Qualitative analysis of a patient’s experience of ketamine-assisted psychotherapy for substance use disorder: Empirical synergies with twelve-step programs.

Abstract

Ketamine has demonstrated early promise for treating substance use disorder (SUD). However, ketamine is also a recreational substance, which raises concerns about its clinical applications to SUD. Despite the emerging evidence for ketamine-based approaches for SUD and these potential risks, little has been published on methods for integrating ketamine-assisted psychotherapy (KAP) with existing pharmacologic, psychosocial, and community-based treatment paradigms (e.g., 12-step programs). Here, we present the case of a 28-year-old female treated for SUD involving misuse of alcohol and prescription opioids. We executed an inter-clinic, collaborative treatment plan that involved a psychedelic, ketamine-based regimen in combination with extant psychosocial and 12-step-based treatments for SUD. Qualitative analysis of the patient’s lived experience suggested that ketamine played an important role in her self-reported experience of recovery, as she attributed psychological and spiritual changes to her ketamine treatments. Specifically, this report highlights the extent to which the patient’s ketamine-induced experiences overlapped with the 12 steps, which will be useful for clinicians treating other 12-step-involved SUD patients with ketamine. Additionally, we detail specific clinical practices that we implemented for managing the unique risks of ketamine interventions as SUD treatments.