Ketamine Care for Patients Managing Addiction or in Recovery
When Depression and Substance Use Overlap, We Treat Both
The Intersection of Depression and Addiction
Depression and substance use disorders frequently co-occur — each worsening the other. We provide thoughtful, evidence-informed ketamine care that honors both parts of your journey without judgment.
Substance use disorders (SUDs) and depressive illness are deeply intertwined. Depression is both a driver of substance use and a consequence of it — many people turn to alcohol or other substances to manage painful emotional states, while chronic use ultimately deepens depressive symptoms and disrupts the brain’s reward and motivation systems.
For patients in recovery, the early post-detoxification period is especially vulnerable. Neurochemical changes following substance withdrawal can produce persistent low mood, anhedonia (inability to feel pleasure), anxiety, and elevated craving — dramatically increasing relapse risk. This is precisely the window where a rapidly acting antidepressant like ketamine may offer meaningful benefit.
Both addiction and depression share a common neurobiological thread: dysregulation of glutamate signaling in the prefrontal cortex and mesolimbic regions, including the amygdala and nucleus accumbens. This overlap is part of why ketamine — as an NMDA glutamate receptor antagonist — has attracted growing research attention as a potential intervention for substance use disorders.
“Ketamine may reduce depressive symptoms in a risky window for addiction relapse.”
— Ezquerra-Romano et al., Neuropharmacology, 2018
What the Research Shows
A 2018 systematic review in Frontiers in Psychiatry (Jones et al.) identified completed clinical studies examining ketamine for alcohol, cocaine, and opioid use disorder. Results suggested ketamine could prolong abstinence in detoxified patients when paired with psychotherapy, with particular strength in alcohol and heroin-dependent populations.
A landmark randomized controlled trial published in the American Journal of Psychiatry (2022) tested IV ketamine infusions plus relapse prevention therapy in patients with alcohol use disorder. The ketamine group showed higher rates of abstinence for up to 24 weeks compared to the placebo group, with better outcomes in those also receiving psychological therapy alongside infusions.
40–80%
Relapse rates within one year for standard addiction treatments — underscoring the need for new options
2+
Potential mechanisms: antidepressant effect AND disruption of drug-related memory reconsolidation
0
Studies in comprehensive reviews have reported a transition to illicit ketamine use following therapeutic treatment
Research on the mechanisms behind ketamine’s potential in addiction identifies several pathways: restoring neuroplasticity and synaptogenesis disrupted by chronic substance use, reducing depressive symptoms that fuel relapse, disrupting reconsolidation of drug-associated memories, and creating an enhanced therapeutic window for psychological interventions.
An important note on evidence
Research on ketamine for substance use disorders is still developing, with most studies limited by small sample sizes and heterogeneous designs. At BHWWC, we are transparent about the current state of evidence and focus our care on the depressive and emotional components that frequently accompany addiction — an area where ketamine’s evidence base is strongest.
Our Approach: Respecting Both Journeys
We recognize that patients managing addiction require careful, individualized evaluation. Not every patient in recovery is an appropriate candidate for ketamine therapy. Our clinical consultation is thorough, and we coordinate closely with addiction specialists, counselors, and recovery programs already involved in your care.
Who we may be able to help
• Patients in stable recovery experiencing treatment-resistant depression
• Individuals with co-occurring major depression and substance use disorder
• Patients in the post-detoxification phase with significant depressive symptoms
• Those whose depression has not responded to conventional antidepressants
• Patients whose treatment team supports exploring ketamine as an adjunct
Safety and screening: All patients undergo a comprehensive intake evaluation. Active, unstable substance use or certain diagnoses may affect eligibility. We discuss all relevant factors openly during consultation and work collaboratively with your existing care team.