Self-reported changes and experiences with substance use among real-world patients treated with medical ketamine.
Shahar Almog, Maribel Rodriguez Perez, Deepthi S Varma, Alexia N Obrochta, Michelle Weiner, Jeewon Cheong, Meredith S Berry
Experimental and Clinical Psychopharmacology July 24, 2025 DOI: 10.1037/pha0000788 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Secondary analysis of a cross-sectional survey Qualitative Peer reviewed |
|---|---|
| Sample size | 201 |
| Population | Real-world patients receiving medical ketamine for psychiatric or pain conditions |
| Intervention | Medical ketamine |
| Topics | Esketamine Ketamine |
| Keywords | Ketamine therapy Medical ketamine Psychiatric ketamine Ketamine treatment Ketamine use Ketamine application Addiction treatment Drug dependence treatment Substance abuse treatment Chemical dependency treatment Recovery Substance cessation Craving reduction Dependence reduction Quitting substances Psychiatric treatment Mental health treatment Psychiatric conditions treatment Mental illness treatment Behavioral health treatment |
| Key findings | Most patients reported positive or no change in other substance use after starting medical ketamine, with the greatest reductions among those with past problematic substance use. |
Abstract
Ketamine is increasingly used in community clinics as a long-term treatment for different psychiatric and pain conditions, including substance use disorders. Data are lacking, however, regarding the potential influence of ketamine on other substance use. In this secondary analysis, we aimed to explore the relationship between medical ketamine and other substance use among real-world patients by combining quantitative and qualitative data. In an online anonymous pilot survey (N = 201), patients rated change in other substance use since medical ketamine initiation and elaborated on their subjective experiences. Most patients self-reported positive/desirable change (54.7%) or no change in substance use (44.3%). Participants reporting past problematic substance use had significantly greater positive change compared with the groups of participants reporting present or no history of problematic substance use (ps < .020). Participants reported positive outcomes such as reduced substance use due to reduced need to self-medicate for coping, reduced craving, or enhanced motivation to quit use. Among participants with minimal or no substance use, ketamine did not appear to induce or increase drug-using behaviors. However, there were some reports of risky behaviors such as openness to using other psychedelics or ketamine used recreationally as a substitute for alcohol. Several implications for providers are discussed. More targeted quantitative and qualitative research is needed to fully characterize all patients but especially those at risk for potentially harmful nonmedical substance use. Such research could inform regulation efforts on safety, screening, monitoring, and patient and provider education, to maximize benefits and minimize risks related to medical ketamine. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
Comparable studies
Other cross-sectional and survey studies on ketamine, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| 5-Year Trends in Use of Hallucinogens and Other Adjunct Drugs among UK Dance Drug Users People who use drugs in dance contexts | 2006 | Repeated-measures cross-sectional survey | |
| Preliminary analysis of positive and negative syndrome scale in ketamine-associated psychosis in comparison with schizophrenia Healthy subjects, ketamine abusers, and schizophrenia patients | 2014 | Cross-sectional study | n = 998 |
| Ketamine as a primary predictor of out-of-body experiences associated with multiple substance use Online survey respondents | 2011 | Cross-sectional survey | n = 192 |
| Self-reported prevalence of dependence of MDMA compared to cocaine, mephedrone and ketamine among a sample of recreational poly-drug users Global non-treatment-seeking sample of last year users of MDMA, cocaine, mephedrone,... | 2014 | Cross-sectional survey | |
| Near-Death States Reported in a Sample of 50 Misusers Previous ketamine misusers who reported a ketamine-related near-death experience | 2010 | Cross-sectional survey | n = 50 |