MAPS Ketamine.heroin addiction

kkgb1035

Bluelighter
Joined
Nov 15, 2010
Messages
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Hey bluelight! I hope this I the correct place to post this .If not let me know and I'll recpost it.

So I'm a heroin addict of about 5 years was just clean for about two month but the last few weeks Iv been back at it.
Iv always been very interested in the more less used methods of battling addiction.
Iv been in maintnece programs and AA/NA and inpatient.I never want to be on bupe or methadone again and yea inpatient has helped and when I kinda look past some things I don't agree with in AA/NA I can make it work for a bit but ther a difference in me compared to other people in meetings.what I mean by that is yes I would love to get off heroin and benzos and meth and pretty much every other opiate (you get the jist).
But I do not want to quit doing ketamine and LSD and other psychedelics / dissociatives that I tend to do every couple months.Twice a month at the most.

Anyway the reason for this post is I have recently read some thing about how ketamine can really help battle addiction.
It's something I want to give a shot.
I am going to list some of the questions I have.

1) How much ketamine would one use at a time? IV? Snorting?
2)How often should someone use through out the day?
3)Is ther a certain type of ketamine that would be preferable for this?

If someone Cab help me with these questions I would very much appreciate it.
I have notice thers is a lot of people who comment on other people's posts and really give it to them and seem to get mad at some questions.Please do not reply if you think my question is stupid or of your gonna say something along the lines of "your talking about quitting drugs with drugs".
I really am interested in the therapudic side of ketamine.
 
Just had it done. A ketamine infusion. You can get up to 500mg over 8 hours in the hospital for pain. I like it. Check with your insurance or doctor about ketamine treatment.


Edit: I don't want to use opiates but on rare occasions. This works. YMMV.
 
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Great find WSH. If anyone else finds anything interesting specifically addressing substance use disorder (preferably opioid use disorder) and ketamine therapy I'd be very keen to see it. I only seem to find the studies out there on it and depression, as that seems to be what the bulk of the research has focused on.
 
I was just on a K drip in the hospital and the gave me 22.5mg per hr and damn it helped. Pit it this way I was using 3g’s a day and was able to get by comfortably on 12mg dilaudid every 3hrs the K drip @ 22.5mg/hr and 1 G tar heroin for 2 days so yes Ketamine was a miricle for withdrwal
 
Great find WSH. If anyone else finds anything interesting specifically addressing substance use disorder (preferably opioid use disorder) and ketamine therapy I'd be very keen to see it. I only seem to find the studies out there on it and depression, as that seems to be what the bulk of the research has focused on.

Maybe have a look here:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5105239/
https://www.frontiersin.org/articles/10.3389/fpsyt.2018.00277/full
http://www.psychiatrictimes.com/art...-use-disorders-classic-hallucinogens/page/0/2
https://www.researchgate.net/public...withdrawal_in_an_addicted_woman_A_case_report
 
^ You're welcome!

Ketamine psychotherapy for heroin addiction: immediate effects and two-year follow-up

Krupitsky E, Burakov A, Romanova T, Dunaevsky I, Strassman R, Grinenko A

Seventy detoxified heroin addicts were randomly assigned to one of two groups receiving ketamine-assisted psychotherapy (KPT) involving two different doses of ketamine. There were 35 heroin addicts in the experimental group, and 35 heroin addicts in the control group. The experimental group received existentially oriented psychotherapy in combination with a psychedelic dose of ketamine (2.0 mg/kg i.m.). The patients of the control group received the same psychotherapy combined with a very low, non-psychedelic dose of ketamine (0.2 mg/kg i.m.). This low-dose induces some pharmacological effects without inducing a peak psychedelic experience. Both the psychotherapist and patient were blind to the dose of ketamine. Otherwise, all patients were treated alike and were given the same preparation. The KPT sessions, regardless of dose, also were similar.

All patients’ evaluations during the treatment and follow-up period were performed by a clinician evaluator other than the psychotherapist providing KPT who was blind to the dose of ketamine. KPT included preparation for the ketamine session, the ketamine session itself, and the post session psychotherapy aimed to help patients to integrate insights from their ketamine session into everyday life. During the ketamine session, the psychotherapist provided emotional support for the subject and carried out psychotherapy.

The results of this double-blind, randomized clinical trial of KPT for heroin addiction showed that high-dose KPT elicits a full psychedelic experience in heroin addicts as assessed quantitatively by the Hallucinogen Rating Scale. On the other hand, low-dose KPT elicits “sub-psychedelic” experiences similar to ketamine-facilitated guided imagery. High-dose KPT produced a significantly greater rate of abstinence in heroin addicts within the first two years of follow-up than did low-dose KPT. High-dose KPT elicited a greater and longer-lasting reduction in craving for heroin, as well as greater positive change in nonverbal unconscious emotional attitudes. Thus, the higher rate of abstinence in the high-dose group may be related to KPT’s effects on craving and modification of nonverbal unconscious emotional attitudes.

