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Using Ketamine for Opiate Cessation

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http://www.benthamscience.com/open/topainj/articles/V004/1TOPAINJ.pdf

This article is very interesting. It talks about using Ketamine to reduce or even fully negate negative symptoms experienced by addicts going through the induction phase (withdrawal onset).

Basically, when inducting oneself from full agonist opioids to a partial agonist/antagonist like buprenorphine, he inevitably experiences some hours of discomfort. In my personal experience I have found that Ketamine can not only partially, but fully deactivate the discomfort period that many experience during the induction phase. I have used Ketamine for this sole purpose on a few occasions, and provided one has enough ketamine, theoretically the induction can be pain free.

Furthermore, I wouldn't think it to be out of the question that ketamine, (again provided one had a large or unlimited supply) could be used continuously throughout the acute withdrawal phase to essentially avoid the physical distress caused by allowing the full agonist opioids to fully clear the system. This information could be very useful to detox centers or hospitals, as I am almost certain that Ketamine can make the opiate withdrawal nearly unnoticeable (again, based on personal experience). The question is, is Ketamine safe to administer at a moderate dosage over the course of a few days, and if not then when and for how long would breaks need to be taken, or is there possibly a drug that negates the damage potentially caused by long term ketamine administration.
 
I don't think Ketamine is as great a fix as you think. It binds to mu at higher doses, so functions as more of a band-aid than a remedy.
 
Ho-Chi-Minh said:
I don't think Ketamine is as great a fix as you think. It binds to mu at higher doses, so functions as more of a band-aid than a remedy.
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I really don't now what you mean by 'band-aid'? The point is to temporarily fully reduce symptoms over the course of induction or possibly for 3 days of acute withdrawal. This is not just speculation, I quit a heavy heroin habit (~2 grams type 4 IV heroin/day) with the help of this method.
 
I mean you're temporarily reducing symptoms by substituting with a drug which acts as an agonist at the receptor site which should be healing through abstinence.
 
Ho-Chi-Minh said:
I mean you're temporarily reducing symptoms by substituting with a drug which acts as an agonist at the receptor site which should be healing through abstinence.
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and? if its weaker at this receptor and i'm pretty sure it is, whats the problem. 3meo-pcp helped my with pod withdrawal remarkably well. the actual 3meo-pcp withdrawal itself was so minor as to be not noticeable
 
Its just not that efficient. Also, I found that the hardest part of any taper is the first lowering and more so the jump, which isn't being dealt with in this instance. Additionally, most opiate addicts when they decide to go through withdrawal find that the lingering mental craving is worse than any physical withdrawal, the latter which would would be what this method most effectively avoids.
 
HCM - Ketamine, although it binds to mu, is probably only a partial agonist or maybe even does nothing. It's not very appreciable, people who do lots of K don't get opioid withdrawal. It's not really a band aid.

This sounds like every other "rapid detox" premise. The premise of which is either induce w/d or wait until you hit w/d, and induce anesthetia with non-opioid drugs, take it off when the peak withdrawal effects are over. Problem is: the treatment is expensive and it doesn't address any of the psychological effects of opi withdrawal, and also coming out of multi day anesthetia plus being in whatever w/d you have less will feel like shit.

The principle of using lower dose K instead of other rougher anesthetics is sound, as ketamine can definitely reduce opioid withdrawal woes at below-K-hole doses (probably cause it's a DRI, ion channel blocker, and nmda antagonist). But a long action drug like MXE, or 4-meo-pcp is probably better to use, as a sort of dissociative methadone if you will. You'll probably be using a lot of K if you're in serious w/d, so you'll be bedridden or at least unable to walk. Smome people also really don't like how dissociatives make them feel - and some people get nauseous too. For administration, ether you fuck your nose up blowing K every 2hours to stay high, have a continuous iv drip going, drink/eat 10x your dose in K pills, or wreck your veins with 10 shots a day... Plus K is not exactly cheap, many places.
 
I really think the psychological premise of addiction is primarily worked on after acute withdrawal, and therefore isn't really much of a consideration for physical detox. I hadn't considered MXE or 4-meo-pcp but they do sound like better options at first glance. I have tried DXM and it really doesn't work for withdrawal pain reduction, so I do know that. I'm suggesting that if this were a legal treatment option, hospitals could provide the necessary oral or IV dosages/amounts and i highly doubt it would cost more than traditional detox. I used sniffing and IV administration and went through about 3.5 grams within a couple days. It wasn't completely pain free but definitely would have been, for sure, if i had more ketamine. Even if you don't particularly care for the dissociation, it's probably better than full blown wds.
 
About 15 years a go I attempted many, many, many times to power through heroin withdrawal with IM shots of ketamine every hour or two. Ugh. No amelioration of opioid withdrawal, at all, but it certainly distracted me most effectively! But after 24 hours or so the residual stimulation, minor for the first few shots, builds up to very uncomfortable levels. To the point of needing a shot of dope! And, then, hey, let's do some more k! Rinse, lather, repeat. This was a place where K was OTC. In my experience ketamine has no detectable effect on the MOR and is of limited use mitigating withdrawal. But hey, better than nothing! And fun!

Enough subjective bullshit from me!
 
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3-meo-pcp is much better. you have to taper the opiate, then when its low take small doses of 3meo-pcp once a day for a few days. simple
 
I'd pick an up-tick in neurogenesis being a major benefiting factor during Heroin withdrawal. Increased BDNF levels during a time of fast adaptation, sound plausible?

