Ketamine in treating opioid use disorder and opioid withdrawal: a scoping review.
Mary R Shen, Dylan E Campbell, Anika Kopczynski, Samuel Maddams, Naomi Rosenblum, Kabir Nigam, Joji Suzuki
Frontiers in psychiatry January 1, 2025 DOI: 10.3389/fpsyt.2025.1552084 via PubMed
Summary
AI-generated from the abstractA scoping review of eight studies found that ketamine may help reduce opioid cravings and use in people with opioid use disorder and can attenuate precipitated withdrawal symptoms, often as an adjunct to buprenorphine. The review searched two databases, yielding 998 studies, of which eight met inclusion criteria: two on opioid use disorder and six on opioid withdrawal. The evidence is preliminary, and more research is needed before widespread clinical use.
Study at a glance
| Characteristics | Scoping review Case report Peer reviewed |
|---|---|
| Intervention | Ketamine |
| Topics | Addiction Ketamine |
| Keywords | Nmda antagonist Opioid withdrawal Addiction treatment Substance abuse treatment |
| Citations | 10 |
| Key finding | Ketamine administration was associated with reduced opioid cravings and use in opioid use disorder and attenuated precipitated withdrawal symptoms in opioid withdrawal. |
Abstract
Opioid use disorder (OUD) continues to be a public health crisis in the United States, with mortality having doubled over the last twenty years, leading to significant economic cost, morbidity, and mortality. This has caused significant demand for novel therapeutics. Preliminary evidence demonstrates that ketamine may be helpful in treating OUD as well as serve as an adjunct during treatment of opioid withdrawal (OW). We conducted a scoping review of two databases (PubMed and PsycINFO) for English language, peer-reviewed manuscripts reporting on use of ketamine in treatment of OUD or OW in humans, excluding protocols and reviews. The study was conducted in accordance with PRISMA guidelines. The search yielded 998 studies. After duplicates were removed, 715 studies underwent title and abstract screening for inclusion in the review. Of those, 21 were further considered under full text review. Three studies were excluded due to wrong study design and ten were excluded due to the wrong indication, specifically the use of ketamine for treatment of pain rather than substance use disorder or withdrawal. Eight studies were included in the review, regarding treatment for OUD (n=2) and OW (n=6). In OUD, ketamine administration was helpful in reducing opioid cravings and opioid use. In OW, ketamine attenuated precipitated withdrawal symptoms and was used in several case series/studies as an adjunct to buprenorphine treatment. In summary, this review presents a baseline of literature supporting the use of ketamine in OUD and OW. However, more research is needed before widespread use.