A US clinic is offering ketamine alongside psychotherapy to people with alcoholism as the fast-growing psychedelics industry moves into the treatment of addiction.
Nushama, which is based in New York, said it would dose its first patients this week with ketamine, a hallucinogenic drug approved by regulators half a century ago as a surgical anaesthetic but which has since gained notoriety as an illegal party drug.
The wellness clinic specialises in using psychedelic therapies to treat depression, anxiety and other mental illness. It licensed the combination therapy to treat alcohol use disorder from Awakn Life Sciences, a UK biotech that is developing psychedelic-assisted treatments for addictions such as gambling, compulsive sexual behaviour and binge eating.
Nushama’s four week ketamine and psychotherapy programme costs about $10,000 per person. It is not covered by US insurers because ketamine has not been approved by regulators to treat alcohol use disorder and is therefore being prescribed on an “off-label” basis by the clinic’s doctors.
Anthony Tennyson, chief executive of Awakn, said there was growing scientific evidence that ketamine-assisted therapies delivered by properly trained professionals can recalibrate the brain, tackle addictive behaviour and prevent relapse. The company has signed licensing deals with several third-party clinics in North America and Europe to use the therapy and has established four of its own clinics in the UK and Norway, he said.
“It’s not a case of come in, chat to a doctor for 15 minutes, take a prescription and go home,” said Tennyson. “We are using psychedelic drugs, ketamine, to disrupt operations within [the brain] to a certain degree. And during this disruption we are coming in with therapy to enable people to recalibrate and get the cognitive part of the brain back in control.”
Last year a mid-stage clinical trial led by the University of Exeter found people were able to stay off alcohol for longer when they were treated with low doses of ketamine combined with psychotherapy. Participants using the therapy were more than 2.5 times more likely to stay abstinent at the end of the trial than those given a placebo, according to results published in the American Journal of Psychiatry.
Researchers reported that the experiences people described after taking ketamine suggest it can give a new perspective that may be helpful in psychological therapy. The drug induces a sense of being outside your body that may help patients take a step back and consider thoughts and emotions, they said.
“We use the drug as a way for people to access the therapy. It is potentially helpful for people who get stuck in a rut and become overwhelmed by their own problems,” said Professor Celia Morgan, principal investigator for the trial at the University of Exeter.
She said ketamine was well tolerated by trial participants and prior concerns that it could impact liver function in alcoholics did not prove to be an issue. Liver function improved for those trial participants taking ketamine because they drank less, said Morgan.
Awakn licensed the therapy package from Exeter university, which is recruiting participants for a late-stage trial that is being co-funded by the UK government and delivered by the NHS. It has also appointed Morgan to its scientific advisory board.
Ketamine is one of several psychedelic drugs such as psilocybin, which is the active ingredient in magic mushrooms, mescaline and ecstasy that are being studied or used “off label” to treat depression, anxiety and a range of other illnesses. They are at the vanguard of the psychedelic drugs industry, which is forecast to increase in value to $8.3bn in 2028, up from $3.6bn in 2021, according to a report by research firm InsightAce Analytic.
Several biotechs, including DemeRX and Atai Life Sciences, are studying whether Ibogaine, a psychoactive plant-based substance found in west Africa, can be used to treat addiction. In 2021 the US National Institutes for Research awarded its first grant in half a century to directly investigate the therapeutic effects of a psychedelic: a $4mn award to Johns Hopkins Medicine to study the impact of psilocybin on tobacco addiction.
The rewards of winning regulatory approval for drugs to treat addiction are potentially huge, given that excessive alcohol use alone is responsible for 140,000 deaths a year in the US and costs the economy about $249bn.
Experts in addiction medicine have welcomed the growing body of research on using psychedelics to treat addiction but say there should be rigorous scrutiny of adverse events during trials. Many psychedelic drugs have side effects, can be addictive and in some cases dangerous, particularly if they are taken without medical supervision, they say.
“It is important to explore the research and therapeutic potential of ketamine in alcohol dependence,” said Professor Michael Farrell, director of the National Drug and Alcohol Research Centre at University of New South Wales, Australia. “[But] caution is required in that ketamine dependence may be a real risk and a devastating complication.”
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