Low-dose ketamine infusion to facilitate opioid tapering in chronic non-cancer pain with opioid-use disorder: a historical cohort study.
Regional anesthesia and pain medicine May 6, 2025 Antoine Elyn, Anne Roussin, Cécile Lestrade et al. 8 citations
Long-term opioid use for chronic pain can lead to tolerance, misuse, and hyperalgesia, making dose reduction difficult, especially when opioid-use disorder is present. Ketamine, an NMDA receptor antagonist with antihyperalgesic effects, may help. In a historical cohort of 59 chronic pain patients with opioid-use disorder who had failed outpatient tapering, a 5-day hospital stay with low-dose ketamine infusion reduced the average daily opioid dose from 207 mg morphine milligram equivalent to 92 mg at discharge and 103 mg at 12 months. Over half of patients achieved more than 50% tapering immediately, and seven stopped entirely. Ketamine was well tolerated with no significant withdrawal symptoms. Controlled studies are needed to confirm these results.