A double-blind pilot study tested whether a single dose of esketamine, combined with two weeks of daily mindfulness-based intervention (MBI), enhances engagement in meditation and improves alcohol-related outcomes among 28 individuals with alcohol problems. Participants received either sublingual esketamine (115.1 mg) or a vitamin C placebo. Esketamine increased psychological engagement with daily MBI and produced transient decreases in alcohol cravings, along with greater mystical experiences and dissociative states compared to placebo. The findings suggest that esketamine may improve treatment outcomes when paired with mindfulness-based therapies by boosting engagement with meditative practice.
Ketamine use disorder (KUD) is linked to frequent physical and psychological symptoms, including bladder problems (60%), nasal problems (60%), 'K-cramps' (56%), and abstinence-related cravings (71%), low mood (62%), and anxiety (59%). A survey of 274 current or former users, 40% treatment-seeking and 60% not, found that treatment-seeking individuals consumed more ketamine daily (2.67 g vs. 1.68 g). Despite these symptoms, 56% did not seek treatment; among those who did, only 36% were satisfied with care. Services were often seen as not tailored to ketamine (43%) and only somewhat effective (43%). Cost and affordability were the top factors for choosing treatment.