Ketamine's Therapeutic Role in Substance Use Disorders: A Narrative Review.
NeuroSci August 27, 2025 Alexander Thomas, R Andrew Chambers 4 citations
Interest in ketamine as a treatment for substance use disorders has grown because it blocks NMDA glutamate receptors and because glutamate signaling is linked to depression and addiction. This narrative review covers clinical evidence from the 1970s to 2025, focusing on randomized blinded controlled trials. Nine such trials have tested ketamine for cocaine (three studies), alcohol (three studies), opioid use disorder (two studies), and nicotine (one study). The evidence suggests ketamine is effective for addiction when combined with psychotherapies, especially at doses that produce mystical or psychedelic experiences. The review calls for more rigorous studies to determine which addictions ketamine may treat, optimal dosing, the role of concurrent psychotherapies, safety monitoring, and contraindications.