Ketamine-assisted alcohol therapy, a potential new therapy for alcoholism, is currently in Phase III of an extensive trial supporting recovering alcoholics. Phase III will determine whether it has the potential to help people with severe alcohol use disorder.
Phase III of the Ketamine for Reduction of Alcohol Relapse (KARE) trial is planned to be implemented in seven NHS sites across the UK. Mid-way through 2023, the researchers will begin to recruit participants with severe alcohol misuse and randomly allocate them to one of two groups to be tested. Half of the participants will be given the same dose of ketamine that was used in the Phase II of the trial and psychological therapy. The remainder will be given a low dose of ketamine and seven educational sessions about the harmful effects of alcohol. Researchers will look at whether the combination of ketamine and therapy reduces harmful drinking. If found to be effective, this treatment will be rolled out into the NHS within the coming years.
Phase II previously found the treatment to be safe and tolerable for people with severe alcohol use disorder, and could be pursued to build on these results for future patients. The majority of those who were prescribed a dose of ketamine alongside therapy stayed completely sober. This remained promisingly high at the six-month follow-up with an abstinence rate of 86%.
Trial lead, Professor Celia Morgan from the University of Exeter, commented: “We urgently need new treatments. If this trial establishes that Ketamine and therapy works, we hope we can begin to see it used in NHS settings.”
The trial has received a staggering £2.4 million in funding from the Medical Research Council (MRC) and the National Institute for Health and Care Research (NIHR) through their Efficacy and Mechanism Evaluation (EME) Programme. Without this funding, it would not be possible to explore and compare the effectiveness of alternative treatments to those already used in current practice.
Currently, alcohol use disorder is treated within the NHS through counseling (including self help groups and talking therapies such as cognitive behavioural therapy), medicines, and detoxification. Despite what seems to be a range of therapies with the potential to work with a myriad of patients, their effectiveness is limited. It is understood these routes don’t work for everyone, and 75% of those that do show signs of improvement will revert to drinking again within a year post-treatment.
Concerns of researchers working this trial are expressed through the statement: “We currently have few effective treatment options for people with alcoholism, and not all of these work for everyone.” Professor Morgan added: “3 out of 4 people who quit alcohol will be back drinking heavily after a year.”
This confirms the necessity to seek alternative treatments to support those suffering from alcohol use disorder, for the benefit of the individuals, as well as their families, friends, and communities around them.
Professor Morgan emphasised that alcohol related deaths have increased further since the pandemic. This clearly brings to light the seriousness of the problem and the devastating consequences many families are facing because of insufficient support.
Alcohol-related harm is estimated to cost the NHS around £3.5 billion each year and the wider UK society around £40 billion. Therefore, it is imperative we seek alternative, more effective treatments to reduce the impact of alcohol use disorder on both the individual and the community.
This trial sheds a new light on promising future treatment options for those with alcohol use disorder to be accessed through the NHS. If Phase III is found to be as successful as the previous trials, we could find ketamine-assisted therapy to be implemented nationally in an attempt to provide relief from alcohol-dependency, and offering a shift in paradigm for how we tackle it.
