Shahar Almog, Maribel Rodriguez Perez, Deepthi S Varma, Alexia N Obrochta, Michelle Weiner, JeeWon Cheong, Meredith S Berry
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Participants reporting past problematic substance use had significantly greater positive change compared with the groups of participants reporting present or no history of problematic substance use (<i>p</i>s < .020). Participants reported positive outcomes such as reduced substance use due to reduced need to self-medicate for coping, reduced craving, or enhanced motivation to quit use. Among participants with minimal or no substance use, ketamine did not appear to induce or increase drug-using behaviors. However, there were some reports of risky behaviors such as openness to using other psychedelics or ketamine used recreationally as a substitute for alcohol. Several implications for providers are discussed. More targeted quantitative and qualitative research is needed to fully characterize all patients but especially those at risk for potentially harmful nonmedical substance use. 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引用次数: 0
摘要
氯胺酮越来越多地被用于社区诊所,作为不同精神和疼痛状况的长期治疗,包括物质使用障碍。然而,缺乏关于氯胺酮对其他药物使用的潜在影响的数据。在这一次要分析中,我们旨在通过定量和定性数据相结合,探讨现实世界患者中医用氯胺酮与其他物质使用之间的关系。在一项在线匿名试点调查(N = 201)中,患者评价了自医用氯胺酮开始使用以来其他物质使用的变化,并详细阐述了他们的主观体验。大多数患者自我报告药物使用阳性/理想变化(54.7%)或无变化(44.3%)。报告过去问题物质使用的参与者与报告现在或没有问题物质使用史的参与者相比,有显著更大的积极变化(ps < 0.020)。参与者报告了积极的结果,如由于减少了应对自我药物的需要而减少了物质使用,减少了渴望,或增强了戒烟的动机。在很少或没有药物使用的参与者中,氯胺酮似乎不会诱发或增加药物使用行为。然而,也有一些危险行为的报道,比如开放使用其他致幻剂或氯胺酮作为酒精的替代品。讨论了对提供者的几个含义。需要更有针对性的定量和定性研究,以充分描述所有患者的特征,特别是那些有使用潜在有害非医疗物质风险的患者。此类研究可以为安全、筛查、监测以及患者和提供者教育方面的监管工作提供信息,以最大限度地提高医疗氯胺酮的效益,并将风险降到最低。(PsycInfo Database Record (c) 2025 APA,版权所有)。
Self-reported changes and experiences with substance use among real-world patients treated with medical ketamine.
Ketamine is increasingly used in community clinics as a long-term treatment for different psychiatric and pain conditions, including substance use disorders. Data are lacking, however, regarding the potential influence of ketamine on other substance use. In this secondary analysis, we aimed to explore the relationship between medical ketamine and other substance use among real-world patients by combining quantitative and qualitative data. In an online anonymous pilot survey (N = 201), patients rated change in other substance use since medical ketamine initiation and elaborated on their subjective experiences. Most patients self-reported positive/desirable change (54.7%) or no change in substance use (44.3%). Participants reporting past problematic substance use had significantly greater positive change compared with the groups of participants reporting present or no history of problematic substance use (ps < .020). Participants reported positive outcomes such as reduced substance use due to reduced need to self-medicate for coping, reduced craving, or enhanced motivation to quit use. Among participants with minimal or no substance use, ketamine did not appear to induce or increase drug-using behaviors. However, there were some reports of risky behaviors such as openness to using other psychedelics or ketamine used recreationally as a substitute for alcohol. Several implications for providers are discussed. More targeted quantitative and qualitative research is needed to fully characterize all patients but especially those at risk for potentially harmful nonmedical substance use. Such research could inform regulation efforts on safety, screening, monitoring, and patient and provider education, to maximize benefits and minimize risks related to medical ketamine. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
期刊介绍:
Experimental and Clinical Psychopharmacology publishes advances in translational and interdisciplinary research on psychopharmacology, broadly defined, and/or substance abuse.