Abstract
This thesis explores the potential of ketamine as a treatment for Alcohol Use Disorder (AUD), a prevalent condition observed both globally, and specifically in Aotearoa New Zealand. Given the small effect sizes and moderate rates of relapse associated with existing treatment, this thesis focuses on the emerging evidence of using ketamine to prevent relapse in people with AUD. The research presented here encompasses a systematic review and meta-analysis, an ethical analysis, and the development of a clinical trial protocol to examine ketamine interventions to prevent relapse in AUD.
Aims
This thesis explores the efficacy of ketamine for preventing relapse in people with AUD, by examining changes in drinking after ketamine intervention as an adjunct to psychotherapy. Specific measures include abstinence, relapse rates, time until return to drinking, and heavy drinking days.
Methods
This thesis is structured into five main chapters. Chapter One introduces AUD and ketamine. Chapter Two presents a systematic review and meta-analysis of ketamine trials for AUD where alcohol use has been quantified after administration. Chapter Three discusses the ethics and practicalities of clinical trials of ketamine for people with AUD. Chapter Four delivers a protocol for such a trial: ketamine-assisted group mindfulness in the treatment of AUD. Chapter Five concludes with a reflection on the strengths and limitations of this thesis.
Results
The systematic review reveals some evidence to support ketamine interventions for AUD, albeit with variability in methodology and rigour. The ethical analysis supports further research. An approved clinical trial protocol and manual are available for future use.
Conclusions
This thesis finds that the current body of evidence indicates potential benefits of ketamine interventions in the treatment of AUD, although effect sizes are likely small. This thesis recommends ongoing research into ketamine to treat Alcohol Use Disorder.