New Hope for Cocaine Addiction: Ketamine Emerges as a Potential Treatment

Cocaine Addiction - Addictionology Center

Summary: Cocaine use disorder (CUD) is quite common in the US, and yet it has received insufficient attention from researchers. There are very few drugs that can help manage CUD. New studies show that ketamine may help achieve CUD remission. A new study using AI went through 90 million EHRs and found that those who received ketamine as an anesthetic were more likely to achieve CUD remission than those who received other anesthetics or antidepressants.

Cocaine addiction and overdose are significant problems in the United States. Millions of individuals struggle with cocaine use disorder (CUD) each year. According to the National Survey on Drug Use and Health, approximately 2 million Americans aged 12 or older had used cocaine in the past month in 2020. Moreover, the number of cocaine overdose deaths in the United States has been increasing steadily over the past decade. In 2022, there were more than 32,000 overdose deaths involving cocaine or other psychostimulants. Over the last decade or so, the number of people living with CUD has increased significantly, and so have overdose-related deaths. Thus, an urgent need is to find an effective treatment for the condition.

Despite years of research, effective treatment options for CUD have remained elusive. The complex nature of cocaine addiction, which affects multiple neurotransmitter systems in the brain, and the lack of research funding for CUD are the main reasons behind the difficulty in developing effective treatments.

Cocaine is a highly addictive stimulant that affects the brain’s reward and motivation pathways. It works by increasing dopamine, norepinephrine, and serotonin levels in the brain, which leads to euphoria and heightened energy. However, the effects of cocaine are short-lived, and individuals who use cocaine frequently develop tolerance, which means they need ever-increasing doses to achieve the same effect. This can lead to dependence, withdrawal symptoms, and compulsive drug-seeking behavior, which are hallmarks of addiction.

Traditional therapies, such as cognitive-behavioral therapy and contingency management, have shown some success in treating CUD. Still, they are often not enough to prevent relapse in the long term. In addition, medications approved for the treatment of drug addiction and other substance use disorders, such as methadone and buprenorphine for opioid use disorder, have not been effective in treating CUD.

The lack of effective treatments for CUD is due in part to the complex nature of the disorder. Cocaine addiction involves changes in multiple neurotransmitter systems in the brain, which can alter reward and motivation pathways. Moreover, cocaine use can have both physical and psychological effects, making it difficult to address through a single approach. Another challenge is the lack of research funding for CUD. Compared to other substance use disorders like opioid addiction, CUD has received relatively little attention from researchers and policymakers. This lack of funding has made conducting large-scale clinical trials and developing new medications and therapies difficult.

However, emerging research suggests that ketamine may be a promising new approach for treating CUD. Ketamine is an anesthetic drug shown to have rapid antidepressant effects in low doses. In addition, studies have suggested that ketamine may also be effective in reducing cocaine cravings and preventing relapse in individuals with CUD. 

With every passing year, evidence is increasing in support of the use of ketamine for treating CUD. In one of the recent studies published in the journal Addiction, researchers used artificial intelligence to understand the role of ketamine in CUD.

Why use artificial intelligence? Well, AI has some distinct benefits, like it is better suited than humans for analyzing massive data sets. For example, researchers used AI in the study to analyze 90 million electronic health records (EHRs). And many of them were given various anesthetics.

In the study, AI found that patients who were given ketamine as an anesthetic and were living with CUD had much higher CUD remission rates compared to patients who were given other anesthetics. For example, the rate of CUD remission was four times higher than patients who received antidepressants or midazolam. Thus, the researchers concluded that ketamine has excellent potential for managing CUD.

Gurpreet Singh Padda, MD, MBA, MHP

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