Written and medically reviewed by Dr. Ladan Eshkevari, CRNA, PhD, FAAN
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.[4]
- 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, detoxification programs, and medication-assisted treatment help, yet relapse is still common. Ketamine therapy is an evidence-based option we offer as an addition to that care, not a replacement for it.
This article explains how ketamine and alcohol use disorder intersect in current clinical research. It covers how ketamine therapy may help people with AUD, the narrow role ketamine plays in severe alcohol withdrawal, the health risks of combining ketamine and alcohol outside a clinical setting, and what patients in the DMV area 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 symptoms.
AUD is one of the most common health conditions in the country, and the Washington, DC area is not exempt. According to the 2023 National Survey on Drug Use and Health, about 28.9 million people aged 12 and older had alcohol use disorder in the past year, roughly 10.2 percent of that age group.[1] Binge-drinking rates in Washington, DC run above the national average, which is part of why we see steady local demand for treatment that standard care does not fully address.
28.9 million people aged 12 and older in the U.S. had alcohol use disorder in 2023 (2023 NSDUH, SAMHSA).[1]
Many people also struggle to hold on to recovery once they start. The NIAAA reports that a large share of people treated for AUD, on the order of 40 to 60 percent, return to some drinking within the first year, though the agency distinguishes a single lapse from a full relapse.[2] That gap between short-term treatment and lasting change is exactly where an adjunct like ketamine is being studied.
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, and they remain first-line care.
Even so, relapse is common, often for reasons standard care does not fully reach: untreated underlying mental health conditions, unaddressed social or environmental triggers, and motivation that fades over time.
Medication can help. The FDA has approved three medications for ongoing AUD treatment: naltrexone (oral, and an extended-release injectable), acamprosate (Campral), and disulfiram (Antabuse).[3] Benzodiazepines such as diazepam or lorazepam are sometimes used to manage acute alcohol withdrawal, but they are not FDA-approved medications for long-term AUD and are not part of maintenance treatment. Ketamine-assisted therapy is being studied as another tool for the cravings and reinforced drinking patterns these approaches can leave behind.
How Ketamine Treats Alcoholism and AUD
Ketamine is FDA-approved as an anesthetic. At lower, sub-anesthetic doses, it is used to help several mental health and substance use conditions. In clinical infusions, ketamine produces a dissociative experience under medical monitoring that acts on the brain’s glutamate system. Researchers believe this can help loosen the entrenched neural pathways tied to substance use, depression, and other treatment-resistant conditions, which is one reason it is being paired with counseling for AUD.
We deliver ketamine as IV ketamine infusions at sub-anesthetic doses, always after a patient has fully detoxed, and always with monitoring throughout the session.
In the context of AUD, the potential benefits people and researchers describe include:
- Reduced cravings and compulsive urges to drink
- Improved mood and emotional regulation, especially when paired with counseling
- Better ability to maintain abstinence over time
None of this positions ketamine as a cure. It is an adjunct that may make the rest of a recovery plan work better.
Evidence That Ketamine Therapy Can Reduce Alcohol Use
Recent clinical trials and reviews suggest ketamine-assisted therapy can support recovery from alcohol use disorder, especially when it is combined with talk therapy rather than given on its own. The strongest signals fall into four areas.
Fewer Cravings and Less Alcohol Use
Across the current literature, ketamine paired with psychological therapy is associated with reduced alcohol cravings, lower overall consumption, and more abstinent days compared with standard treatment alone. These are group-level findings from small-to-midsize trials, not guarantees for any one patient, which is why we frame ketamine as one part of a broader plan.
Higher Abstinence and Lower Relapse Risk
The clearest trial evidence comes from the KARE study (Ketamine for Reduction of Alcoholic Relapse), a randomized controlled trial published in the American Journal of Psychiatry in 2022. Adults with severe AUD who received ketamine plus relapse-prevention therapy stayed abstinent about 87 percent of days over the six-month follow-up and were more than two and a half times more likely to be fully abstinent at the end of the trial than the placebo group. The combination was well tolerated, with no serious adverse events reported.[4]
In the KARE trial, the ketamine-plus-therapy group stayed abstinent about 87% of days over six months (Grabski et al., Am J Psychiatry, 2022).[4]
A separate randomized pilot trial at Columbia University tested a different question: whether a single infusion could help. A single ketamine dose paired with motivational enhancement therapy was associated with reduced heavy drinking and greater abstinence over a follow-up measured in weeks to months.[5] The two studies point the same direction using different protocols, which strengthens the overall picture. Because AUD so often travels with depressed mood, some patients also explore ketamine therapy for depression as part of the same care conversation.
