Ketamine for alcoholism and alcohol use disorder (AUD) is a monitored, in-clinic treatment that may reduce cravings, disrupt the reinforced memories that drive drinking, and lower relapse risk when paired with counseling. It works alongside standard AUD care, not in place of it. Talk with our care team to find out whether you may be a candidate.
Key takeaways
- Ketamine may reduce alcohol cravings and drinking: clinical trials report fewer heavy-drinking days and longer abstinence when ketamine is paired with talk therapy.
- Ketamine is an adjunct, not a standalone cure: it works alongside detox, counseling, peer support, and FDA-approved AUD medications.
- Treatment happens in a monitored clinical setting: ketamine is a dissociative anesthetic with psychedelic-like effects, given at sub-anesthetic doses after patients have fully detoxed.
- Mixing ketamine and alcohol outside treatment is dangerous: the combination can cause extreme sedation, slowed breathing, and unconsciousness.
For opioid, cocaine, or stimulant recovery, see our guide to ketamine therapy for drug addiction recovery.
Alcohol use disorder affects millions of Americans, including thousands across the DMV (DC, Maryland, Virginia) region. Traditional therapies like counseling, detox programs, and medication help many people, but relapse is still common. Monitored ketamine therapy is an evidence-based option that targets two of the drivers those approaches often miss: cravings and the reinforced memories that keep drinking in place.
This article explains how ketamine and alcohol use disorder intersect in current clinical research, what the benefits and limits are, the real risks of combining ketamine and alcohol outside a clinical setting, and what patients across DC, Maryland, and Virginia should know before starting treatment.
What Is Alcohol Use Disorder (AUD)?
Alcohol use disorder (AUD) is a chronic condition in which a person cannot control their drinking despite negative consequences. AUD ranges from mild to severe and often includes cycles of craving, loss of control, tolerance, and withdrawal.
AUD is one of the most common substance use disorders in the country. According to the 2024 National Survey on Drug Use and Health, about 27.9 million people aged 12 and older had an alcohol use disorder in the past year.[1] In the Washington, DC area, binge-drinking rates run above the national average, and relapse after treatment is common, especially early on: the National Institute on Alcohol Abuse and Alcoholism notes that the first year of recovery is often a mix of gains and setbacks, even as most people with AUD reduce or resolve their drinking over time.[2]
Why Traditional AUD Treatment Often Is Not Enough
Traditional treatment for alcohol use disorder usually follows a multi-step, evidence-based approach designed to help people stop drinking, manage withdrawal, avoid relapse, and build long-term recovery. Medical detox, behavioral therapy and counseling, peer support, and rehabilitation programs help many people.
Even so, relapse rates stay high, often for reasons standard care does not fully reach:
- untreated underlying mental health conditions
- unaddressed social or environmental triggers
- motivation that declines over time
- limited response to, or side effects from, FDA-approved AUD medications
For context, the three medications the FDA has approved specifically for alcohol use disorder are naltrexone, acamprosate, and disulfiram. Benzodiazepines such as diazepam or lorazepam are used to manage acute withdrawal, but they are not maintenance treatments for AUD. When these tools are not enough on their own, monitored ketamine therapy can add a different mechanism to the recovery plan.
How Ketamine Treats Alcoholism and AUD
Ketamine is FDA-approved as an anesthetic. At lower, sub-anesthetic doses, it can also relieve symptoms of mental health and substance use disorders. In the clinic, a ketamine infusion produces a dissociative experience under medical monitoring, and it acts on the brain’s glutamate system in a way that can help loosen the entrenched neural patterns tied to compulsive drinking, depression, and other treatment-resistant conditions.
For people with AUD, the potential benefits of monitored ketamine therapy can include:
- reduced cravings and compulsive urges to drink
- improved mood and emotional regulation, especially when paired with counseling
- a better chance of maintaining abstinence over time
These effects are not guaranteed, and they are strongest when ketamine is combined with therapy rather than used alone. Ketamine also opens a short window of increased neuroplasticity, a period when the brain is more receptive to change, which is why we pair it with counseling or integration coaching rather than treating the infusion as a stand-alone fix.
