Targeting craving with ketamine treatment in substance use disorders : a systematic review and meta-analysis
Open MIND June 1, 2026 Kellie Elkrief
Substance use disorders affect about 2% of the global population and are marked by intense craving, a key predictor of relapse. Treatment options targeting craving are limited. A systematic review and meta-analysis of 11 randomized controlled trials examined the effect of ketamine, an NMDA receptor antagonist, on craving across different substance use disorders. Among nine studies (389 participants), ketamine significantly reduced craving compared to control (Hedges' g = 0.34; 95% CI: 0.09–0.59). Larger effects appeared in cocaine dependence, cue-induced craving paradigms, and acute assessments. Ketamine also increased the likelihood of abstinence (risk ratio = 1.95; 95% CI: 1.06–3.59) in four studies (152 participants). These findings suggest ketamine may reduce craving, but larger trials are needed to identify response moderators and clarify its long-term role.