Ketamine psychotherapy for heroin addiction: immediate effects and two-year follow-up
This randomised double-blind clinical trial (2002, n=70) found that existential psychotherapy in combination with psychedelic doses of intramuscular (im) ketamine (140mg/70kg) achieved larger results in the treatment of heroin addiction than sub-hallucinogenic doses (14mg/70kg).
Authors
- Rick Strassman
Published
Abstract
Seventy detoxified heroin-addicted patients were randomly assigned to one of two groups receiving ketamine psychotherapy (KPT) involving two different doses of ketamine. The patients of the experimental group received existentially oriented psychotherapy in combination with a hallucinogenic (psychedelic) dose of ketamine (2.0 mg/kg im). The patients of the control group received the same psychotherapy combined with a low, non-hallucinogenic (non-psychedelic), dose of ketamine (0.2 mg/kg im). Both the psychotherapist and patient were blind to the dose of ketamine. The therapy included preparation for the ketamine session, the ketamine session itself, and the post session psychotherapy aimed to help patients to integrate insights from their ketamine session into everyday life. The results of this double blind randomized clinical trial of KPT for heroin addiction showed that high dose (2.0 mg/kg) KPT elicits a full psychedelic experience in heroin addicts as assessed quantitatively by the Hallucinogen Rating Scale. On the other hand, low dose KPT (0.2 mg/kg) elicits sub-psychedelic experiences and functions as ketamine-facilitated guided imagery. High dose KPT produced a significantly greater rate of abstinence in heroin addicts within the first two years of follow-up, a greater and longer-lasting reduction in craving for heroin, as well as greater positive change in nonverbal unconscious emotional attitudes than did low dose KPT.
Research Summary of 'Ketamine psychotherapy for heroin addiction: immediate effects and two-year follow-up'
Introduction
Krupitsky and colleagues situate their study within a body of work suggesting that drug-assisted, or psychedelic, psychotherapy can enhance conventional psychotherapy and may have particular utility in addiction treatment. Earlier clinical reports from the 1960s and 1970s, more recent studies of ketamine in alcoholism, and anecdotal evidence for ibogaine indicate possible anti-craving and transformative effects, but methodological heterogeneity, legal constraints and concerns about toxicity for some compounds have limited replication. The authors note specific practical reasons for studying ketamine in Russia: a recent heroin epidemic linked to HIV, and the legal prohibition of opioid agonist maintenance therapies such as methadone and buprenorphine, leaving few treatment options beyond naltrexone and psychosocial approaches. This paper reports a double-blind, randomised clinical trial comparing ketamine psychotherapy (KPT) using a psychedelic, high dose (2.0 mg/kg intramuscular) with an active, sub-psychedelic low dose (0.20 mg/kg intramuscular) in 70 detoxified intravenous heroin addicts. The investigators aimed to test whether a full psychedelic ketamine experience combined with existentially oriented psychotherapy produced greater abstinence, larger reductions in craving, and more pronounced psychological and nonverbal emotional changes than the same psychotherapy paired with a low, active-placebo ketamine dose, with follow-up extending to 24 months.
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Study Details
- Study Typeindividual
- Journal
- Compound
- Topics
- Author
- APA Citation
Krupitsky, E., Burakov, A., Romanova, T., Dunaevsky, I., Strassman, R., & Grinenko, A. (2002). Ketamine psychotherapy for heroin addiction: immediate effects and two-year follow-up. Journal of Substance Abuse Treatment, 23(4), 273-283. https://doi.org/10.1016/S0740-5472(02)00275-1
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Papers cited by this study that are also in Blossom
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Krupitsky, E. M., Grinenko, A. Y. · Journal of Psychoactive Drugs (1997)
Strassman, R. J. · Journal of Nervous and Mental Disease (1995)
Strassman, R. J., Qualls, C. R., Berg, L. M. · Biological Psychiatry (1996)
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