Ketamine-assisted buprenorphine initiation: a pilot case series.
Addiction science & clinical practice August 29, 2024 Lucinda A Grande, Tom Hutch, Keira Jack et al. 6 citations
A sub-dissociative dose of ketamine, self-administered sublingually, helped patients with opioid use disorder complete buprenorphine initiation in an outpatient setting. Over 14 months, 37 patients were prescribed 4-8 doses of sublingual ketamine 16 mg. Among the 24 patients who reported trying ketamine, 16 (67%) completed buprenorphine initiation, and 11 of the last 12 completers (92%) remained in treatment for 30 days. Most patients reported reduced or eliminated spontaneous withdrawal symptoms, and some avoided severe precipitated withdrawal. Four patients completed initiation over four days with only mild symptoms. Two patients experienced cognitive changes at higher doses. The protocol suggests ketamine can lower barriers to buprenorphine treatment, but further research is needed.