Have We Eliminated Stigma Surrounding Ketamine-Assisted Treatment?

by Tom Crouch

 

Ketamine is beginning to be used as a treatment for mental health conditions such as depression and addiction and although research is progressing, societal stigma has been a significant barrier. This has limited access to funding, in turn limiting clinical research and a desire to engage in this area

Research has shown that public opinion is a limiting factor for ketamine being used to treat depression because of the public’s associations to ketamine’s reputation as a horse tranquiliser and hallucinogenic taken in nightclubs. Another barrier to the exploration of therapeutic ketamine treatment are concerns over the long term side-effects and also the risk of addiction, which was another observation supported by the 2019 study into attitudes on ketamine.  

Partly because of this stigma, the only large-scale studies on ketamine treating alcohol addiction up until now have been done in Russia, in the 1980s. Despite being dated, some promising conclusions were made in these studies, chiefly that 66% of patients who had undergone the treatment were abstinent a year later compared to 24% of patients who did not receive ketamine. This rate is much higher than rates for other methods of alcohol relapse prevention. 

However, this research was in some ways compromised as participants chose whether they were assigned to the ketamine group or control group, which could lead to predetermined bias.

A fortnight ago, the University of Exeter’s study on the effect of ketamine and psychotherapy on alcohol addiction was published in the American Journal of Psychiatry. Using psychotherapy alongside ketamine was an evolution from previous studies and this combination prolonged abstinence in those who took part. This is not overly surprising as participants in a 2019 study noted how talking therapy is equally as crucial as taking ketamine when trying to move away from alcohol.

The media’s tone when reporting on this research is an important factor in determining the perceived, and likely changing, societal stigma of this field. Several news sites reporting on the study were almost entirely positive in their articles and stayed away from commenting on how ketamine, if legalised, could lead to addiction. 

This is great progress from the 2019 study around public opinion on ketamine mentioned earlier. Popular media and public opinion work hand in hand as one can drive the other and vice versa. If popular media, such as the BBC and ITV, are now publishing more positive articles on ketamine then this can both influence public opinion and represent it. This can only be positive in attempting to lessen the stigma around medical ketamine, which can allow for more funding to explore its uses in the fight against alcohol addiction. 

It must be said, though, that positive drug news coverage is not widespread. Just recently Volteface posted an article on the media’s disingenuous reporting of drugs. Despite more positive language being on show in the articles around medical ketamine, images accompanying drug news stories can offer the equivalent of a sensationalist headline. This can in turn reinforce negative attitudes towards drugs that the wider public may have. 

Throughout several studies, ketamine has demonstrated its ability to help those struggling with alcoholism. Its fast-working nature and efficacy compared to other tools used in the fight to combat alcohol addiction are especially positive. Even more positive is the discovery of its combination with psychotherapy to lengthen its effect on addiction. 

Ketamine is not a miracle drug and it should not be expected to be. It is a facilitator for recovery and we must be patient when it comes to exploring the drug and its positive effects. For example, outside of alcohol addiction treatment, we currently do not know about the long term effects of ketamine on treating depression. 

Its acceptance as a pharmacological tool will only occur with a change in public opinion, which can happen through more positive media coverage. Up until recently, negative media coverage has been a constant thorn in the side of those trying to study the uses of medical ketamine. 

However, more positive media coverage of ketamine, alongside reporting of its therapeutic uses, can help change this situation. This can then hopefully lead to increased funding for study for a greater holistic understanding of the drug. As a result, public scepticism and the stigma around ketamine should diminish, if there is a greater public knowledge of the medical uses of ketamine.  

This piece was written by Tom Crouch, contributor at Volteface. Tweets @TomCrouch6

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