Alcohol use disorder (AUD) is one of the most challenging addictions to overcome, often characterized by repeated relapses and deeply ingrained patterns in the brain. While traditional treatments such as rehab, talk therapy, and medication have proven beneficial for many, they do not work for everyone—leaving millions struggling to break free.
Currently, an innovative treatment is offering new hope: ketamine therapy. Renowned for its ability to promote neuroplasticity—the brain’s capacity to develop new, healthier connections—ketamine is emerging as a powerful tool in treating alcoholism. Studies indicate that ketamine can help reduce alcohol cravings, alleviate withdrawal symptoms, and support long-term recovery by reshaping the brain’s reward system.
Can ketamine help disrupt the cycle of addiction? Let’s explore the science and possibilities surrounding the use of ketamine therapy for alcohol dependence.
Alcohol use disorder (AUD), commonly known as alcoholism, represents a serious public health crisis with devastating impacts on both individuals and society. Excessive alcohol consumption accounts for approximately 178,000 deaths each year in the U.S., reflecting a 29% increase in recent times.
Chronic alcohol abuse is a leading contributor to liver disease, mental health disorders, and cognitive decline, significantly heightening the risk of conditions such as depression, anxiety, and neurological damage.
In addition to health issues, alcohol addiction fosters violence, crime, and financial strain, with alcohol-related crashes alone costing the U.S. nearly $69 billion every year. Drunk driving continues to be a major cause of fatalities, with 13,524 deaths reported in 2022, representing 32% of all traffic-related deaths. Worldwide, alcohol is linked to over 2.6 million deaths annually, imposing a heavy burden on public safety and healthcare systems.
Traditional treatments for alcohol dependence, such as rehabilitation and behavioral therapy, frequently struggle to prevent relapse, sparking increased interest in innovative treatment alternatives for alcohol addiction.
One key aspect of ketamine’s mechanism of action is its ability to induce a state in which the mind becomes more open to change and therapeutic intervention. Rather than serving as a standalone solution, ketamine acts as a catalyst—like grease on the wheels—helping to generate momentum for deeper healing through therapies such as traditional talk therapy or Motivational Enhancement Therapy (MET).
Research indicates that ketamine temporarily reopens “critical periods” of neuroplasticity, significantly enhancing the brain’s capacity to rewire and adapt for about 48 hours following each infusion. Standard treatment protocols typically involve two sessions per week for three to four weeks, maintaining this window of increased plasticity throughout the treatment series.
During this time, psychotherapy plays a vital role, and patients are encouraged to adopt new, healthy routines while letting go of habits that no longer benefit them—such as alcohol consumption. Many describe this experience as pressing a mental reset button, providing an opportunity to build resilience, avoid triggers that may have previously led to substance use, and establish safeguards to prevent relapse.
A systematic review published in 2023 in Cureus evaluated 11 studies involving 854 adults from the USA, UK, and Russia, focusing on ketamine’s effectiveness in reducing alcohol consumption, preventing relapse, and managing withdrawal symptoms. The findings indicate that ketamine, particularly when combined with psychotherapy, may improve long-term recovery outcomes for individuals with AUD.
Multiple studies reviewed indicate that patients undergoing ketamine therapy achieved significantly greater abstinence rates than those receiving standard treatments. A 1997 study by Krupitsky and Grinenko tracked patients who participated in ketamine-assisted psychotherapy (KPT), reporting a 65.8% abstinence rate after one year, in stark contrast to just 24% in the conventional treatment cohort. Additionally, a 2022 randomized controlled trial (RCT) conducted by Grabski et al. demonstrated that ketamine combined with psychotherapy resulted in higher abstinence rates at the six-month mark compared to the placebo treatments.
Ketamine considerably lowered alcohol intake and binge drinking for individuals not fully abstinent. A 2019 research by Das et al. revealed that ketamine could pharmacologically “rewrite” detrimental drinking memories, resulting in a substantial decrease in alcohol use over nine months. Additionally, a 2020 study by Dakwar et al. demonstrated that when combined with Motivational Enhancement Therapy (MET), ketamine heightened the chances of achieving alcohol abstinence and prolonged the time before relapse.
Although much of the research emphasizes relapse prevention, certain studies indicate that ketamine might effectively manage alcohol withdrawal symptoms, especially in cases resistant to benzodiazepines. A study conducted in 2018 by Pizon et al. revealed that patients treated with ketamine needed fewer benzodiazepines, experienced shorter stays in the ICU, and had a lower likelihood of requiring intubation compared to those undergoing standard alcohol withdrawal therapy alone.
