Ketamine use disorder (KUD) is linked to frequent physical and psychological symptoms, including bladder problems (60%), nasal problems (60%), 'K-cramps' (56%), and abstinence-related cravings (71%), low mood (62%), and anxiety (59%). A survey of 274 current or former users, 40% treatment-seeking and 60% not, found that treatment-seeking individuals consumed more ketamine daily (2.67 g vs. 1.68 g). Despite these symptoms, 56% did not seek treatment; among those who did, only 36% were satisfied with care. Services were often seen as not tailored to ketamine (43%) and only somewhat effective (43%). Cost and affordability were the top factors for choosing treatment.
Directly observing therapeutic connection during psilocybin-assisted therapy is feasible. In a clinical trial, three coders independently reviewed audio and video from four 8-hour psilocybin administration sessions, identifying 372 moments of therapeutic connection. Eighty-three percent of these moments were detected by at least two coders, and 41% by all three. Coders used both audible cues (speech prosody, words) and visible cues (body movements, eye gaze, touch) in 51% of observed events. The expressions of connection varied as the drug's effects on consciousness changed over time. The findings suggest that evaluating both sound and video is necessary to capture the full range of therapeutic connection.