Disrupted Drinking Memories
A study in Nature Communications showed that ketamine can interfere with the reconsolidation of alcohol-related memories, the ingrained emotional cues and habits that keep drinking on autopilot. By interrupting the brain’s process of replaying and reinforcing those memories, ketamine appeared to weaken alcohol’s pull on behavior. Participants in the ketamine condition drank less than the comparison group and reported a reduced long-term urge to drink.[6]
Improved Motivation and Confidence to Abstain
In one small open-label pilot study of 18 patients who received three infusions after detox, self-rated confidence to abstain rose about 52 percent from baseline on a standard self-efficacy scale.[7] This is an early, small signal rather than a settled result: the study was not placebo-controlled, and part of the gain faded within two weeks. We include it because it is consistent with the broader pattern, not because it proves a large or durable effect.
Across our own DC, Maryland, and Virginia clinics, we have seen similar improvements in motivation and control over drinking when infusions are paired with personalized protocols and long-term support. Over 1,600 patients and more than 20,000 treatments in, our experience matches what the research suggests: for the right candidate, ketamine can strengthen a recovery plan.
Reach out to our ketamine care team if you or a loved one is struggling with alcohol use disorder and cannot find relief through traditional treatment.
Can Ketamine Help With Alcohol Withdrawal?
Ketamine has a real but very narrow role in alcohol withdrawal, and it is not an outpatient service we provide. In hospitals, clinicians sometimes add ketamine in the intensive care unit for patients with severe or treatment-resistant alcohol withdrawal, typically once standard medications like benzodiazepines have not controlled symptoms or when delirium tremens has emerged.[8][9]
This use is strictly an ICU adjunct under continuous medical supervision, not a substitute for detox and not something anyone should attempt on their own. The ketamine therapy we offer for AUD is different: it begins only after a patient has fully and safely detoxed, and it targets cravings and relapse risk, not the acute withdrawal itself.
Risks of Combining Ketamine and Alcohol Outside of Treatment
Ketamine therapy can be safe and effective for AUD in clinically supervised settings, and patients must be fully detoxed before starting. Outside of that context, combining ketamine and alcohol introduces serious health risks. The two substances interact in ways that can compromise physical safety, mental clarity, and long-term treatment outcomes.
Short-Term Dangers
Ketamine and alcohol both depress the central nervous system. Taken together, they amplify each other and can lead to:
- Increased sedation: extreme drowsiness, slowed breathing, and in severe cases unconsciousness.
- Mental impairment: nausea, confusion, and impaired coordination, which raise the risk of blackouts, injury, or overdose.
Long-Term Health Consequences
Repeated combined use of ketamine and alcohol may contribute to liver and kidney damage, cardiovascular problems, gastrointestinal inflammation, cognitive decline and memory loss, and a higher risk of anxiety, depression, or psychotic episodes. Drinking during or after a course of ketamine therapy can also blunt its benefit and raise the odds of relapse. This is a large part of why treatment stays monitored and structured.
Getting Ketamine Treatment for AUD in DC, Maryland, and Virginia
Ketamine-assisted therapy may offer a new path for people who have not found lasting relief in alcohol recovery, and it works best as part of a plan rather than on its own. We build personalized treatment protocols, monitor each patient closely, and coordinate with counseling support so ketamine has the best chance to help.
We have provided monitored, in-clinic ketamine care since 2018, and our founder, Dr. Ladan Eshkevari, is a nationally recognized figure in nurse anesthesia. We treat patients across the DMV at five locations: Bethesda MD, Washington DC, Columbia MD, Tysons (Vienna) VA, and Norfolk VA. If you are searching close to home, our ketamine treatment in Washington DC clinic serves patients throughout the District, and you can reach our care team to ask whether treatment is right for your situation.
Book a free consultation to talk through your goals and get honest answers about whether ketamine therapy at Avesta fits your recovery.
Frequently Asked Questions
Is ketamine safe for alcoholism?
Ketamine can be safe for alcohol use disorder when it is used under clinical supervision. Reputable clinics screen for active alcohol use and confirm that patients are fully detoxed before treatment begins, which prevents the dangers of mixing the two substances. Ketamine is given at sub-anesthetic doses with monitoring throughout, and it is used as an adjunct to counseling and standard care rather than on its own.
What does ketamine do for alcohol use disorder?
