*5.5. Substance and Alcohol Use Disorders*

There have been several reviews, including one systematic review, detailing the antiaddiction properties of ketamine [12–14]. Collectively, the studies have suggested that ketamine improves cravings, motivations to quit, physiological reactions to withdrawal and, importantly, reduces or completely abolishes the self-administration of drugs/alcohol [13]. For addiction, ketamine is often administered alongside psychotherapy, termed "ketamine psychedelic therapy" (KPT), which generally consists of a preparation phase, dosing phase and integration phase. This allows patients to fully take advantage of a hyperplastic brain state. Interestingly, this idea has been harnessed by a study investigating the potential for ketamine to rewrite the maladaptive reward memories associated with alcohol and drugs [93]. Participants were presented with a glass of beer and then retrieved maladaptive reward memories through exposure to a beer-related cue. Participants administered ketamine directly after this reported lower alcohol consumption over 10 days over and above participants who were either given the retrieval task or ketamine alone. The authors suggested that the ketamine facilitated the rewriting of drinking memories, which occurred within a critical reconsolidation window [93]. This brings into light the potential role of ketamine in enhancing the efficacy of therapies or abolishing learned associations via neuroplastic mechanisms.
