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Ketamine Therapy for Chronic Pain Provides Added Benefits for Substance Misuse Therapy

Olumuyiwa A. Bamgbade, Olumide O. Asaolu, Daniel O. Bamgbade, Olajumoke O. Lawal, Gugulami P Butelezi, Bolajoko E. Bada, Oleksandra Chorna, Mwewa Chansa, Olamide O. Oyewole, Sharon E. Omonua, Alain Irakoze, Kimberly Savage, Miriam Kessi, Lysiane M. Atcham-Amougou

SVOA Medical Research March 2, 2026 DOI: 10.58624/svoamr.2026.04.006 via OpenAlex

Summary

AI-generated from the abstract

In a small group of 20 adults with chronic pain and substance misuse, regular monthly injections of a low dose of ketamine (0.25 mg/kg) combined with lidocaine and magnesium nerve blocks were associated with improvements in pain, mood, and substance dependence. Opioid misuse was the most common category (45% of patients), followed by benzodiazepines, cocaine, and kratom. After repeated treatments, all patients showed reduced substance misuse, pain scores dropped from severe to moderate, depression scores (PHQ-9) improved from moderately severe to mild, and dependence severity reached satisfactory levels. The findings suggest ketamine-based therapy may help manage both chronic pain and substance misuse together.

Study at a glance

Characteristics Observational study Peer reviewed
Sample size 20
Population Adult chronic pain patients with comorbid substance misuse
Interventions intramuscular ketamine magnesium nerve blocks
Dose 0.25 mg/kg per treatment session
Topics Addiction Ketamine
Keywords Medicine Chronic pain Observational study Psychiatry
Key finding After repeated monthly intramuscular ketamine treatments combined with lidocaine and magnesium nerve blocks, all 20 chronic pain patients with substance misuse showed improvements in pain, mood, and dependence severity.

Abstract

Background: Chronic pain is complicated by comorbid substance misuse. This multifaceted problem increases the risks of polypharmacy, overdose, impaired driving, and avoidable emergency care. Methods: This is an observational study of a convenience sample of twenty adult chronic pain patients who underwent regular monthly intramuscular ketamine for multimodal pain therapy. Ketamine was administered at 0.25 mg/kg per treatment session. Each treatment also involved lidocaine plus magnesium nerve blocks. The cohort was profiled by gender and substance misuse category (benzodiazepine, cocaine, kratom, opioid). Numeric pain score, Severity of Dependence Scale (SDS), and PHQ-9 scores were analyzed. Results: Females comprised 55% (11/20) and males 45% (9/20). Opioids were the most frequent misuse category (45%; 9/20), followed by benzodiazepines (25%; 5/20), cocaine (20%; 4/20), and kratom (10%; 2/20). After repeated treatments, substance misuse improved in all patients, with concordant improvements in mood, pain, and dependence severity. PHQ-9 improved from moderately severe to mild mood disorder, pain improved from severe to moderate, and SDS improved to satisfactory levels. Conclusion: These outcomes indicate that ketamine-based chronic pain therapy is a potential system for integrated substance-misuse therapy within value-based healthcare, highlighting measurable outcomes, risk mitigation, and public safety. Future studies should include larger prospective studies and collaboration with clinical pharmacists and public safety professionals.

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