KETAMINE - MEDICAL USES, DEPENDENCY & TREATMENT - Written by Dean Gustar, Relapse Prevention Specialist

What is Ketamine

Ketamine is a medication that is primarily used as a general anaesthetic for surgical procedures. It is also used as a sedative and pain reliever. In low doses, it can also be used as an antidepressant. It is a dissociative anaesthetic, meaning it causes a person to feel detached from their surroundings and can produce hallucinations. Ketamine is also used in veterinary medicine as an anaesthetic for animals.

There is a growth of ongoing research taking place around the use and efficacy of ketamine as a medical treatment for a variety of different psychiatric conditions. These include depression, especially treatment-resistant depressions, and alcohol and drug dependency. Ketamine is also recognised in clinical practice as a preventative medicine in the management of cases of acute suicidal risk.

Ketamine is sometimes used as a recreational or party drug due to its dissociative and hallucinogenic effects. It is usually snorted or taken orally in a powder or liquid form. Recreational users often describe the effects of ketamine as "out of body" or "dissociative" experiences, in which users feel detached from their surroundings and their own bodies. Some people also report experiencing hallucinations, euphoria, and a sense of detachment from reality.

Taking ketamine recreationally can be dangerous, as it can cause confusion, and delirium, as well as other negative long-term effects such as respiratory depression and cognitive impairment. Additionally, there is a possibility of overdose, particularly when ketamine is combined with other substances. It is also important to note that ketamine is a controlled substance, and its possession and use is illegal in many countries.

Clinical use of Ketamine for treatment-resistant depression

Ketamine has been studied as a potential course of treatment for treatment-resistant depression, which is a form of depression that does not respond to traditional antidepressants. Researchers suggest that ketamine may work by rapidly and effectively reducing depressive symptoms, including suicidal thoughts, in affected patients who have not responded to other treatments.

Ketamine works by binding to a specific type of glutamate receptor in the brain, known as the NMDA receptor. This leads to an increase in the levels of certain neurotransmitters, such as glutamate and GABA, which play a role in regulating mood.

Clinical studies that have treated people with treatment-resistant depression have shown that a single dose of ketamine can produce a rapid and significant reduction in signs of depression, often within hours of administration. The duration of effectiveness can last for several days to a week, but varies from person to person.

Ketamine should be administered only under the supervision of a qualified healthcare professional and in a clinical setting, as it can cause a distortion of reality and dissociation, and has potential for abuse and dependence.

Clinical use of Ketamine in the treatment of alcohol use disorder and substance use disorder

Ketamine has been studied as a potential treatment for alcoholism and addiction to other substances, such as opioids and cocaine. Research has shown that ketamine may help reduce cravings and the risk of relapse in persons with these conditions.

One mechanism by which ketamine may be effective in treating addiction is through its ability to regulate the activity of certain neurotransmitters, such as glutamate and GABA, which play a role in regulating mood and addiction-related behaviours.

Research studies have also shown that ketamine can frequently reduce the depressive symptoms and anxiety in individuals with alcoholism, which may in turn help them to better cope with the challenges of addiction recovery, and influence positive outcomes.

It's also worth noting that addiction treatment is typically a multidisciplinary approach, so it's important to seek professional help from addiction specialists and services, who can provide a comprehensive treatment plan that addresses the physical, psychological, and social aspects of addiction.

What is Ketamine addiction

Ketamine addiction is characterised by a problematic pattern of using ketamine that leads to clinically significant impairment or distress. This can manifest in several ways such as continuous use despite knowledge of having a physical or psychological problem that is likely to have been caused or exacerbated by the substance, difficulty in controlling use, spending a lot of time using the substance or recovering from its effects, giving up important activities in order to use the substance, and using the substance despite the risk of harm to oneself or others.

Indicators of ketamine addiction include strong cravings for the drug, difficulty controlling use, continuing to use despite negative consequences, and withdrawal symptoms such as agitation and insomnia when not using the drug. Long-term use can also lead to cognitive impairment, bladder pain and dysfunction, and chronic kidney disease.

It is important to note that ketamine use disorder is not widely recognised as a separate diagnosis and is often referred to as substance-related disorder.

What are the risks associated with Ketamine use

The most common risks associated with ketamine use include disorientation, confusion, loss of coordination and delirium. High doses can also lead to respiratory depression, which can be fatal. Other potential side effects include increased heart rate and blood pressure, nausea, and vomiting.

Long-term use of ketamine can also lead to cognitive impairment, bladder pain and dysfunction, chronic kidney disease, and liver damage. Additionally, ketamine can be addictive, and people who use it regularly may develop a dependence on it. Mixing ketamine with other substances can also increase the risk of negative side effects.

What are the signs of Ketamine addiction

The warning signs of ketamine addiction can include:

1. Tolerance: needing more of the drug to achieve the desired effect.
2. Withdrawal: experiencing negative symptoms such as agitation, insomnia, and cravings when not using the drug.
3. Loss of control: difficulty controlling use and continuing to use despite negative consequences.
4. Prioritising drug use: giving up important activities or neglecting responsibilities in order to use the drug.
5. Continued use despite harm: using the drug even when it causes physical or psychological problems.
6. Neglecting self-care: neglecting personal hygiene or neglecting physical health.
7. Social, occupational or recreational activities are given up or reduced because of drug use.
8. Persistent desire or unsuccessful efforts to quit or reduce use.

