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Spotlight: Ketamine Harm Reduction

Prevention & Treatment in Ketamine Use Disorder - When a medicine becomes a poison
Michael DeMarco, PhD

by Michael DeMarco, PhD

Ketamine is a well-studied medicine compound in various species, including humans, at a wide range of doses and routes of administration. When ketamine is misused, as with any medicine, it can be detrimental effects on the body, mind, heart and spirit.

From the psychedelic harm reduction approach, the use of this medicine is lacking integration. When we are out of balance with the medicine, making sense of the experiences and applying this knowledge as future wisdom in a healthy, happy, self-actualized life going forward.

Practitioners in a healthier balance with psychedelic medicine work with the minimal amount of medicine journeys, for the most amount of long-term improvement in mind, body, heart and spirit, it - the human experience.

Psychotherapists are practitioners of the conscious human experience.

Let's address how you can work with a medicine that improves your human experience, and how to prevent or treat misusing a drug that is doing you harm.

Naltrexone in the Treatment of Ketamine Use Disorders: A Case Report and Literature Review (Verma, et al, 2025)
“findings consistent w/ 2 prior reports - use of naltrexone in KUDs at the dosage of 50 mg/day successfully helped patients achieve abstinence... naltrexone reduces antidepressant effects of ketamine, indicating overlap between opioid system & ketamine’s NMDA receptor activity. ”
Psychedelic Institute of Mental Health & Family TherapyMichael DeMarco, PhD

(2025) Naltrexone study suggests positive results in the treatment of ketamine use disorder

Ketamine Harm Reduction
Ketamine prescribed off label is a legal possibility for some use cases. Your medical provider and pharmacist will discuss the various indications and risks involved. Talk to your independent medical provider to see if you might be a candidate for medicine in conjunction with psychotherapy.
Psychedelic Institute of Mental Health & Family TherapyMichael DeMarco, PhD

Ketamine harm reduction resources | Psychedelic Institute of Mental Health & Family Therapy

Spotlight: On “Rare but relevant: Ketamine-induced cystitis - an in-depth review for addiction medicine” (Abdelrhamen, et Belal 2025) and psychedelic harm reduction, psychotherapy, support
Rare in ketamine use disorder. Rarer still in ketamine psychedelic assisted psychotherapy as prescribed by your medical provider with support from a mental health specialist, supportive cognitive behavioral therapy approaches to mental health, recovery and harm reduction.
Psychedelic Institute of Mental Health & Family TherapyMichael DeMarco, PhD

2025 research on what has been called "ketamine bladder", a condition not usually seen in structured ketamine-assisted psychotherapy treatment.

Spotlight: Smart Recovery & Psychedelic-Assisted Psychotherapy
On Psychedelics in Recovery
Psychedelic Institute of Mental Health & Family TherapyMichael DeMarco, PhD

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Spotlight: The effects of low-dose ketamine and (2R,6R)-Hydroxynorketamine on affective behaviors associated with protracted oxycodone withdrawal (Lehane, et al, 2025)

"These findings demonstrate the therapeutic potential of (2R,6R)-HNK and ketamine in alleviating affective symptoms of oxycodone withdrawal. "

Naltrexone in the Treatment of Ketamine Use Disorders: A Case Report and Literature Review (Verma, et al, 2025)

"findings consistent w/ 2 prior reports - use of naltrexone in KUDs at the dosage of 50 mg/day successfully helped patients achieve abstinence... naltrexone reduces antidepressant effects of ketamine, indicating overlap between opioid system & ketamine's NMDA receptor activity. "

Spotlight: Ketamine for treatment-resistant post-traumatic stress disorder: double-blind active-controlled randomised crossover study (Beaglehole, et al, 2025)

"We provide preliminary support for the efficacy and tolerability of i.m. ketamine in a community sample of individuals with PTSD."

Spotlight: The transformational power of psychedelics: catalysts for creativity, consciousness, and mental health (Du, et al, 2025)

"Psychedelics, such as psilocybin, lysergic acid diethylamide (LSD), ketamine, and N,N-dimethyltryptamine (DMT), have captured the attention of scientists, artists, and seekers alike for their profound ability to alter consciousness and inspire creativity."

Spotlight: Efficacy of Intravenous Racemic Ketamine on Global Severity and Individual Symptoms of Depression: An Exploratory Retrospective Analysis (Landrum, et al, 2025)

" Maintenance intravenous racemic ketamine therapy demonstrated significant, persistent, and broad efficacy for treatment-resistant depression ...Side effect burden was no greater in higher doses as compared with lower. "

Spotlight: Key competencies for psychedelic treatment in real-world mental health care settings (Wolff, et al, 2025)

"To accommodate mainstream adoption of these treatments, the competencies framework we present respects the distinctive contextual and cultural sensitivities of psychedelic care while remaining anchored in established psychotherapeutic, medical, and scientific paradigms."
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