Drug overdose, particularly from fentanyl, is the leading cause of injury deaths in young adults in the United States, resulting in over 70,000 deaths annually. Many individuals who become addicted to fentanyl struggle to break free from their addiction due to fears and a low tolerance for the withdrawal symptoms, which include muscle cramps, nausea, chills, sweats, and intense cravings. However, there are medications such as methadone and buprenorphine that can significantly reduce the risk of overdose death for those struggling with fentanyl addiction. Unfortunately, many individuals find it challenging to start these medications due to severe withdrawal symptoms that may occur.
A recent pilot study published in Addiction Science & Clinical Practice offers hope for individuals trapped in fentanyl addiction. The study found that a small amount of ketamine can reduce or even eliminate the withdrawal symptoms associated with quitting fentanyl, providing an easier pathway for individuals to start treatment. Dr. Lucinda Grande, a clinical assistant professor of family medicine at the University of Washington School of Medicine and the lead author of the study, highlighted the significance of these findings in helping individuals initiate treatment for fentanyl addiction. Co-author Dr. Tom Hutch, the medical director of the opioid treatment program at We Care Daily Clinics in Auburn, Wash., discussed how ketamine can bridge the gap for individuals who struggle to start methadone or buprenorphine due to withdrawal symptoms.
During the 14-month study period, Grande and colleagues prescribed ketamine to 37 fentanyl-addicted patients who were hesitant to try buprenorphine due to fear of withdrawal symptoms. Of the 24 patients who tried ketamine, 16 successfully transitioned to buprenorphine with a reduction or elimination of withdrawal symptoms after each ketamine dose. Patients reported that the effects of ketamine lasted for hours, allowing them to comfortably transition to buprenorphine. Additionally, 92% of the patients who completed the transition remained in treatment for at least 30 days, highlighting the effectiveness of ketamine in facilitating the initiation of treatment for fentanyl addiction.
The study employed a low dose of ketamine, administered in the form of a lozenge or syrup placed under the tongue. This dose was significantly lower than what is typically used for anesthesia, as well as lower than the smallest dose prescribed for depression treatment, another common use of ketamine. Researchers closely monitored the patients’ progress and adjusted the treatment strategy based on patient response and prescriber experience. Grande developed the concept after learning about the success of using ketamine in higher doses to treat severe withdrawal symptoms in an emergency department setting.
Despite the negative attention ketamine has received in the media, particularly following actor Matthew Perry’s overdose on the drug, Grande emphasized the potential of ketamine in addressing various health issues, including fentanyl-use disorder. She expressed optimism for the results of this pilot study and hopes that larger studies will confirm the effectiveness of using ketamine to facilitate the transition to buprenorphine for individuals struggling with fentanyl addiction. Ultimately, these findings present a promising opportunity to save lives and improve outcomes for individuals battling opioid addiction.
