*The FDA has not approved intravenous ketamine or NAD+ for the treatment of any psychiatric or pain condition. These articles reference off-label use. Like all medical treatments, the discussed therapies carry risks and benefits. Speak with a doctor at Clarus Health to learn if these therapies may be right for you.
Addiction Treatment with Ketamine
IV Ketamine can be a powerful tool to treat addiction at the root cause for sustained sobriety
Addiction is a challenging condition that affects over 40 million Americans. There are vanishingly few effective therapies to support long term sobriety. In fact, many therapies have relapse rates between 40-80% at one year. IV Ketamine is a powerful therapy that can support sobriety when used holistically and responsibly.
Addiction: Symptom vs Diagnosis
Addiction is defined by behaviors with three characteristics. Whether to chemical substances, gambling, sex, shopping, or other triggers, addictions involve:
- Short term pleasure
- Long term harm
- Inability to hit the "abort button"
There are several key observations about addictions, which can explain how IV Ketamine can be so effective:
- The addiction is an attempt to satisfy an underlying need
- Addicts are typically not happy with their addiction, but use them in place of satisfying the root cause of their needs
- Addiction is a symptom of seeking something greater (rather than a diagnosis)
The more times a person engages in an addictive behavior, the stronger the behavior becomes engrained in our central nervous system. Neuroscientists give this a catch phrase: "neurons that fire together wire together." This means that the more neurons "fire together" during an addictive behavior (like seeing alcohol and then taking a shot) the more the neurons "wire together." This means that those neurons become more tightly linked and the habit becomes stronger.
How Ketamine Can Break the Addiction Cycle
There are many theories for how IV Ketamine can break the cycle of addiction, including:
- Updating social reward learning
- Enhancing neuroplasticity to form new cognitive loops
- Disrupting deeply engrained behaviors and habits
- Treating co-existing depression, anxiety, and PTSD
- Blocking "reconsolidation" of drug-related reward memories
- Inducing "mystical experiences"
- Supporting talk therapy
Ketamine was initially studied in alcoholics in Russia in the 1990's. It has since been studied in cocaine abuse, food addictions, and other addictions.
Ketamine's potent neuroplasticity is believed to underly some of its addiction treatment effects. This may be due to the increase in brain-derived neurotrophic growth factor (BDNF) that promotes nerve growth. Patients with addiction have lower levels of BDNF, suggesting that supporting BDNF may be part of the solution to long-term healing.
Breaking deeply engrained behaviors is also believed to contribute to Ketamine's effectiveness in treating addiction. This may be due to Ketamine reducing connectivity of brain regions called the default mode network. This network is active during our "thoughtless" or "default" mind states, where addictive tendencies flourish.
Ketamine preparation and integration are key to long-lasting results. This allows the "mystical" experiences to be better engaged with to allow for becoming "unstuck" from the grips of addiction. It involves careful preparation with your doctor before starting your Ketamine journey and "processing" with your therapist after each experience. The greater the mystical experience the greater the addiction treatment effect of the Ketamine.
Ketamine Affects Memory Consolidation
Every time a stable memory is accessed, our brain modifies that memory. The stable memory is considered "consolidated" and the modification of that memory is called "reconsolidation." Reconsolidation can increase or decrease the emotional connection to that memory. For example, phobias can be worsened or healed based on how the phobia's memory is consolidated. Ketamine's NMDA receptor antagonism can disrupt maladaptive memories (related to both addiction and trauma). Ketamine doesn't erase memories, but through its neuroplasticity, can change our relationship with harmful and painful memories.
Is Ketamine Addictive?
Ketamine can be a drug of abuse when used outside of ethical and responsible medical settings. Fortunately, when used in medically supervised settings, the risk of addiction appears very low. However, there must always be a risk-benefit discussion when using Ketamine, especially with patients who are susceptible (genetically, socially, etc.) to addiction.
Anthony Kaveh MD
Dr. Kaveh is a Stanford and Harvard-trained anesthesiologist and integrative medicine specialist. He has over 800,000 followers on social media and has guided hundreds of patients throughout transformative healing experiences. He is an authority on Ketamine, NAD, and SGB therapies. He is a registered continuing education lecturer in the Bay Area.
