A currently ongoing study based at University College London (UCL) involves giving a dose of ketamine to alcohol abusers. Yes, you read that correctly. Ketamine is a legal tranquilizer, used mainly on small animals by veterinarians. However, ‘Special K’ doubles as a recreational drug, found most often at dance parties and nightclubs. So how the heck does ketamine stop alcohol abuse? The answer is by manipulating alcohol-associated memories.
Let’s start over.
Certain things make drinkers want to drink. Ask anyone who consumes alcohol often, and they’ll tell you it’s true. Maybe the smell of alcohol triggers the desire to drink. Maybe it’s a certain place, or some classic rock song. When this happens, the drinker’s memories of alcohol giving pleasure are recalled, and his or her brain wants that alcohol-induced pleasure again. This is the precursor to alcoholism, wherein the brain can’t function without alcohol.
Cravings are essentially fond memories. You are recalling the pleasure of something and desiring it again. During this memory recall, “…the neural connections that encode [the memory] are temporarily destabilized, meaning that our recollection can be slightly altered before it goes back into storage,” as written in The Guardian, linked above.
Ketamine causes memory loss and/or disruption, by blocking a receptor in the brain called NMDA. This particular receptor is partly responsible for our ability to form memories. The UCL research team believes they can use this effect of ketamine to ‘erase’ the memories associated with craving alcohol. “There is evidence that it could be useful as a treatment for alcoholism,” said lead researcher Ravi Das.
The Library Book Metaphor
Every time you access a memory, you are basically removing it from your mental library. In a real library, a book can be removed and read, like a memory can, but it also becomes vulnerable. The book borrower could rip a page out, cross out some text, or even damage the book. The same thing goes for memories. This is why we give slightly different accounts of our past each time we do so.
Because ketamine disrupts the memory-formation process, the idea of the UCL study is to trigger alcohol cravings in participants, and then give them ketamine. The hope is to weaken the alcohol-related memories, ultimately to the point of non-existence.
A dose of ketamine administered at the time of alcohol-related memory recall, the researchers hope, will make it so you lose the book of alcohol-craving from your mental library. The ‘temporary destabilization’ of our memories, when recalled, acts as the window of opportunity for ketamine to work. The ultimate goal is to eliminate the triggers for craving a drink.
The UCL Study
The research team consists of psychologists from University of Exeter, Imperial College London, and UCL. Participants must consume at least forty drinks per week, drinking four or more days per week. This qualifies them as heavy drinkers. However, participants cannot be clinical alcoholics. Anyone with diagnosable alcohol dependence would be excluded. They are aiming for 90 people to participate, and at the time of a July 2016 publication, over 50 people were already in.
Apparently no further details have been published yet about whether or not the quota has been met. Some details on what the study involves have been published, and as of the time of this writing, a flyer advertising the study is still online. So far, here’s what we know the study entails:
The psychologists intentionally trigger the craving for alcohol in the participants. A glass of beer is placed directly in front of each person. This is a surefire trigger – no scientific explanation needed. The details of what happens next are being withheld by the team. However, according the Guardian, “They will then disrupt the memory, by surprising the participant (the team is not disclosing the exact details as this could bias the results).”
The ketamine comes next. After the memory is triggered and disrupted, each participant is either given “a ketamine infusion, with a concentration equivalent to a high recreational dose, or a placebo.” The team then stays in touch with all 90 people for one full year after the ketamine dose, to see how their drinking habits have changed.
Short-term Results are Promising
One participant, who already received the ketamine dose, claims that it worked. According to the Guardian article, 31-year-old Nikki, a consultant in London, took part in the study when she realized she was drinking heavily. She was even drinking more than she wanted to. “It’s just in the culture. That’s what all my friends are like… everyone drinks to excess,” she said before the study.
After her alcohol craving was triggered and her memory was manipulated, Nikki was given her ketamine dose. She described the experience as overwhelming and intense, but not unpleasant. “It was quite psychedelic. I felt untethered from my body,” she said.
One week later, Nikki reported an “incredible positive mood,” and said she was much more aware of her decisions regarding drinking. She didn’t say she gave up alcohol completely. However, she did praise the study. “In the past, there were occasions where I would be drinking and I’d be on autopilot: ‘Let’s get another drink’,” said Nikki.
Although one week is only 1/52nd of a year, Nikki’s story proves as a promising example of how a ketamine dose could prevent heavy drinking.