Learn more about IV ketamine infusions at Avesta.
Evidence That Ketamine Therapy Can Reduce Alcohol Use
A growing body of clinical research suggests ketamine-assisted therapy can support recovery from alcohol use disorder, especially when combined with talk therapy.
Fewer Cravings and Less Alcohol Use
A 2023 scoping review in Frontiers in Psychiatry found that across studies, ketamine treatment was associated with reduced cravings, lower overall consumption, and more abstinent days compared with standard treatment.[3]
Higher Abstinence and Lower Relapse Risk
The strongest single piece of evidence comes from the KARE trial, published in the American Journal of Psychiatry in 2022. In this double-blind, placebo-controlled study of 96 people with severe alcohol use disorder, the group that received three ketamine infusions plus relapse-prevention therapy stayed abstinent for 162 of 180 days (about 87%) over the six-month follow-up, and was more than 2.5 times as likely to remain fully abstinent as the placebo group. The treatment was well tolerated, with no serious adverse events linked to the study drug.[4]
Disrupted Drinking Memories
A study in Nature Communications showed that ketamine can interfere with the reconsolidation of alcohol-related memories, the ingrained emotional associations and habits linked to drinking. By interrupting the brain’s process of replaying and reinforcing those memories, ketamine appeared to weaken alcohol’s pull on behavior. Participants who received ketamine drank significantly less than the control group and reported a reduced long-term urge to drink.[5]
Improved Motivation and Confidence to Abstain
In one small pilot study published in the Annals of Indian Psychiatry, patients’ self-rated confidence to abstain from alcohol rose about 52% from baseline after three infusions.[6] This was a small study (18 patients), and the effect eased somewhat after two weeks, so it is best read as an early signal rather than a settled result. Still, the direction is consistent with what we see in practice.
At Avesta Ketamine and Wellness, we have seen similar improvements in motivation and control over drinking when infusions are paired with supportive, longer-term care. Since 2018, our monitored, physician-led program has delivered more than 20,000 treatments to over 1,600 patients across our DC, Maryland, and Virginia clinics.
If you or a loved one is struggling with alcohol use disorder and cannot find relief through traditional treatment, contact our care team to talk through your options.
Can Ketamine Help With Alcohol Withdrawal?
Ketamine is not an outpatient treatment for alcohol withdrawal, and we do not offer it that way. In hospital settings, clinicians sometimes use ketamine as an add-on in the intensive care unit (ICU) for severe or benzodiazepine-resistant alcohol withdrawal, including delirium tremens, once standard medications have not controlled symptoms. A scoping review in Frontiers in Psychiatry[3] and a retrospective ICU evaluation[7] describe this narrow, closely monitored use. It happens only under continuous medical supervision in an ICU, which is very different from the elective, scheduled ketamine therapy we provide for AUD.
Risks of Combining Ketamine and Alcohol Outside of Treatment
Ketamine therapy can be safe and effective for alcohol use disorder in clinically supervised settings, and patients must be fully detoxed before starting. Outside of that setting, combining ketamine and alcohol introduces serious risks, because the two substances act on the body in overlapping ways.
Short-Term Dangers
Ketamine and alcohol both depress the central nervous system. Taken together, they can amplify each other and lead to:
- Increased sedation: extreme drowsiness, slowed breathing, and in severe cases loss of consciousness.
- Mental impairment: nausea, confusion, and poor coordination, which raise the risk of blackouts, injury, or overdose.
Long-Term Health Consequences
Repeated recreational co-use of ketamine and alcohol may contribute to:
- liver and kidney damage
- cardiovascular problems
- gastrointestinal inflammation and digestive issues
- cognitive decline and memory loss
- higher risk of anxiety, depression, or psychotic episodes
Drinking during or after ketamine therapy can also reduce its benefit and raise the chance of relapse. This is exactly why our clinics screen carefully and monitor every patient: the same medicine that helps in a controlled setting becomes dangerous when it is mixed with alcohol on your own.
Getting Ketamine Treatment for AUD in DC, Maryland, and Virginia
Monitored ketamine therapy may offer a new path for people who have not found lasting relief in alcohol recovery. At Avesta, we build a personalized treatment plan, monitor each patient closely, and connect you with counseling support when it helps.
