What if you could take a pill that would cure you of your addiction?
Would you do it?
Imagine a world in which you could forget your past addictions and where the skeletons in your closet don’t come back to haunt you. That’s exactly what the researchers at University College London are currently studying. More so, VICE’s new film Eternal K-Hole of the Spotless Mind, will delve into the personal life of a patient undergoing ketamine infusions to try to cure him of his alcohol addiction.
To examine the possibility of ketamine relieving addictions such as alcohol addiction, we have to understand how addiction is formed in the brain.
Addiction Brain Chemistry
Addiction is a multifactorial process which includes genetic predispositions, environmental and societal cues, and brain chemistry differences. We’re going to focus on brain chemistry.
Most drugs of abuse increases or mimics neurotransmitters in the brain. Neurotransmitters are chemical messengers.
Think of neurotransmitters as mail and neurotransmitter receptors as mailboxes.
These little neurotransmitters carry information to different parts of your brain, affecting how you think and act.
These drugs increase a neurotransmitter, dopamine, and it’s pathways to the brain region that has drug reinforcing effects. This dopamine pathway plays a part in reinforcement, reward and addiction.
With the development of sophisticated brain imaging, scientists discovered that there is a lower number of dopamine receptors in individuals who eventually become addicted.
This means that if you were born with a lower number of dopamine receptors, your chance of becoming addicted to a drug is higher than average.
Alcohol Dependence Chemistry
In addition to dopamine, other neurotransmitter systems linked to alcohol dependence. These include serotonin and opiate receptors as well as the GABA system. Neuroimaging studies have been crucial to understanding how these drugs play a part in the living human brain.
Ketamine Trials For Depression and Alcohol Dependence
So how does ketamine play a part in this all? A large clinical trial done at VA CT healthcare in collaboration with Yale University, is underway to explore the use of ketamine for depression and alcohol dependence. Since there have been robust results of ketamine therapy on depression, researchers want to further examine treatment-resistant depression patients with a family history of alcoholism.
Previous studies have shown that ketamine was more efficacious in reducing depression symptoms in those with alcohol dependence.
This study hypothesizes that ketamine will help those with depression and alcohol dependence. The results of this study will hopefully give us new insight into the use of ketamine and alcohol dependence.
Ketamine and Depression
Ketamine’s mechanism of action on depression isn’t completely clear yet. Recent studies have shown that it can rapidly improve depressive symptoms in patients with treatment-resistant depression.
Ketamine Affects Neuroplasticity
Ketamine’s effect on depression is theorized to stem from its ability to reverse neuroplasticity deficits and induce neuroplastic changes.
Researchers used neuroimaging and found that ketamine may change the pattern of your nerve pathways in the brain by modulating activity and connectivity in the reward circuits.
This neuroplasticity involves the glutamatergic receptors which play an important role in learning and memory in the brain. According to Dr. Ravi Das, the researcher taking part of the University College London study says ketamine may be able to block memory connections in the brain. These memory connections are determined by NMDA receptor, which ketamine essentially blocks.
Re-wiring the Brain
Perhaps the ability of ketamine to “re-wire” the brain can break the addictive chain of the reward and reinforcement that one gets from drinking alcohol. Ketamine may allow your brain to open up to new protective learning when combined with behavioral treatment programs.
Chronic Ketamine Use and Side Effects
Although these findings present new hope for a disorder suffered by millions of people worldwide, ketamine is not without adverse effects.
A study published in Addictive Behaviors found that repeated ketamine use may impair cognitive processing speed, verbal fluency, and learning.
Longer ketamine use was correlated with worse memory performances. More specifically, ketamine may cause impairments in neuro-organization and encoding information.
However, those who used ketamine chronically had also drank more alcohol than the control group. We cannot rule out that alcohol may potentially be causing these impairments and confounding the findings.
Another concern of ketamine treatment for alcohol dependence may switching from one addiction to another.
Ketamine may lead to drug abuse and addiction.
Ketamine has positive reinforcement effects such as dissociative anesthetic and euphoria effects basically “getting high”. After stopping ketamine, withdrawal symptoms arise which includes craving, a feeling of unease, anxiety and sleep problems.
Reinforcement and Substance Abuse
The therapeutic value of ketamine to treat mental health illnesses presents its own challenges since ketamine also has its own substantial reinforcing effects.
Researchers have found that ketamine increases dopamine in the brain.
Ketamine could cause reinforcement and lead to the initiation of self-administration in order to activate the reward center in the brain.
The Ketamine Conundrum
The rise of ketamine infusion clinics and its use in the treatment of depression has been a hot topic due to its controversial use.
Once a party drug on the streets, “special k” has now risen to a level of higher scientific curiosity in the medical community due to its rapid benefits on depression.
Now, ketamine is being studied for treating alcohol dependence due to its ability to perhaps “re-wire” or “erase” memories and learned behaviors. But this is not without its own dangers, as ketamine is also a drug of abuse itself.
It is definitely an interesting conundrum.
Ketamine holds tremendous potential in treating a serious mental illness and addiction.
Future studies will further need to be done to understand what role ketamine plays on depression and addiction.
Interesting Books to Check Out
- Bryant B. Could Ketamine Cure Addiction? Vice. https://www.vice.com/en_us/article/a3dzaj/could-ketamine-cure-addiction. Published June 30, 2017. Accessed January 31, 2019.
- Chan, Kahlen et al. Effects of chronic ketamine use on frontal and medial temporal cognition. Addictive Behaviors. 2013; 38(5): 2128-2132
- Liu, Yu et al. Ketamine abuse potential and use disorder. Brain Research Bulletin. 2016; 126: 68-73
- Urban, Nina and Martinez, Diana. Neurobiology of Addiction. Psychiatric Clinics of North America. 2012; (35): 521-541
- Wilkinson, Samuel et al. Leveraging Neuroplasticity to Enhance Adaptive Learning: The Potential for Synergistic Somatic-Behavioral Treatment Combinations to Improve Clinical Outcomes in Depression. Biological Pyschiatry. 2018.