Similar Approaches to Different Problems
Using one drug to fight the abuse of another drug is not unheard of. Actually, two years ago, Merel Kindt and Marieke Soeter of University of Amsterdam performed a study that used a beta-blocker to get rid of arachnophobia. Beta-blockers are used primarily for cardiac care. The particular one used in the study, propranolol, treats high blood pressure, and is also used to reduce performance anxiety.
Fifteen participants with diagnosed arachnophobia, a fear of spiders, were shown a giant tarantula, and told they had to touch it. Then they were each given a dose of propranolol. The arachnophobia was gone for good.
According to the article linked above, “They erased their spider fear memories and then rewrote them with one of triumph — touching the tarantula a week after their treatment. When they returned to her lab three months and a year later, the effects stuck.”
Michael Saladin is attempting to end tobacco addiction with a similar approach. He is a professor at the Medical University of South Carolina, and he believes smoking addictions can be ended by getting rid of the cues (triggers) that make addicts smoke.
“There is a vast animal research literature that suggests memories can be manipulated following reactivation,” Saladin said. “I am convinced that there is sufficient evidence to believe that memory reconsolidation can be harnessed for clinical purposes.”
The process being utilized in the UCL study, as well as in both studies mentioned above, is known as memory reconsolidation. The entire concept is relatively new. Essentially, the idea is to replace the bad memories associated with certain things with good memories, feelings of accomplishment and healthy pride. In the case of resisting alcohol, the already-consolidated memories of drinking will be replaced with new memories of feeling proud of not drinking. The ketamine allows this process to occur.
This may seem futuristic to you, and frankly it is. Scientists discover new information every day, and in the age of the microchip, our limits are becoming harder to see. New methods for how we do just about everything are being found. Yet when the use of illegal drugs, (ketamine is illegal to possess and is not a prescribed drug), becomes one of the methods that scientists discover, there tends to be a lot of pushback.
The scientists wish people would stop resisting.
Just because something is illegal and/or looked down on by society doesn’t mean that something isn’t effective in another way. We are seeing this nationwide with marijuana.
Lead researcher Das spoke to this resistance the public has for illegal/illicit drugs being used as medicines: “There’s just the general social attitude that everything that’s illegal is terrible. There will obviously be that kind of narrow-sighted pushback, but if it’s safe and effective enough it should be recommended.”
Das isn’t implying that ketamine is safe to use for anyone who wants to fix a bad memory. What he’s implying is that in a controlled, medical environment, a one-time dose of ketamine could help heavy drinkers relax on the booze.
Quoted in the Guardian article, Andrew Misell is a spokesman for Alcohol Concern, a non-profit charity working to reduce alcohol harm in the UK. Speaking about the UCL study in particular, he said, “The researchers have quite rightly highlighted what a lot of people in recovery from alcohol problems know from experience, namely that cues or triggers like the smell of beer can cause a relapse even after long periods of abstinence. Any work looking at how people can overcome these pitfalls is going to be useful.”
Misell added that he knows ketamine-based therapy has risks. What Misell didn’t add is that alcohol abuse has much more inherent risk than drug-based therapy. Not to mention, ketamine itself is significantly safer, and much less abused, than xanax, the number one drug used in all of psychotherapy.
Why the Pushback?
Medicine is medicine. Unless you the reader are a scientist or a doctor, you and I have no influence on what becomes medicine. If a one-time dose of ketamine can prevent alcoholism, why would anyone resist? Xanax is the most prescribed drug in all of psychotherapy, yet people abuse it WAY more often than ketamine. The NY Post published an article just last year explaining this, going so far as to say that xanax is ruining lives.
Drug/alcohol abuse is a horrible thing. People are dying in mass numbers from drug/alcohol abuse, and not just in America. This author does not condone the abuse of alcohol, nor does this author condone the use of illicit drugs. However, as this author wrote prior, what becomes a medicine is not a decision for anyone but scientists and doctors. If yours truly was a heavy drinker, and a doctor told me that habit could be stripped away with a one-time dose of ketamine, believe that no more questions would be asked.
One can only wait for the final results from the UCL study to see how many more participants turn out like Nikki. If and when the study proves effective for more and more people, we may begin to see a radical change in the way we fight addiction. It may seem like fighting fire with fire, but sometimes it works. Brushfires that spread rapidly are sometimes stopped by deliberately burning a section of earth where the fire is headed. Maybe ketamine is that deliberate burn in the realm of alcohol addiction