Combining the psychedelic anesthetic ketamine with existentially oriented psychotherapy appears to be an effective treatment for heroin addiction, according to a study published in The Journal of Substance Abuse Treatment.

The study was conducted by Evgeny Krupitsky and his colleagues from the St. Petersburg Research Center of Addictions and Psychopharmacology in Russia. The results were published in 2002.

Ketamine is typically used as an anesthetic, but sub-anesthetic doses of ketamine produce psychedelic experiences. As Krupitsky and his colleagues explain, they choose to use ketamine because, “as an adjunct to the psychotherapeutic treatment of addiction, ketamine has several advantages over other psychedelics: it is safe and short acting; it is already an approved prescription medicine, and it has been shown to be an effective treatment for alcoholism.”

To examine the effectiveness of ketamine-assisted psychotherapy for the treatment of heroin addiction, Krupitsky and his colleagues recruited 70 heroin-addicted patients from a local drug abuse treatment center. The patients were randomly assigned to one of two groups. One group received a high-dose of ketamine in conjunction with psychotherapy while the other received a sub-psychedelic dose in conjunction with psychotherapy. Neither the patients or their psychiatrist knew whether they were in the high-dose group or the low-dose group.

Before receiving their session of ketamine-assisted psychotherapy, the patients received ten hours of psychotherapy to prepare them for the psychedelic experience. As Krupitsky and his colleagues note, “during the ketamine sessions, subjects often experience an altered state that has been described as the separation of consciousness from the body and the dissolving of the ego. Therefore, it is very important to prepare subjects carefully for such an unusual experience”

During the session, which lasted from one and a half to two hours, the patient laid on a couch while wearing eyeshades. Calming music was also played in the background. The psychotherapy during this time was oriented towards the “resolution of [the patient’s] personality problems and the formation of a stable orientation to a future without drugs.”

After the session of ketamine-assisted psychotherapy, the patients received another five hours of psychotherapy to help them interpret their psychedelic experience and integrate it into their lives.

According to Krupitsky and his colleagues, after a two year follow-up the rate of abstinence from heroin was significantly higher for the group of patients that received the high-dose of ketamine compared to those who received the sub-psychedelic dose. As they explain, “This double-blind, active-placebo controlled study demonstrates that ketamine-assisted psychotherapy of heroin addicts is more effective when a high, psychedelic, dose of ketamine is administered than when a low, sub-psychedelic, dose is administered.”

Krupitsky and his colleagues also claim that the rate of abstinence for those in the high-dose group were greater than the typical rate of abstinence in more traditional drug treatments.

Noting that drug treatment programs like Alcoholics Anonymous have a religious or spiritual orientation, Krupitsky and his colleagues suggest that the spiritual nature of the psychedelic experience may contribute to its effectiveness.

“Many reports suggest that religious or spiritual conversion is an important factor in ‘spontaneous’ recovery from drug abuse. […] A therapy that enhances the likelihood of a conversion or spiritual experience therefore might have utility in the treatment of substance abuse. Ketamine-assisted psychotherapy may represent one method of eliciting spiritual experiences in subjects with chemical dependence and thus help promote abstinence.”

Reference:

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. The Journal of Substance Abuse Treatment, Vol 23: 273-283.