For alcohol use disorder, ketamine may reduce cravings, improve mood, and help loosen the reinforced thought patterns and memories that keep compulsive drinking going. It acts on the brain’s glutamate system and appears to support neuroplasticity, the brain’s ability to form new patterns. Paired with psychotherapy, it may support longer abstinence and lower relapse risk, though results vary from person to person.
Is ketamine similar to alcohol?
Ketamine and alcohol overlap in one way: both depress the central nervous system. Beyond that they differ sharply. Alcohol is the substance driving the disorder, while ketamine, at monitored sub-anesthetic doses, is being used as a treatment that also supports neuroplasticity and mood regulation. The two should never be combined outside a clinical setting, where the shared sedative effect becomes dangerous.
What happens if you mix alcohol and ketamine?
Mixing ketamine and alcohol can be very dangerous. Because both depress the central nervous system, combining them raises the risk of extreme sedation, slowed breathing, unconsciousness, memory loss, and impaired coordination. Over time, repeated co-use can also contribute to organ and cognitive damage. Never combine the two outside a supervised clinical setting.
How many ketamine sessions are needed for alcohol use disorder?
There is no single fixed number, and the right course depends on the person. In research, protocols have ranged from a single infusion paired with therapy to a short series of infusions after detox, and ongoing recovery is supported with counseling rather than ketamine alone. At Avesta, we set the number and spacing of sessions during a personal evaluation, based on your history, goals, and response to treatment.
Where can I get ketamine treatment for alcoholism near Washington, DC?
We provide monitored ketamine therapy at five locations across the DMV: Bethesda MD, Washington DC, Columbia MD, Tysons (Vienna) VA, and Norfolk VA. Patients near the District are typically closest to our Washington DC clinic. Every location follows the same standards: full detox before treatment, sub-anesthetic dosing, monitoring throughout, and coordination with counseling. Reach out to our care team to find the nearest option and check your fit.
References
- Substance Abuse and Mental Health Services Administration (SAMHSA). Key Substance Use and Mental Health Indicators in the United States: Results from the 2023 National Survey on Drug Use and Health. https://www.samhsa.gov/data/report/2023-nsduh-annual-national-report (Accessed July 22, 2026)
- National Institute on Alcohol Abuse and Alcoholism (NIAAA). Treatment for Alcohol Problems: Finding and Getting Help / relapse and recovery data. https://www.niaaa.nih.gov (Accessed July 22, 2026)
- National Institute on Alcohol Abuse and Alcoholism (NIAAA). Medications Development Program: FDA-approved medications for alcohol use disorder. https://www.niaaa.nih.gov/medications-development-program (Accessed July 22, 2026)
- Grabski M, McAndrew A, Lawn W, et al. Adjunctive Ketamine With Relapse Prevention-Based Psychological Therapy in the Treatment of Alcohol Use Disorder (the KARE trial). Am J Psychiatry. 2022;179(2):152-162. PMID 35012326. https://pubmed.ncbi.nlm.nih.gov/35012326/ (Accessed July 22, 2026)
- Dakwar E, Levin F, Hart CL, et al. A Single Ketamine Infusion Combined With Motivational Enhancement Therapy for Alcohol Use Disorder: A Randomized Midazolam-Controlled Pilot Trial. Am J Psychiatry. 2020;177(2):125-133. https://psychiatryonline.org/doi/full/10.1176/appi.ajp.2019.19070684 (Accessed July 22, 2026)
- Das RK, Gale G, Walsh K, et al. Ketamine can reduce harmful drinking by pharmacologically disrupting maladaptive drug memory reconsolidation. Nat Commun. 2019;10:5187. https://www.nature.com/articles/s41467-019-13162-w (Accessed July 22, 2026)
- Ketamine Therapy in Patients of Alcohol Use Disorder. Annals of Indian Psychiatry. 2024. https://journals.lww.com/aips/fulltext/2024/08040/ketamine_therapy_in_patients_of_alcohol_use.10.aspx (Accessed July 22, 2026)
- Ketamine as an adjunct for severe, benzodiazepine-refractory alcohol withdrawal (scoping review). Front Psychiatry / PMC10172666. 2023. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10172666/ (Accessed July 22, 2026)
- Pizon AF, Lynch MJ, Benedict NJ, et al. Adjunctive Use of Ketamine for Benzodiazepine-Resistant Severe Alcohol Withdrawal. PMC6097970. https://pmc.ncbi.nlm.nih.gov/articles/PMC6097970/ (Accessed July 22, 2026)
