Anesthesia & Clinical Research
Open Access

Abstract

Sustained Opioid Cessation Following Rapid Opioid Detoxification with Ketamine Infusion Therapy in Veterans a Preliminary Study

Randall J Malchow, Jennifer W Baker and Ashley P Yost

Objective: The primary outcome of this study utilizing ketamine assisted opioid detoxification is long-term opioid cessation, while secondary outcomes are assessments of opioid withdrawal, pain reduction, and ketamine side effects.

Design: Preliminary observational study involving a comprehensive review of a prospectively collected database.

Setting: Veterans Affairs Medical Center in Nashville, Tennessee.

Subjects: 41 veterans with chronic non-cancer pain and on chronic opioids who received ketamine assisted opioid detoxification.

Methods: The authors conducted a review of a real time data collection of forty-one patients who met inclusion criteria. The authors reviewed data collected over a 28-month period (April 2016-July 2018). Following detoxification and the initial ketamine infusion series, the patients were monitored at regular intervals for up to 12 months postinfusion; this monitoring period extended through October 2018 to ensure all patients had at least 3 months of monitoring data.

Results: Most veterans remained opioid free long after treatment: 83%, 75%, and 58% at one, three, and six months respectively (p=0.0001). Seventy-six percent of patients reported opioid withdrawal as either none or mild severity. Median pain reductions at one and three months were 50% and 40%, respectively. The incidence of troubling ketamine side effects was low.

Conclusion: Ketamine assisted opioid detoxification appears to be a safe and effective tool to target opioid misuse and has the potential to decrease opioid consumption, overdose related deaths, and chronic pain.