Is ketamine addictive? Is it habit forming? Is it abusable?
What will happen if I treat a client with ketamine who suffers from either an active or stable history of substance use disorder? These are some of the leading questions that are being investigated with regards to ketamine’s ability to treat clients with these conditions.
It is well known that ketamine has been used as a drug of recreational abuse for decades, particularly in the nightclub subculture. While rare, cases of ketamine addiction have been described both anecdotally as well as in the medical literature. However, a recent study has demonstrated that ketamine actually has a very low addiction potential.
Here is why:
Like other addictive substances, ketamine does interact with the neurotransmitter dopamine, in brain areas involved with addictive disorders such as the nucleus accumbens (NA) and the ventral tegmental area (VTA). However, a recent study shows that while ketamine does stimulate dopamine, it does not have the reinforcing properties that other drugs have because it does not let dopamine activity run rampant in the brain. Instead, ketamine seems to put the brakes on further dopamine involvement in brain areas associated with addiction, and thus is unlikely to cause addiction.
Other research demonstrates that ketamine, in combination with certain forms of psychotherapy, can be effective in treating clients who suffer from alcohol use disorder, cocaine use disorder and heroin/opiate addiction.
When thinking about ketamine as a way to treat addictive disorders it is important to remember that many people who suffer from addiction also suffer from underlying psychiatric problems such as depression, severe anxiety, PTSD, bipolar disorder and other problems related to severe trauma. These are commonly known as “Co-occurring disorders”. The “self-medication hypothesis” suggests that many people who suffer from these co-occurring disorders actually “self-medicate” with drugs of abuse as a way to ease the underlying symptoms of these disorders. Unfortunately, self-medication with drugs of abuse often leads to more complicated problems with substance abuse and addiction.
Clinically, we see that many clients are able to manage their substance use problems and even achieve remission from addictive disorders once the underlying psychiatric problems are stabilized, which is why ketamine can be very effective for clients who suffer from substance use issues.
Click here to download the reference article by Linda D. Simmler, Yue Li, Lotfi C. Hadjas, Agnès Hiver1, Ruud van Zessen & Christian Lüscher