Just thinking out loud: opiates decrease neurogenesis riiight? are there feedback mechanisms surrounding growth factors which would result some sort of upregulation during withdrawal?
 
amanitadine said:
About 15 years a go I attempted many, many, many times to power through heroin withdrawal with IM shots of ketamine every hour or two. Ugh. No amelioration of opioid withdrawal, at all, but it certainly distracted me most effectively! But after 24 hours or so the residual stimulation, minor for the first few shots, builds up to very uncomfortable levels. To the point of needing a shot of dope! And, then, hey, let's do some more k! Rinse, lather, repeat. This was a place where K was OTC. In my experience ketamine has no detectable effect on the MOR and is of limited use mitigating withdrawal. But hey, better than nothing! And fun!

Enough subjective bullshit from me!
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That's crazy. I shit you not that ketamine completely, i mean 100% deactivated every withdrawal symptom i had from full blown WD after a bundle/day IV heroin habit.
 
One anecdote said that memantine worked well to prolong the antidepressant effect of ketamine, for withdrawals may be another issue but perhaps low daily doses till the wost is over and then substituting it with mem might be a good idea (if youd still need it on ocasion for depression).

One anecdote doesnt mean much offcourse.
 
i second sekio's comment as i have found MXE and DXM but mxe more , a great tool during opiod detox, i used MXE when coming off of 12mg suboxone for mental aspects like: energy,motivation, relief of depression, but mxe/NMDA antagonist did nothing for the actual physical withdrawl and in the case of mxe the DRI effects can make it worse( the flushing and chills/insomnia) thats why i combined it with clonazepam as this combo ( not recommended without tolerance!) produced a effect that knocked the edge off and allowed sleep, i would not advise through personal expirience using copious amounts of NMDA antagonists for detox as more harm may be done, but moderate polypharmacy ie: a custom formula might be the ticket for the sake of harm reduction i wont post a formula for it as there are plenty on the net and BL, but NMDA antagonists are a nice tool.
 
Read the paper and have 2 problems with it:
1. The ketamine is given with an NSAID. Who's to say the NSAID didn't relieve the symptoms. It was given at a therapeutic dose
2. The dose of ketamine is minuscule. 5mg repeated is not enough to have any mu activity.
If ketamine does work for withdrawal it should be used by every physician in that business. Ketamine purchased from wholesale medical supply houses costs [no costs dude] Unless my calculator died that's enough to treat 100 people!!! The IV catheter and fluids probably cost more. If ketamine does work, it can't be from mu agonist affinity.
 
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The advantages of such a procedure would clearly outweigh its benefits.

Ketamine is a powerful anasthetic with known physical and psychological withdrawl systems as will as high potential for addiction and abuse.

Highly unrecommended.
 
pontifex01 said:
Lol, what? What does a "physical withdrawal system" of ketamine feel like, exactly? You sound like a DEA spokesperson.
What the hell does the syntax of your first sentence even mean? The advantages outweigh the benefits...?

As sekio and others have said, longer-acting dissociatives like MXE and DXM are more worthwhile, for obvious reasons. An above poster mentions that the DRI properties of MXE can make some aspects of the withdrawal worse. I have to disagree with that (as has been pointed out a number of times, dopamine affinity for MXE has been disproven, but we all know it does seem to have some stimulant properties, so I understand where you're coming from), but the key is to keep doses low.

I'm also surprised said poster said it didn't relieve physical withdrawals. I found with 15mg sub-lingual doses 4x a day I literally didn't feel a thing. Also excellent for PAWS depression, motivation etc.

I'm glad this knowledge is becoming more widespread; MXE and its ilk can relieve so much suffering. Of course the immediate concern is that having a "magic bullet" for withdrawals always at hand will make heroin use that much more attractive and prolong binges...

[EDIT] To the above poster, the woman in the first case was also having rather severe marital troubles (husband cheating on her), it's more than likely that this exacerbated depression.
Also, ketamine is a psychologically addictive drug. Like any other such drug discontinuation can lead to depression (you're not having fun anymore) - that doesn't necessarily constitute withdrawal in the way, say, that discontinuing a 2mg/day alprazolam habit can lead to depression through withdrawal. The same can be said for drugs like cannabis - a lot of people feel depressed after discontinuing its use for long periods of time, but that is mostly due to missing the feeling of being high.

Even excluding that, there is a significant difference between using ketamine for a couple of weeks to get over opiate withdrawals, and injecting ketamine daily for 4 years, don't you think?

The second article (which admittedly I only skimmed, so forgive me if I missed something) focuses on cognitive impairment (which nobody disputes) and, again, depression upon cessation, which, again, can be explained as purely psychological and not necessarily a symptom of withdrawal. And once again, the article dealt with chronic, heavy users, making it irrelevant to this thread.
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I'm not disputing whether ketamine is beneficial during withdrawal. Nonetheless, regardless if the withdrawal is purely psychological or purely physical doesn't change the fact that as you said "long term users" of ketamine do suffer withdrawal. Phychological withdrawal from any drug are more debilitating than physical ones and its the severity of those psychological symptoms that's detrimental in how much discomfort the user will feel. Lets take cannabis, opioids, and benzodiazepines for example. Benzodiazepine withdrawal is more discomforting and unpleasant than opioid withdrawal, and opioid withdrawal more so than cannabis withdrawal even though they all share the same psychological symptoms, insomnia, depression anxiety, so on and so forth, and opioid withdrawal has the most severe physical symptoms. Even though you make a fair point, comparing cannabis withdrawal and ketamine withdrawal is sapless.

In the UK ketamine withdrawal has become a subject of interest as addiction rates are rising, and in India as well. I would highly suggest you watch a discovery channel segment on ketamine abuse and addiction in Canada and the UK.
 
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