How Ketamine Can Help Those With Alcohol Use Disorder
February 10, 2021
Millions of Americans struggle with substance use disorders, and nearly three quarters of those with addiction cite alcohol as their substance of choice. The prevalence of alcohol in advertisements and other cultural imagery can make recovering from alcohol dependency even more difficult for those with unhealthy drinking habits.
Fortunately, psychiatric research continues to explore various treatment interventions that may help those grappling with alcohol addiction flourish into an addiction-free life. The administration of ketamine by mental health professionals shows a promising future in helping those dealing with alcohol use disorder. Read down below to learn more about the bright future that ketamine shows for substance use treatment:
- What is ketamine?
- What is alcohol use disorder?
- How ketamine and other treatment options can help with alcohol addiction
What is Ketamine?
Ketamine is a dissociative anesthetic that can be used medicinally in either powdered or liquid form. It’s typically used in human anesthesia and veterinary medicine to provide pain relief and induce unconsciousness in patients before medical procedures.
Ketamine is usually administered intravenously for clinical purposes, and it’s most often utilized in emergency operating rooms and post-op pain management treatments. Though the history of ketamine is mainly rooted in medicine, research has discovered the potential uses for the anesthetic to span from treating mood disorders, anxiety, and alcohol use disorder.
History of Ketamine
Ketamine was originally discovered in a laboratory in 1962 when chemist Calvin Stevens was researching an alternative anesthetic medicine to phencyclidine, which has been discontinued for use in medicine. Research on ketamine was conducted on animals for two years before human subjects had started to be used in 1964.
Ketamine offered a safer alternative anesthetic option without the many dangerous side effects of phencyclidine, and ketamine was officially introduced as an anesthetic in clinical practice in 1970. The first major clinical use of the medicine was in treating soldiers injured during the Vietnam War.
Ketamine works as an anesthetic and pain reliever by interrupting nerve signals throughout the brain and body, preventing the brain from processing pain or maintaining memory of a clinical procedure. In its uses for mental disorder treatment, ketamine targets specific receptors in the brain--these include the depression-related NMDA, AMPA, and sigma receptors.
Ketamine’s blocking of the NMDA, AMPA, and sigma receptors can disrupt pathways in the brain associated with depression symptoms. Research studies performed throughout the late twentieth-century into present-day continue to discover ketamine’s wide-ranging effects on various mental disorder diagnoses.
Common Uses for Ketamine in Mental Health
Major depression is a mood disorder with symptoms of prolonged depressed mood, disruptions in eating and sleeping patterns, and generally loss of interest in life activities and socializing that lasts for at least two weeks. Though antidepressant medication is a common treatment option for the mood disorder, studies have shown that ketamine works much faster than antidepressants.
Intravenous ketamine administration has displayed depression symptom relief in a matter of a few hours compared to the weeks that antidepressants typically require to start working. Areas of the brain associated with symptoms display heightened metabolism rates following ketamine administration, which explains the rapid effects. Ketamine is FDA approved for treatment-resistant depression.
Post-Traumatic Stress Disorder (PTSD)
PTSD is defined by symptoms of heightened stress and flashback reexperiences in response to a traumatic event. Trauma-focused psychotherapy and medications are common treatment options for PTSD, but ketamine can also provide relief for symptoms.
Studies show that ketamine can prevent avoidance tendencies following a traumatic event, which can reduce stress and anxiety in response to a trauma. Ketamine also disrupts the brain in consolidating traumatic memories and makes it easier for PTSD patients to avoid reliving traumas. Ketamine treatment for PTSD is still investigational and not FDA approved yet.
What is Alcohol Use Disorder?
Alcohol use disorder is defined by a pattern of uncontrollable drinking, preoccupation with consuming alcohol, and having to consume higher amounts of alcohol to achieve the same effects. Those with alcohol use disorder often continue drinking even when alcohol begins to disrupt their lives and may suffer from withdrawal symptoms if they don’t maintain their alcohol consumption.
Alcohol use becomes unhealthy when it jeopardizes your own safety and health. Alcohol use disorder can cause extreme distress and problematic functioning in one’s daily life, and it ranges from mild to severe forms. Early diagnosis and treatment is essential in curtailing the detrimental health effects that a mild disorder can cause.
- Inability to limit how many drinks you consume
- Desire to reduce drinking and unsuccessful attempts to do so
- Work, school, and home obligations disrupted by alcohol use
- Maintaining alcohol use despite health, social, and interpersonal problems it causes
- Developing a higher tolerance to alcohol that requires higher consumption to achieve effects
- Withdrawal symptoms if drinking isn’t maintained, including nausea, sweating, and tremors
Ketamine and Other Potential Treatments for Alcohol Addiction
Various research studies have confirmed the relieving effects that ketamine can provide for those suffering with alcohol use disorder. Symptom relief is amplified when ketamine is combined with another treatment, such as therapy or counseling. Ketamine treatment for substance use disorders is investigational and not yet approved by the FDA, but there’s considerable evidence of its efficacy.
