Ketamine may help treat cocaine addiction. An AI scan of 90 million electronic health records tracked people who got ketamine as an anesthetic. They were more likely to reach remission from cocaine use disorder than people given other anesthetics or antidepressants. Few other medicines work for cocaine addiction.
Summary: Cocaine use disorder (CUD) is common in the US. Yet researchers have given it too little attention. Very few drugs help with CUD. New studies show that ketamine may help people reach CUD remission, meaning they stop using. A new study used AI to go through 90 million EHRs. People who got ketamine to put them under for a procedure were more likely to reach CUD remission. They did better than those who got other anesthetics or antidepressants.
Cocaine addiction and overdose are big problems in the United States. Millions of people struggle with cocaine use disorder (CUD) each year. The National Survey on Drug Use and Health found that about 2 million Americans used cocaine in the past month in 2020. That counts people aged 12 or older. Cocaine overdose deaths in the United States have climbed steadily over the past decade. In 2022, there were more than 32,000 overdose deaths involving cocaine or other psychostimulants. Over the last decade, the number of people living with CUD has gone up significantly. So have overdose deaths. We urgently need a treatment that works.
Despite years of research, good treatments for CUD are still missing. There are two main reasons. Cocaine addiction hits many brain chemical systems at once. And there is little research money for CUD.
Cocaine is a highly addictive stimulant. It hits the brain’s reward and drive pathways. It raises dopamine, norepinephrine, and serotonin in the brain. That brings euphoria (a rush of joy) and energy. But the high is short. People who use cocaine often build tolerance, so they need bigger and bigger doses for the same effect. This can lead to dependence, withdrawal, and a drive to seek the drug no matter what. Those are the marks of addiction.
Talk therapies help some people with CUD. These include cognitive-behavioral therapy and contingency management (rewards for clean drug tests). Still, they often do not stop relapse over the long run. Medicines approved for the treatment of drug addiction have not worked for CUD. That includes methadone and buprenorphine, which work for opioid use disorder.
Part of the problem is how complex CUD is. Cocaine addiction changes many brain chemical systems, which rewires reward and drive. Cocaine also harms both body and mind, so it is hard to treat with a single approach. Money is the other problem. CUD gets far less attention from researchers and lawmakers than opioid addiction and other substance use disorders. Without that money, large clinical trials and new medicines and therapies are hard to get done.
But new research suggests ketamine may be a promising new way to treat CUD. Ketamine is an anesthetic. In low doses, it lifts depression fast. Studies also suggest ketamine may cut cocaine cravings and prevent relapse in people with CUD.
Each year brings more proof for the use of ketamine for treating CUD. In one recent study in the journal Addiction, researchers used AI to study what ketamine does in CUD.
Why use AI? It is better than people at sorting through huge piles of data. In this study, AI went through 90 million electronic health records (EHRs). Many of those patients had been put under with various anesthetics.
The AI found a clear pattern. Patients with CUD who got ketamine for a procedure got better far more often than those given other anesthetics. For example, the CUD remission rate was four times higher than in patients who got antidepressants or midazolam. Remission means the drug use stopped. So the researchers concluded that ketamine has great promise for CUD.
Frequently asked questions
What medications are used for cocaine use disorder?
Very few work. Medicines that help opioid addiction, such as methadone and buprenorphine, have not worked for cocaine use disorder. Talk therapy helps some people. That includes cognitive-behavioral therapy and contingency management. But it often does not stop relapse over the long run. Ketamine is the newest candidate. Studies suggest it may cut cocaine cravings and stop relapse.
Can ketamine help with cocaine addiction?
The proof keeps growing. A study in the journal Addiction used AI to scan 90 million health records. Some people with cocaine use disorder got ketamine to put them under for a procedure. They got into remission far more often than those given other anesthetics. Remission was four times higher than in patients who got antidepressants or midazolam.
Can people recover from cocaine addiction?
Yes. Remission from cocaine use disorder is the goal researchers measure. The ketamine study counted the patients who got there. Recovery is hard because cocaine changes several brain chemical systems at once. These include dopamine, norepinephrine and serotonin. Those changes drive tolerance, withdrawal and the urge to seek the drug. That is why one approach alone rarely works.
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