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 (opens in new tab)
Study at a glance
AI-extracted from the abstract| 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 Esketamine |
| Keywords | Chronic pain Observational study Anesthesia Mood Physical therapy Prospective cohort study Lidocaine Substance abuse Randomized controlled trial |
| Key findings | 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.
Comparable studies
Other observational and cohort studies on ketamine for addiction, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Brain damages in ketamine addicts as revealed by magnetic resonance imaging Ketamine addicts | 2014 | Observational cohort | n = 21 |
| Characterization of Oral Ketamine Use: A Retrospective Review. Hospitalized patients aged 18 years or older receiving oral ketamine | 2025 | Retrospective cohort study | |
| Maintenance Intramuscular Ketamine-Assisted Psychotherapy, a Retrospective Chart Review of Efficacy, Adverse Events, and Dropouts from a Community Practice. Patients receiving intramuscular ketamine with contemporaneous psychotherapy for... | 2024 | Observational study | n = 70 |
| Prescribing bias and adverse outcomes of esketamine in major depression comorbid substance. Adults aged 18 years or older with major depressive disorder in the TriNetX US... | 2026 | Retrospective cohort study | n = 30,670 |
| Associations between psychedelic use and adverse outcomes in substance use disorders: a real-world EHR-based cohort study. U.S. patients aged 12 years and older with a documented substance use disorder... | 2025 | Retrospective cohort study | n = 3,209,798 |