Self-reported changes and experiences with substance use among real-world patients treated with medical ketamine.
Experimental and clinical psychopharmacology – July 24, 2025
Source: PubMed
Summary
Many people using medical ketamine for psychiatric conditions report a surprising benefit: reduced reliance on other substances. A survey of 201 patients explored this, finding over half reported positive changes in their substance use. Notably, those with a history of problematic use experienced the most significant improvements, often citing reduced cravings and enhanced motivation to quit. For individuals with minimal prior substance use, ketamine did not appear to encourage new drug-using behaviors. This suggests medical ketamine can be a valuable tool for those seeking to lessen their dependence on other substances.
Abstract
Ketamine is increasingly used in community clinics as a long-term treatment for different psychiatric and pain conditions, including substance use disorders. Data are lacking, however, regarding the potential influence of ketamine on other substance use. In this secondary analysis, we aimed to explore the relationship between medical ketamine and other substance use among real-world patients by combining quantitative and qualitative data. In an online anonymous pilot survey (N = 201), patients rated change in other substance use since medical ketamine initiation and elaborated on their subjective experiences. Most patients self-reported positive/desirable change (54.7%) or no change in substance use (44.3%). Participants reporting past problematic substance use had significantly greater positive change compared with the groups of participants reporting present or no history of problematic substance use (ps < .020). Participants reported positive outcomes such as reduced substance use due to reduced need to self-medicate for coping, reduced craving, or enhanced motivation to quit use. Among participants with minimal or no substance use, ketamine did not appear to induce or increase drug-using behaviors. However, there were some reports of risky behaviors such as openness to using other psychedelics or ketamine used recreationally as a substitute for alcohol. Several implications for providers are discussed. More targeted quantitative and qualitative research is needed to fully characterize all patients but especially those at risk for potentially harmful nonmedical substance use. Such research could inform regulation efforts on safety, screening, monitoring, and patient and provider education, to maximize benefits and minimize risks related to medical ketamine. (PsycInfo Database Record (c) 2025 APA, all rights reserved).