The first United States citizen to receive a specialized treatment for ketamine-assisted therapy for alcohol use disorder was dosed today at the New York City-based ketamine clinic Nushama.
The proprietary protocol, “Ketamine for the Reduction of Alcohol Use Disorder,” was developed by Nushama’s partner Awakn Life Sciences, a biotech company focusing on psychedelic therapies for addiction whose team includes psychiatrist and MDMA researcher Ben Sessa, and pharmacologist and former UK government drug advisor David Nutt.
The KARE protocol combines psychotherapy with ketamine infusions over the course of four weeks, including preparation and integration. “It is a uniquely effective treatment for alcohol use disorder,” says Jay Godfrey, Nushama’s CEO and cofounder, “because it is intended to provide insights into the underlying cravings for alcohol and understand the deeply rooted behavioral patterns that keep individuals stuck in cycles of addiction.”
Andrew Tatarsky, psychologist and founder of Center for Optimal Living, sees the triad of preparation, psychotherapy, and integration in combination with ketamine treatment as synergistic.
“Preparation and integration can really enhance the ketamine experience,” says Tatarsky. “But then the ketamine experience can support psychotherapy by increasing neuroplasticity – windows of increased receptiveness to new learning. There’s a kind of dissolving of old psychic structures. That’s where ketamine can really enhance the effectiveness of psychotherapy.”
Awakn sponsored the world’s first randomly controlled clinical trial on ketamine-assisted therapy for the treatment of alcohol use disorder, which utilized the KARE protocol. Led by Awakn’s head of ketamine-assisted psychotherapy for addiction Celia Morgan, the study demonstrated 86% abstinence from alcohol after six months among a group of 96 participants.
What makes KARE distinct from other psychedelic-assisted therapy modalities is “a greater emphasis on a mindfulness-based psychotherapy component, a total of 18 hours across 4 weeks,” says Godfrey. After the final session, patients are evaluated to assess the need for further treatment. “At this time, we recommend further psychotherapy, if deemed necessary, to continue the process of unveiling the triggers and cravings surrounding their addiction.”
The cost of treatment is a flat fee of $9,950 for the four-week treatment. According to the National Center for Drug Abuse Statistics, the average cost of a conventional in-patient rehab facility in the United States can range from $5,000 to $20,000 for a 30-day program, although the price point in New York City is steeper. “On average an individual enrolled in New York residential rehab can expect to pay $56,653,” writes NCDAS.
Total Abstinence vs. Psychedelic-Assisted Therapy
Alcohol use disorder has traditionally been met with a zero tolerance abstinence-only policy, most famously by Alcoholics Anonymous. For those who’ve long been taught by groups like AA that total abstinence from all drugs is the only path to healing, the ketamine clinic’s approach may seem counterintuitive, carrying risk of relapse.
“Current research demonstrates psychedelics have important therapeutic properties and can be used safely as treatments for a wide range of medical conditions, including fighting addiction,” says Godfrey. “The way ketamine or any other psychedelic medicines are used recreationally is very different from how they are used in controlled medical settings. In the medical context, the medicines used are pure without adulterants, and participants are closely monitored before, during, and after medicine sessions, making psychedelic therapy very safe.”
“A supervised ketamine experience in a knowledgeable, safe environment is not getting high,” agrees Tatarsky. The more “fundamentalist approach” of the abstinence-only model is “really problematic,” he continues. “That’s what I call the abstinence-only disease model: addiction as a permanent, chronic, progressive disease only arrested by complete and total abstinence. And if you violate abstinence, even with a sip, you relapse. It’s a narrative that can program people and become a self fulfilling prophecy.”