KPT-induced effects on depression, anxiety, anhedonia, and psychological changes were similar in the experimental and control groups. These results support the conclusion that high-dose ketamine-assisted psychotherapy may improve abstinence in heroin addicts through reduction in craving. However, it also appears that the acute psychedelic effects induced by psychedelic psychotherapy on the verbal level do not always lead to high rates of abstinence from drugs and alcohol. Further research should explicate how high-dose KPT improves relapse rates, and how to apply more optimally acute drug-induced psychological effects towards therapeutic ends.

https://www.ncbi.nlm.nih.gov/pubmed/12495789
 
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Interesting.. Have never tried Ketamine but have heard of it being used for depression, has anyone here tried it at these doses in a therapeutic environment?
 
^

Onetime party drug hailed as a miracle for treating severe depression

By Sara Solovitch

It was November 2012 when Dennis Hartman, a Seattle business executive, managed to pull himself out of bed, force himself to shower for the first time in days and board a plane that
would carry him across the country to a clinical trial at the National Institute of Mental Health (NIMH) in Bethesda.

After a lifetime of profound depression, 25 years of therapy and cycling through 18 antidepressants and mood stabilizers, Hartman, then 46, had settled on a date and a plan to end it all.
The clinical trial would be his last attempt at salvation.

For 40 minutes, he sat in a hospital room as an IV drip delivered ketamine through his system. Several more hours passed before it occurred to him that all his thoughts of suicide had evaporated.

My life will always be divided into the time before that first infusion and the time after, Hartman says today. That sense of suffering and pain draining away. I was bewildered by the absence of pain.

Ketamine has been around since the early 1960s. It is a staple anesthetic in emergency rooms, regularly used for children when they come in with broken bones and dislocated shoulders. Its an important tool in burn centers and veterinary medicine, as well as a notorious date-rape drug, known for its power to quickly numb and render someone immobile.

Since 2006, dozens of studies have reported that it can also reverse the kind of severe depression that traditional antidepressants often dont touch. The momentum behind the drug has now reached the American Psychiatric Association, which, according to members of a ketamine task force, seems headed toward a tacit endorsement of the drug for treatment-resistant depression.

Experts are calling it the most significant advance in mental health in more than half a century. They point to studies showing ketamine not only produces a rapid and robust antidepressant effect; it also puts a quick end to suicidal thinking.

Traditional antidepressants and mood stabilizers, by comparison, can take weeks or months to work. In 2010, a major study published in JAMA, the journal of the American Medical Association, reported that drugs in a leading class of antidepressants were no better than placebos for most depression.

A growing number of academic medical centers, including Yale University, the University of California at San Diego, the Mayo Clinic and the Cleveland Clinic, have begun offering ketamine treatments off-label for severe depression, as has Kaiser Permanente in Northern California.

The next big thing?

This is the next big thing in psychiatry, says L. Alison McInnes, a San Francisco psychiatrist who over the past year has enrolled 58 severely depressed patients in Kaisers San Francisco clinic. She says her long-term success rate of 60 percent for people with treatment-resistant depression who try the drug has persuaded Kaiser to expand treatment to two other clinics in
the Bay Area. The excitement stems from the fact that its working for patients who have spent years cycling through antidepressants, mood stabilizers and various therapies.

Psychiatry has run out of gas in trying to help depressed patients for whom nothing has worked, she says. There is a significant number of people who dont respond to antidepressants,
and we have had nothing to offer them other than cognitive behavior therapy, electroshock therapy and transcranial stimulation.


McInnes is a member of the APAs ketamine task force, assigned to codify the protocol for how and when the drug will be given. She says she expects the APA to support the use of ketamine treatment early this year.

The guidelines, which follow the protocol used in the NIMH clinical trial involving Hartman, call for six IV drips over a two-week period. The dosage is very low, about 1/10 of the amount used in anesthesia. And when it works, it does so within minutes or hours.

Its not subtle, says Enrique Abreu, a Portland, Ore., anesthesiologist who began treating depressed patients with it in 2012. Its really obvious if its going to be effective. And the response rate is unbelievable. This drug is 75 percent effective, which means that three-quarters of my patients do well. Nothing in medicine has those kind of numbers.

So far, there is no evidence of addiction at the low dose in which infusions are delivered. Ketamine does, however, have one major limitation: Its relief is temporary. Clinical trials at NIMH have found that relapse usually occurs about a week after a single infusion.

Ketamine works differently from traditional antidepressants, which target the brains serotonin and noradrenalin systems. It blocks N-methyl-D-aspartate (NMDA), a receptor in the brain that is activated by glutamate, a neurotransmitter.

In excessive quantities, glutamate becomes an excitotoxin, meaning that it overstimulates brain cells.

Ketamine almost certainly modifies the function of synapses and circuits, turning certain circuits on and off, explains Carlos Zarate Jr., NIMH chief of neurobiology and treatment of mood disorders, who has led the research on ketamine. The result is a rapid antidepressant effect.

