ketamine therapy for OUD, health insurance carriers may not cover its costs, further limiting accessibility for many people.

Learn more about opioid treatment and rehab

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The use of ketamine for OUD is an ongoing area of research. Some evidence suggests ketamine may help improve neuroplasticity and reduce opioid withdrawal symptoms, but more research is needed to prove its efficacy and safety.

Due to its potential for abuse, long list of potential side effects and risks, and limited accessibility, ketamine therapy may not be an option for everyone recovering from OUD.