Ketamine-facilitated behavioral treatment for cannabis use disorder: A proof of concept study. (2nd January 2021)

• Record Type: Journal Article
• Authors: Azhari, Nour; Hu, Helen; O'Malley, Kate Y.; Blocker, Megan E.; Levin, Frances R.; Dakwar, Elias
• Is Part Of: American journal of drug and alcohol abuse. Volume 47:Number 1(2021)
• Page Start: 92
• Page End: 97
• Publication Date: 2021-01-02
• Subjects: Ketamine -- cannabis use disorder -- glutamate -- medication-assisted treatment -- motivational enhancement therapy -- mindfulness-based relapse prevention; Drug abuse -- Treatment -- Periodicals; Alcoholism -- Treatment -- Periodicals; Substance-abuse -- Treatment -- Periodicals; Alcoholism -- Periodicals; Substance-Related Disorders -- Periodicals; 616.86
• DOI: 10.1080/00952990.2020.1808982
• Languages: English
• ISSNs: 0095-2990

Abstract

ABSTRACT: Background: Sub-anesthetic ketamine infusions may benefit a range of psychiatric conditions, including alcohol and cocaine use disorders. Currently, there are no effective pharmacological treatments for cannabis use disorder. Objectives: The objective of this uncontrolled proof of concept trial was to test the feasibility, tolerability, and potential therapeutic effects of integrating ketamine infusions with a behavioral platform of motivational enhancement therapy and mindfulness-based relapse prevention in treating cannabis use disorder (CUD). Methods: Eight cannabis-dependent individuals (four female, four male) receiving motivational enhancement therapy and mindfulness-based relapse prevention behavioral treatments completed this single-blind outpatient 6-week study. Participants received either one or two infusions of ketamine (0.71 mg/kg [infusion 1]; 1.41 mg/kg [infusion 2] for non-responders) during the study. Participants self-reported cannabis use (Timeline Follow-Back) and underwent an assessment of confidence in abstaining from using cannabis (Drug-Taking Confidence Questionnaire) at predetermined time points throughout the study. Results: Ketamine infusions were well-tolerated and there were no adverse events. Frequency of cannabis use decreased significantly from baseline (B = 5.1, s.e = 0.7) to the week following the first infusion (B = 0.8, s.e = 0.412), and remained reduced at the end of the study (B = 0.5, s.e = 0.3). Participants' confidence in their ability to abstain from cannabis in potentially triggering situations increased significantly from baseline to the end of study. Conclusions: These findings suggest that combining ketamine with behavioral therapy is feasible, tolerable, and potentially helpful, in treating cannabis-dependent individuals.