Ketamine treatment for AUD varies in the number of treatments administered. The studies reviewed include different protocols, but several key patterns emerge:
Single infusion plus therapy: One study administered a single IV ketamine infusion (0.71 mg/kg) combined with Motivational Enhancement Therapy (MET) over five weeks. This approach showed benefits in increasing the number of alcohol abstinence days and delaying relapse.
Multiple infusions plus therapy: Another study used three weekly IV ketamine infusions (0.8 mg/kg) over one to three months in conjunction with psychotherapy or alcohol education. The group receiving psychotherapy exhibited the best outcomes regarding abstinence.
Intramuscular (IM) ketamine plus therapy: Some older studies employed one to two high-dose IM ketamine sessions (2-3 mg/kg) with psychotherapy and showed sustained abstinence rates for up to three years in a subset of patients.
Adjunct ketamine for alcohol withdrawal: In cases of severe alcohol withdrawal, ketamine was occasionally administered continuously as an IV infusion (0.15-0.3 mg/kg/hr) over 24-72 hours alongside benzodiazepines.
The combination of several ketamine sessions with psychotherapy led to the highest rates of abstinence and also reduced the number of heavy drinking days. Research monitoring patients for months after treatment showed longer-term benefits.
At our clinic, located in San Luis Obispo, California, we adhere to a protocol grounded in the latest and highest-quality research on ketamine therapy for Alcohol Use Disorder. Our approach combines IV ketamine with psychotherapy, providing a comprehensive and evidence-based treatment plan. The protocol includes six IV ketamine infusions, administered twice a week over three weeks. Psychotherapy begins before the first ketamine session, ideally continues after each infusion, and often extends well beyond the treatment series to foster long-term integration and sustained recovery. We understand that the integration process is ongoing, and our goal is to offer the necessary therapeutic support to maximize the benefits of ketamine therapy.
While the findings are promising, researchers agree that more large-scale clinical trials are needed to refine dosing strategies, optimize treatment protocols, and assess long-term safety. Nevertheless, the current evidence strongly supports ketamine’s potential role in treating AUD, particularly for those who have not responded to traditional medications.
If you or a loved one has struggled with alcohol dependence despite attempting conventional treatments, ketamine therapy may offer a promising alternative. At Innerbloom Ketamine Therapy, we specialize in personalized treatment plans that integrate IV ketamine infusions with expert-led psychotherapy, ensuring a comprehensive approach to recovery.
For more information or to schedule a consultation, visit our website or contact our clinic today.
About the Author
Dr. Ray Rivas, a former general and trauma surgeon with over a decade of experience utilizing ketamine, became a ketamine therapy specialist to treat mental health and pain after witnessing its profound impact on his hospital trauma patients and his own mental health. As the founder and medical director of Innerbloom Ketamine Therapy in San Luis Obispo, California, Dr. Rivas applies his extensive medical expertise to provide safe, evidence-based ketamine treatments for mood disorders, including depression, anxiety, PTSD, and chronic pain. His passion lies in helping patients find relief and rediscover hope through personalized, compassionate care.
References:
Dakwar, Elias et al. “A Single Ketamine Infusion Combined With Motivational Enhancement Therapy for Alcohol Use Disorder: A Randomized Midazolam-Controlled Pilot Trial.” The American journal of psychiatry vol. 177,2 (2020): 125-133. doi:10.1176/appi.ajp.2019.19070684
Das, R.K., Gale, G., Walsh, K. et al. “Ketamine can reduce harmful drinking by pharmacologically rewriting drinking memories.” Nat Commun 10, 5187 (2019). https://doi.org/10.1038/s41467-019-13162-w
Goldfine, Charlotte E et al. “The therapeutic use and efficacy of ketamine in alcohol use disorder and alcohol withdrawal syndrome: a scoping review.” Frontiers in psychiatry vol. 14 1141836. 27 Apr. 2023, doi:10.3389/fpsyt.2023.1141836
Grabski, Meryem et al. “Adjunctive Ketamine With Relapse Prevention-Based Psychological Therapy in the Treatment of Alcohol Use Disorder.” The American journal of psychiatry vol. 179,2 (2022): 152-162. doi:10.1176/appi.ajp.2021.21030277
Kelson, Michael et al. “Ketamine Treatment for Alcohol Use Disorder: A Systematic Review.” Cureus vol. 15,5 e38498. 3 May. 2023, doi:10.7759/cureus.38498
Krupitsky, E. M., & Grinenko, A. Y. “Ketamine psychedelic therapy (KPT): A review of the results of ten years of research.” Journal of Psychoactive Drugs, 29(2), 165–183. (1997): doi.org/10.1080/02791072.1997.10400185
Pizon, Anthony F et al. “Adjunct Ketamine Use in the Management of Severe Ethanol Withdrawal.” Critical care medicine vol. 46,8 (2018): e768-e771. doi:10.1097/CCM.0000000000003204
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