Ketamine Therapy for Addiction Recovery

For anyone fighting a substance use disorder, recovery can feel like the longest climb of their life. Nearly 49 million Americans live with at least one substance use disorder, yet fewer than 1 in 4 receive any treatment for it.¹ For people who have tried traditional rehab, medication, or counseling without lasting relief, ketamine therapy for addiction is one of the most promising additions to recovery care to emerge in the last decade. At Avesta Ketamine & Wellness, our clinicians deliver IV ketamine infusions and ketamine-assisted psychotherapy at five locations across the DMV — Washington, D.C., Bethesda and Columbia, Maryland, and Tysons and Norfolk, Virginia — to support patients working toward long-term sobriety.

Can ketamine help with addiction recovery?

The short answer: a growing body of clinical research suggests yes — particularly for patients who have not responded to first-line treatments. Ketamine doesn’t replace evidence-based addiction care (12-step programs, medication-assisted treatment, therapy). It works alongside them by targeting two underlying drivers of relapse:

• The depression and anxiety that so often co-occur with addiction. Roughly 1 in 5 adults with a substance use disorder also has a major depressive episode in the same year.² Ketamine is one of the fastest-acting antidepressants available, with effects that can begin within hours rather than weeks.
• The reward and craving circuitry in the brain. Ketamine appears to “reset” maladaptive learning around the substance, blunting cravings and weakening the pull of conditioned cues.³,⁴

Patients we see at Avesta typically come to ketamine therapy after months or years of cycling between sobriety and relapse, often carrying a treatment-resistant mood disorder underneath. Ketamine therapy is designed to help break that cycle.

How ketamine works in the brain to support recovery

Ketamine is an NMDA receptor antagonist. In plain language: it temporarily quiets a specific signaling pathway in the brain that’s tied to mood regulation, learning, and habit formation. Three effects matter most for addiction recovery:

1. Rapid relief from depression. A 2019 study in Science showed that a single sub-anesthetic dose of ketamine triggers the growth of new dendritic spines — the tiny connections between neurons — in the prefrontal cortex. These structural changes correlate with sustained antidepressant effects.⁵
2. Increased neuroplasticity. The same mechanism that helps with depression also creates a window in which the brain is more receptive to behavior change, which is why ketamine pairs so well with therapy and integration coaching.
3. Disrupted craving memories. Animal and early human studies suggest ketamine can interfere with the reconsolidation of drug-associated memories, weakening the cues that drive relapse.⁴
   

It’s the combination of these three effects — fast mood relief, a more flexible brain, and weaker cravings — that makes ketamine such a uniquely useful tool in recovery.

Ketamine for alcohol use disorder

Alcohol is the most common substance use disorder we treat. About 28.9 million U.S. adults meet the criteria for an alcohol use disorder, and only a small fraction get specialty treatment in any given year.¹

A landmark UK study published in Nature Communications (Das et al., 2019) showed that a single ketamine infusion paired with a brief therapy session targeting alcohol memories cut self-reported drinking nearly in half over the six months that followed, compared with control conditions.⁶ More recent open-label work in patients with severe alcohol use disorder has reported sustained abstinence rates that meaningfully exceed those of standard outpatient care.⁷

At Avesta, ketamine for alcohol addiction is usually delivered as a series of IV infusions, often paired with ketamine-assisted psychotherapy (KAP) or integration coaching so that the neuroplastic window opened by ketamine is used to do the harder work of changing patterns around drinking.

Ketamine for cocaine cravings

Cocaine use disorder has no FDA-approved medication, which makes it one of the most difficult substance use disorders to treat. Ketamine is one of the few interventions with positive published trial data in this population.

A 2019 randomized trial from Columbia University found that a single ketamine infusion (combined with mindfulness-based relapse prevention) led to significantly more participants achieving abstinence — and longer time between cocaine uses — than the active control group.⁸ The mechanism appears to be a combination of reduced cravings and stronger engagement with therapy after the infusion.

Cocaine recovery patients at Avesta are typically evaluated for a full multi-infusion protocol alongside a referral to ongoing therapy or recovery coaching.

Ketamine for opioid and heroin recovery

Opioid use disorder responds well to medication-assisted treatment (buprenorphine, methadone, naltrexone), and ketamine is not a replacement for those gold-standard medications. It can, however, be a valuable adjunct.

Research dating back to Krupitsky and colleagues found that heroin-dependent patients who received ketamine-assisted therapy were significantly more likely to remain abstinent at one and two years compared with those who received conventional counseling alone.⁹ More recent observational data suggests ketamine also helps with post-acute withdrawal symptoms — the prolonged low mood, anhedonia, and sleep disruption that drive many relapses in the weeks and months after detox.

For patients in recovery from opioids, we coordinate closely with their MAT prescriber and recovery team before starting any ketamine protocol.

Is ketamine itself addictive? Understanding the difference between recreational misuse and medical treatment

This is the question we hear most often, and it deserves a direct answer.

Ketamine, when misused recreationally at high doses and high frequency, can produce psychological dependence and is a controlled substance for that reason. That is a different scenario than what happens in a medical clinic.