A study from 2019 focused on the alcohol addiction relief provided by ketamine combined with motivational enhancement therapy. Motivational enhancement therapy encourages patients to cease their drug use and consider addiction treatment. Patients receiving this therapy approach along with the administration of ketamine showed higher rates of abstaining from alcohol use, longer time elapsed before succumbing to relapse, and fewer days of heavy drinking compared to those receiving just psychiatric medication.
Another study from 2019 assessed the effects of ketamine on memory reconsolidation in those with excessive drinking patterns. Memory plays a role in alcohol addiction because drinkers tend to develop learned associations between environmental cues related to alcohol and expected reward from consuming alcohol.
An example is how images of alcoholic drinks may cause drinkers to recall memories associated with consuming alcohol as well as the memories of pleasure from drinking, eventually inducing them to consume alcohol in pursuit of that reward. When ketamine was administered to drinkers during this process of alcohol-related memory reconsolidation, ketamine interfered with the memory recall process and displayed decreased alcohol use in study subjects.
The first step in treating alcohol use disorder with medication is detox. For heavy, long-term drinkers, detoxing from alcohol can lead to painful and potentially life-threatening withdrawal symptoms. Fortunately, medications can help manage withdrawal and make it less uncomfortable.
Withdrawal symptoms typically appear between a few hours and a few days after drinking ceases, and they include severe tremors, headaches, nausea, and anxiety. An extreme symptom is seizures that can be life-threatening without medical attention. Detox and medication management are typically provided at inpatient substance abuse treatment centers and hospitals. Typically, these providers will provide medication to reduce withdrawal symptoms while observing patients’ progress, and the process of detox lasts between two and seven days.
There are also medications that have been shown to reduce desire to drink. Disulfiram can induce symptoms of nausea, vomiting, and headaches when one consumes alcohol to discourage drinking. Naltrexone can reduce the feelings of pleasure that can result from drinking. Acamprosate can help combat alcohol cravings once one ceases drinking. Mental health professionals and inpatient treatment providers can help connect those with alcohol addiction to these medications.
Substance abuse counseling is a common and effective treatment option that can be combined with medication management. Licensed counselors help those suffering from a chemical or alcohol dependency gain self-sufficiency. While they don’t prescribe medication or practice psychotherapy, their focus on advocating against chemical use and providing mentoring are effective for those with alcohol use disorder.
Substance abuse counselors ultimately help those with a chemical dependency understand the underlying nature of their dependency, overcome trauma that may play a part in their addiction, build the support network needed to successfully recover, and learn self-sufficiency with gainful employment and other necessary mundane tasks. Counselors can help those with alcohol use disorder combat their habits and flourish into a self-sufficient person free of chemical dependency. Counselors tend to work at hospitals and inpatient treatment centers.
Transcranial Magnetic Stimulation (TMS Therapy)
The therapeutic mechanisms behind TMS therapy are based on the delivery of electromagnetic pulses that transmit through the human skull, influencing activity levels in areas of the brain. Since the brain’s mode of communication relies on electrical currents to influence its vital functions, the pulses transmitted by a TMS device can adjust areas of irregular neuronal activity in the brain. TMS therapy is often practiced in treating major depression and OCD, but its mechanisms show promise in helping those with substance use disorders.
Though research has focused on chemical dependency in relation to the brain for the last few decades, a treatment based on neurons and neuronal circuits has yet to be curated. However, researchers have begun to study how TMS can affect the brains of those who abuse cocaine or alcohol.
Previous research studies have concluded that certain cues and triggers those with substance use disorder associate with their substance of choice can induce increased neuronal activity in various brain areas. Studies focused on assessing brain activity prior to and following TMS therapy--they specifically wanted to know if TMS could decrease and regulate those areas of heightened neuronal activity.
The studies concluded that TMS was successful in reducing brain activity in response to substance use cues in both alcohol and cocaine users. This means that TMS has the potential to curb patients’ reactivity to these triggering cues. The only downside to these results is that there’s no guarantee that reduced reactivity will lead to reduced substance use behaviors. Nonetheless, these results can lead to a promising future in TMS therapy research regarding the therapy’s effects translating to behavioral changes in substance users.
Grappling with any substance use disorder can be incredibly difficult and stressful, but there’s always professional help to make persevering to recovery more possible. If you know someone who’s struggling with their alcohol consumption, rest assured that there are plenty of effective resources to aid them in overcoming their addiction.