It's important to note that addiction is a complex condition, and it may not manifest the same way for everyone. If you suspect someone you know might be struggling with a ketamine addiction, it's important to seek professional help, as being addicted to a substance can have serious and long-term negative effects on a person's health and well-being.

How to treat Ketamine addiction

Treatment for ketamine addiction typically involves a combination of therapy and medication.

• Behavioural therapy: This can include cognitive-behavioural therapy, which helps individuals identify and change negative thought patterns and behaviours related to drug use. It can also include other therapies such as motivational interviewing, which helps individuals overcome ambivalence and resistance to change.
• Medication-assisted treatment: While there are currently no reported FDA-approved medications specifically for treating ketamine addiction, some medications may be prescribed to help manage the withdrawal process, such as antidepressants and anti-anxiety medications.
• Rehabilitation and Residential Programmes: This can include inpatient or outpatient programmes, where individuals receive around-the-clock care and support as they detox and recover from addiction.
• Support groups: Support groups such as Narcotics Anonymous or SMART recovery can provide a sense of community and accountability for people in recovery and can be beneficial in helping people maintain sobriety.

It's important to note that treatment should be tailored to the individual and may vary depending on the severity of addiction and other factors such as co-occurring mental health conditions.

Additionally, an emphasis on follow-up care and aftercare support can be essential for maintaining long-term recovery, as relapse is a common part of the recovery process for most people.

How to support a family member with Ketamine addiction

Supporting a family member with ketamine addiction can be challenging, but there are a few things you can do to help:

• Educate yourself: Learn as much as you can about ketamine addiction and its effects on the mind and body.
• Listen and be understanding: Let your loved one know that you are there for them and that you understand the difficulties they are facing.
• Be non-judgmental: Avoid criticising or blaming your loved one for their addiction.
• Encourage them to seek professional help: Help your loved one find a qualified addiction treatment professional and encourage them to seek help.
• Be supportive during treatment: Attend family therapy sessions and support groups with your loved one, and encourage them to stay engaged in their treatment programme.
• Create a safe and sober environment at home: Remove any drugs or alcohol from your home and make sure your loved one has a safe and sober place to live.
• Set boundaries and consequences: Communicate clearly and calmly with your loved one about what you expect from them and what will happen if they don't meet your expectations.
• Take care of yourself: Supporting a loved one with addiction can be emotionally and physically draining. Make sure to take care of your own physical and mental well-being.

An important issue to remember is that addiction is a condition that affects many people and recovery is a process that takes time. Be patient and supportive and be prepared for setbacks. Remember that your loved one is not defined by their addiction, and they deserve love, compassion, empathy and support.

How do we treat substance use disorders at The Kusnacht Practice

At The Kusnacht Practice, we have developed our programme based on effective evidence-based interventions, alongside our experience and expertise of working with adults who have a substance use disorder. We believe in having a person-centred approach to our work. We understand that the relationship with the client can help form the foundation to recovery. We work with the client in establishing goals, treatment plans and boundaries, each step of the way.

The first steps of the programme will be an evaluation with our dedicated Medical and Psychiatric Teams who will work to ensure that all current and potential medical issues, and any existing mental health issues are diagnosed and addressed. They will plan an appropriate detox regime and setting – ensuring the safety of the client and managing a safe withdrawal from the drug. This important phase of substance use disorder treatment creates a safe platform for the other teams – psychiatry, psychotherapy and BIO-R® nutrition and lifestyle – to engage with and support the client.

The Kusnacht Practice is renowned for its absolute, dedicated attention and precision, honesty, and transparency in a warm and empathetic environment for all. With the pure waters of Switzerland’s Lake Zurich lapping on its nearby shores and among nature and clean air, the treatment centre offers a holistic, 360-degree, mind, body and soul rebalancing and restoration. Its state-of-the-art facility combines Swiss standards of excellence, luxury and cutting-edge, innovative technology with world-renowned medical expertise, compassion, and sensitivity. Each patient is treated uniquely and privately in their own sumptuous, five-star residence and provided with the highest standards of professionalism, care, and discretion.

We have successfully treated many individuals with substance use disorders. We will provide a safe, kind, and friendly environment where discretion and privacy are key. And our tranquil location and luxurious surroundings will help you relax and focus on your well-being. A place where we can concentrate on nothing more than improving your health and to support you onto a path of recovery.

Our experienced team of experts and professionals will seek to scratch beneath the surface to identify the roots of your issues. We wish to give you back control of your life and to learn coping strategies for a more content future – for you and your loved ones. Our treatment plans are unique and absolutely personalised, but simply opening up about your problem to a discreet professional is a big first step – alongside other therapies, naturally. We will organise everything for you with no detail overlooked.

Written by Dean Gustar