In a supervised setting like Avesta, ketamine is:

• Delivered at a precise sub-anesthetic dose calibrated to your body weight
• Administered by board-certified anesthesia and psychiatric clinicians
• Spaced out across a defined protocol (typically six infusions over two to three weeks, followed by boosters as needed)
• Paired with monitoring, integration, and a clear off-ramp
  

Across more than 16,000 infusions delivered at Avesta to over 1,200 patients, the rate of clinically significant ketamine misuse in our population is essentially zero. The risk profile of medically supervised ketamine therapy is well-understood — and very different from the risk profile of recreational ketamine use.

What ketamine therapy for addiction looks like at Avesta

Every patient starts with a free 15-minute phone consultation. From there, a typical addiction recovery protocol includes:

1. Comprehensive medical and psychiatric intake — including review of your substance use history, co-occurring mood symptoms, current medications, and recovery team
2. A series of IV ketamine infusions — usually six over two to three weeks, each about 40–60 minutes long
3. Integration support — through ketamine-assisted psychotherapy (KAP) with one of our clinicians or referral to a partner therapist
4. Maintenance and follow-up — booster infusions or Spravato (esketamine nasal spray) on a personalized schedule

We see patients from across Washington, D.C., Northern Virginia, suburban Maryland, and Hampton Roads.

Schedule your free consultation at the Avesta location nearest you:

• Washington, D.C. — central DC clinic serving Capitol Hill, Dupont, and Georgetown patients → Book a consult — DC
• Bethesda, MD — serving Montgomery County and Northwest DC → Book a consult — Bethesda
• Columbia, MD — serving Howard County and the Baltimore/DC corridor → Book a consult — Columbia
• Tysons, VA — serving Fairfax, Arlington, and Loudoun counties → Book a consult — Tysons
• Norfolk, VA — serving Hampton Roads, Virginia Beach, and the Tidewater region → Book a consult — Norfolk

Prefer to talk to someone? Call (301) 381-8381 — same number for all five clinics.

Frequently asked questions about ketamine therapy for addiction

Does ketamine cure addiction? No. Ketamine is not a cure — addiction is a chronic relapsing condition. Ketamine is a powerful tool that can reduce cravings, treat the underlying mood disorders that fuel substance use, and open a window of neuroplasticity in which therapy and lifestyle change become more effective.

How many ketamine treatments will I need for addiction recovery? Most patients begin with a series of six infusions over two to three weeks, then move to maintenance boosters as needed. The exact protocol is personalized after your intake.

Will insurance cover ketamine therapy for substance use disorder? IV ketamine infusions are typically paid out of pocket. Spravato (esketamine), an FDA-approved nasal spray, is covered by many commercial plans and Medicare for treatment-resistant depression — which often co-occurs with addiction. Our team will help you check benefits.

Can I combine ketamine therapy with my current recovery program — AA, SMART Recovery, methadone, Suboxone? Yes. Ketamine is meant to complement, not replace, your existing recovery work. We coordinate with your therapist, sponsor, and MAT prescriber as appropriate.

Is ketamine therapy safe if I’m currently using substances? You don’t need to be fully sober to begin a consultation, but most ketamine protocols for addiction are started after a period of medical stabilization. We’ll assess this during your intake.

Where is the closest Avesta clinic to me? We have five DMV-area clinics — Washington DC, Bethesda MD, Columbia MD, Tysons VA, and Norfolk VA. Call (301) 381-8381 to be routed to the nearest one.

If you or someone you love is fighting addiction and feeling out of options, you don’t have to stay stuck. Ketamine therapy isn’t a magic bullet — but for many of our patients, it has been the turning point that finally made the rest of their recovery work click.

Request a free 15-minute consultation or call (301) 381-8381 — and let’s talk about whether ketamine therapy is the right next step for you.

Footnotes

1. SAMHSA, 2023 National Survey on Drug Use and Health: Key Substance Use and Mental Health Indicators in the United States. (Most recent SAMHSA NSDUH at the time of refresh.)
2. National Institute on Drug Abuse, Common Comorbidities with Substance Use Disorders Research Report.
3. Ivan Ezquerra-Romano, I., Lawn, W., Krupitsky, E., & Morgan, C. J. A. (2018). Ketamine for the treatment of addiction: Evidence and potential mechanisms. Neuropharmacology, 142, 72–82.
4. Jones, J. L., et al. (2018). Efficacy of ketamine in the treatment of substance use disorders: A systematic review. Frontiers in Psychiatry, 9, 277.
5. Moda-Sava, R. N., et al. (2019). Sustained rescue of prefrontal circuit dysfunction by antidepressant-induced spine formation. Science, 364(6436), eaat8078.
6. Das, R. K., Gale, G., Walsh, K., et al. (2019). Ketamine can reduce harmful drinking by pharmacologically rewriting drinking memories. Nature Communications, 10, 5187.
7. Grabski, M., et al. (2022). Adjunctive Ketamine with Relapse Prevention–Based Psychological Therapy in the Treatment of Alcohol Use Disorder. American Journal of Psychiatry, 179(2), 152–162.
8. Dakwar, E., et al. (2019). A Single Ketamine Infusion Combined With Mindfulness-Based Behavioral Modification to Treat Cocaine Dependence: A Randomized Clinical Trial. American Journal of Psychiatry, 176(11), 923–930.
9. Krupitsky, E., et al. (2002). Ketamine psychotherapy for heroin addiction: Immediate effects and two-year follow-up. Journal of Substance Abuse Treatment, 23(4), 273–283.