Rapid effect

A study published in the journal Science in 2010 suggested that ketamine restores brain function through a process called synaptogenesis. Scientists at Yale University found that ketamine
not only improved depression-like behavior in rats but also promoted the growth of new synaptic connections between neurons in the brain.

Even a low-dose infusion can cause intense hallucinations. Patients often describe a kind of lucid dreaming or dissociative state in which they lose track of time and feel separated from their bodies. Many enjoy it; some dont. But studies at NIMH and elsewhere suggest that the psychedelic experience may play a small but significant role in the drugs efficacy.

Its one of the things thats really striking, says Steven Levine, a Princeton, N.J., psychiatrist who estimates that he has treated 500 patients with ketamine since 2011. With depression, people often feel very isolated and disconnected. Ketamine seems to leave something indelible behind. People use remarkably similar language to describe their experience: a sense of connection to other people, a greater sense of connection to the universe.

Although bladder problems and cognitive deficits have been reported among long-term ketamine abusers, none of these effects have been observed in low-dose clinical trials. In addition to depression, the drug is being studied for its effectiveness in treating obsessive-compulsive disorder, post-traumatic stress disorder, extreme anxiety and Rett syndrome, a rare developmental disorder on the autism spectrum.

Booster treatments

The drugs fleeting remission effect has led many patients to seek booster infusions. Hartman, for one, began his search before he even left his hospital room in Bethesda.

Four years ago, he couldnt find a doctor in the Pacific Northwest willing to administer ketamine. At the time, psychiatrists hovered between willful ignorance and outright opposition to it,
says Hartman, whose depression began creeping back a few weeks after his return to Seattle.

It took nine months before he found an anesthesiologist in New York who was treating patients with ketamine. Soon, he was flying back and forth across the country for bimonthly infusions.

Upon his request, he received the same dosage and routine he received in Bethesda: six infusions over two weeks. And with each return to New York, his relief seemed to last a little longer. These days, he says that his periods of remission between infusions often stretch to six months. He says he no longer takes any medication for depression besides ketamine.

I dont consider myself permanently cured, but now its something I can manage,
Hartman says, like diabetes or arthritis. Before, it was completely unmanageable. It dominated my life
and prevented me from functioning.


In 2012 he helped found the Ketamine Advocacy Network, a group that vets ketamine clinics, advocates for insurance coverage and spreads the word about the drug.

And word has indeed spread. Ketamine clinics, typically operated by psychiatrists or anesthesiologists, are popping up in major cities around the country.

Levine, for one, is about to expand from New Jersey to Denver and Baltimore. Portlands Abreu recently opened a second clinic in Seattle.

Depression is big business. An estimated 15.7 million adults in the United States experienced at least one major depressive episode in 2014, according to the NIMH.

Theres a great unmet need in depression, says Gerard Sanacora, director of the Yale Depression Research Program. We think this is an extremely important treatment. The concern
comes if people start using ketamine before CBT [cognitive behavioral therapy] or Prozac. Maybe someday it will be a first-line treatment. But we are not there yet.


Many unknowns

Sanacora says a lot more research is required. Its a medication that can have big changes in heart rate and blood pressure. There are so many unknowns, I am not sure it should be used more widely till we understand its long-term benefits and risks.

While a single dose of ketamine is cheaper than a $2 bottle of water, the cost to the consumer varies wildly, anywhere from $500-$1,500 per treatment. The drug is easily available in any pharmacy, and doctors are free to prescribe it, as with any medication approved by the Food and Drug Administration for off-label use. Practitioners attribute the expense to medical monitoring of patients and IV equipment required during an infusion.

There is no registry for tracking the number of patients being treated with ketamine for depression, the frequency of those treatments, dosage levels, follow-up care and adverse effects.

We clearly need more standardization in its use, Zarate says. We still dont know what the proper dose should be. We need to do more studies. It still, in my opinion, should be used predominantly in a research setting or highly specialized clinic.

As a drug once known almost exclusively to anesthesiologists, ketamine now falls into a gray zone.

Most anesthesiologists dont do mental health, and there is no way a psychiatrist feels comfortable putting an IV in someones arm, Abreu says.

It is a drug, in other words, that practically demands collaboration. Instead, it has set off a turf war. As the use of ketamine looks likely to grow, many psychiatrists say that use of ketamine
for depression should be left to them.

The bottom line is you are treating depression, says psychiatrist David Feifel, director of the Center for Advanced Treatment of Mood and Anxiety Disorders at the University of California at San Diego. And this isnt garden-variety depression. The people coming in for ketamine are people who have the toughest, potentially most dangerous depressions. I think it is a disaster if anesthesiologists feel competent to monitor these patients. Many of them have bipolar disorder and are in danger of becoming manic. My question [to anesthesiologists] is: Do you feel comfortable that you can pick up mania?

But ketamine has flourished from the ground up and with little or no advertising. The demand has come primarily from patients and their families; Zarate, for instance, says he receives
at least 100 emails a day
from patients. "Nearly every one of them wants to know where they can get it."

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Definitely have a look here, too:

http://www.bluelight.org/vb/threads/823370-Treating-depression-with-psychedelics
 
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