We provide care across the DMV at five locations: Bethesda, MD, Washington, DC, Columbia, MD, Tysons, VA, and Norfolk, VA. Founded in 2018 by Dr. Ladan Eshkevari, we are the longest-standing provider of ketamine and Spravato care in DC, Maryland, and Virginia.
Reach out today to explore whether ketamine therapy at Avesta is the right next step. You will receive a free consultation and clear answers to your questions.
FAQ
Is ketamine safe for alcoholism?
Used under clinical supervision, ketamine can safely support treatment for alcohol use disorder. Reputable clinics screen for active alcohol use and confirm patients are fully detoxed before starting, which prevents the risks that come from mixing the two substances.
What does ketamine do for alcohol use disorder?
At sub-anesthetic doses, ketamine may reduce alcohol cravings, improve mood, and help interrupt the thought and memory patterns that reinforce compulsive drinking. Paired with psychotherapy, it can support longer-term recovery and lower relapse risk.
How many ketamine sessions are needed for alcohol use disorder?
There is no single answer. Most protocols involve a short series of infusions over a few weeks, followed by maintenance sessions as needed. Your exact plan is set after a medical and psychiatric intake, and it depends on your history and how you respond.
Is ketamine similar to alcohol?
In one narrow sense, yes: both act on the central nervous system and can be sedating. But they are different in mechanism and in use. Unlike alcohol, ketamine at clinical doses can support neuroplasticity and mood regulation, which is what makes it a treatment rather than a harmful substance when it is given in a monitored setting.
What happens if you mix alcohol and ketamine?
Mixing them can be very dangerous. Combining ketamine and alcohol raises the risk of unconsciousness, memory loss, slowed breathing, and long-term cognitive damage. Never combine them outside a clinical setting.
Where can I get ketamine treatment for alcoholism near Washington, DC?
We offer monitored ketamine care at five DMV locations: Bethesda MD, Washington DC, Columbia MD, Tysons VA, and Norfolk VA. Call (301) 381-8381 to reach the clinic nearest you.
Dr. Eshkevari is Professor Emeritus at Georgetown University, where she served over 25 years as full-time faculty and retired as Professor and Program Director of the nationally ranked graduate Nurse Anesthesia Program in the School of Nursing and Health Studies. She is founder and co-CEO of Avesta Ketamine and Wellness, the longest-standing provider of ketamine and Spravato treatments in DC, Maryland, and Virginia.
References
- SAMHSA. “2024 National Survey on Drug Use and Health: Key Substance Use and Mental Health Indicators in the United States.” SAMHSA, released July 2025. In 2024, about 27.9 million people aged 12 and older had a past-year alcohol use disorder. Accessed July 7, 2026.
- National Institute on Alcohol Abuse and Alcoholism (NIAAA). “Alcohol Use Disorder: From Risk to Diagnosis to Recovery.” NIAAA Core Resource on Alcohol, last revised May 2025. Accessed July 7, 2026.
- Goldfine CE, Tom JJ, Im DD, et al. “The therapeutic use and efficacy of ketamine in alcohol use disorder and alcohol withdrawal syndrome: a scoping review.” Frontiers in Psychiatry, 2023;14:1141836. Accessed July 7, 2026.
- Grabski M, et al. “Adjunctive Ketamine With Relapse Prevention-Based Psychological Therapy in the Treatment of Alcohol Use Disorder (KARE trial).” American Journal of Psychiatry, 2022;179(2):152-162. Accessed July 7, 2026.
- Das RK, et al. “Ketamine can reduce harmful drinking by pharmacologically rewriting drinking memories.” Nature Communications, 2019;10:5187. Accessed July 7, 2026.
- “Ketamine Therapy in Patients of Alcohol Use Disorder” (pilot study). Annals of Indian Psychiatry, 2024. Accessed July 7, 2026.
- “Adjunctive Use of Ketamine for Benzodiazepine-Resistant Severe Alcohol Withdrawal” (retrospective ICU evaluation). Accessed July 7, 2026.
