Journal of addiction medicine
Emmert Roberts, Elizabeth Sanderson, Irene Guerrini
14 citations
A systematic review of pharmacological treatments for ketamine use disorder found only 12 studies (368 participants), including 1 controlled trial, 2 retrospective case series, and 9 case reports. All evidence was very low quality, with only descriptive outcomes reported. Benzodiazepine regimens and haloperidol showed potential utility for managing intoxication and withdrawal, while naltrexone, lamotrigine, and a combination of paliperidone palmitate and bupropion were reported as potentially useful for craving and relapse prevention. The review highlights a severe lack of rigorous research, with benzodiazepine regimens appearing most promising for future investigation in intoxication and withdrawal.
Journal of addiction medicine
Kevin H Yang, Wayne Kepner, Anamika Nijum et al.
11 citations
An estimated 0.9% of US individuals aged 12 or older used ecstasy/MDMA in the past year, based on a national survey from 2015 to 2020. Use was more common among younger people, with those aged 35–49 as the reference; those over 50 had very low odds of use. Bisexual women and people identifying as Asian, Black, or multiracial had higher odds of use compared with heterosexual men or White individuals. Past-year use of other drugs, prescription drug misuse, nicotine dependence, and alcohol use disorder were also associated with increased odds. The findings can help inform prevention and harm reduction strategies for high-risk subpopulations.
Journal of addiction medicine
Ameya Krishnan
3 citations
Among 20.4 million US adults with substance use disorders, up to 60% return to use despite treatment. Standard care—pharmacotherapy and behavioral interventions—appears insufficient. A literature review suggests that integrating yoga-derived breathwork and meditation, specifically Sudarshan Kriya yoga (SKY), can improve recovery. SKY practice impacts quality of life, well-being, functioning, and substance use. In alcohol use disorder, SKY contributes to significant reductions in depressive symptoms, stress biomarkers, and alcohol use up to 6 months after treatment. SKY practitioners on opioid partial agonist therapy may experience buprenorphine potentiation, eliminating concurrent nonprescribed opioid use. SKY achieves tobacco cessation rates comparable to bupropion. Evidence supports integrating SKY into substance use treatment.
Journal of addiction medicine
May 28, 2025
Sara Prostko, Alexander Wu, Samuel Maddams et al.
2 citations
Among 192 adults with alcohol use disorder, opioid use disorder, or psychiatric disorders surveyed at a large hospital, 66% had previously tried psychedelics, 72.4% believed psychedelics could help patients with substance use or psychiatric disorders, and 69.8% said they would personally try psychedelic-assisted treatment for such a condition. Willingness to try psychedelic treatment was significantly higher among those who had previously used psilocybin (90.0% vs. 47.8%), MDMA (89.7% vs. 61.2%), or ketamine (100% vs. 65.7%). Participants opposed to psychedelic treatment were more likely to perceive risks including depression, anxiety, heart damage, brain damage, and addiction. The authors conclude that further safety trials and educational interventions are needed.
Journal of addiction medicine
Tucker Avra, Felipe Vasudevan, Rohit Mukherjee et al.
2 citations
A 32-year-old man with ketamine use disorder experienced severe cravings that persisted after residential and intensive outpatient treatment. After resuming use following a period of abstinence, he was started on lamotrigine and naltrexone for depressive symptoms and cravings. This combination caused nausea and reduced hallucinogenic effects while on ketamine and substantially decreased his cravings, helping him achieve longer-term abstinence alongside dialectical behavioral therapy, family support, and 12-step programming. Ketamine use disorder is poorly described but may become more prevalent as US ketamine use increases. Combining treatment of depressive symptoms and cravings with lamotrigine and naltrexone may be a promising pharmacotherapeutic strategy, though more research is needed.
Journal of addiction medicine
October 2, 2025
Rishi Verma, Tom Colley, Claire Waldock et al.
1 citation
A 25-year-old woman with ketamine use disorder (KUD) who used ketamine daily and experienced intense cravings was prescribed naltrexone off-label, starting at 25 mg/day and increasing to 50 mg/day after 7 days. After starting naltrexone, she reported a marked reduction in cravings, maintained abstinence, and progressed in recovery. This case, consistent with two prior reports where 50 mg/day naltrexone helped patients achieve abstinence, suggests naltrexone may be an effective intervention for KUD. Larger double-blind studies are needed to evaluate its efficacy, safety, and optimal dosing.
Journal of addiction medicine
January 1, 2016
Nitin Chopra, Lon Hays
1 citation
A man in his twenties with no psychiatric history experienced a psychotic episode after chewing leaves of Coleus blumei, a common garden plant, seeking euphoria based on social media claims. Laboratory tests, drug screening, and imaging were negative; vital signs and physical exam were normal. His mental status improved substantially with risperidone 2 mg twice daily during a five-day psychiatric hospitalization. This case highlights Coleus blumei as a potential psychotropic substance needing further study.
Journal of addiction medicine
Babak Tofighi, Christina Marini, Joshua D Lee et al.
1 citation
Among 72 patients prescribed buprenorphine for opioid use disorder in office-based opioid treatment, 90.3% reported practicing at least one category of meditation-based intervention (MBI) on at least a daily (39.6%) or weekly (41.7%) basis. The most common type was spiritual meditation (67.7%), followed by nonmantra meditation (61.3%), mindfulness meditation (54.8%), and mantra meditation (29.0%). Interest in MBI was motivated by improving general health and well-being (73.4%), treatment outcomes (60.9%), and relationships (60.9%). Perceived benefits included reduced anxiety or depression (70.3%), pain (62.5%), substance use (60.9%), cravings (57.8%), and withdrawal symptoms (51.6%). The findings suggest high acceptability for adopting MBI in this population.
Journal of addiction medicine
January 15, 2026
Dale Terasaki, Nathan Sackett, Andrew Monte
Ibogaine, a psychedelic substance, is attracting interest as a potential treatment for opioid use disorder (OUD), with many states funding research. Some proponents frame ibogaine as an alternative to standard, mortality-reducing medications for OUD (MOUD), rather than as a complement. The path to remission varies, but switching from methadone or buprenorphine to an unproven therapy like ibogaine could increase the risk of opioid overdose for some individuals. The addiction medicine community should be aware of this risk and continue to defend evidence-based care while ibogaine is developed.