Alcoholics will be offered the drug ketamine as part of a landmark clinical trial to tackle “a national alcohol crisis” in Scotland.
About 20 patients at a Scottish site will take part in the phase three trial, led by the University of Exeter, to research the efficiency of ketamine-assisted therapy to treat alcohol-dependence.
Ketamine is classified as a class B banned substance by the Home Office when used recreationally but it is also a licensed drug used as an anaesthetic.
Phase two showed that a dose of the drug was not only safe and tolerable for heavy drinkers but also effective at keeping them sober alongside therapy.
The Ketamine for Reduction of Alcohol Relapse trial will now move on to the next step of drug development with the aim of rolling it out into the NHS if it proves effective. The trial will be delivered across seven NHS sites in the UK including one in Scotland. Its location is yet to be confirmed but could be in Glasgow. People with alcohol dependencies aged 18 to 60 will be eligible for the trial but those with a risk of self-harm will be excluded.
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A total of 280 people with alcohol problems across the UK will be recruited and given a managed ketamine dose alongside psychological therapy and education about the effects of alcohol.
Previous phases found that participants who had ketamine and therapy stayed sober, representing 86 per cent abstinence, in the six-month follow-up.
Dr Iain Smith, senior collaborator and adviser for the trial, said: “That’s a good outcome at six months. If I treat someone with alcohol dependence through usual treatment, I follow up with them at three months and usually a third of them won’t have relapsed. By a year, 90 per cent of them will have relapsed. We need new and better and more treatment around alcohol abuse in Scotland. We have got a worse problem than England so it is important. We have a national alcohol crisis.”
In 2021, 1,245 people died from conditions caused by alcohol in Scotland, according to National Records of Scotland. This was the most deaths since 2008 and 5 per cent higher than 2020. Smith explained how the ketamine works to treat patients, saying: “The theory is they’re more likely to be receptive to the psychotherapy, they’re more likely to make changes in relation to it. The other thing to know about Ketamine is that it is a licensed drug. It’s a drug that’s already used in psychiatry for treating depression, it has been used as an anaesthetic agent.
“It’s well funded, it’s all going on in a very controlled way. If someone doesn’t seem to react well to the ketamine — which is unlikely because it will be done in a managed, supported environment — they would come out the trial and there would be lots of safety protocols.
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“Ketamine is potentially addictive and there is a small percentage who maybe like it too much. We’re aware of that and I don’t think the people who will be selected are likely to have experienced the drug before. You can’t neglect the social and psychological dimensions, there is never going to be a magic drug on its own — and this treatment isn’t the drug on its own.”
Smith said if the trial was successful a wider rollout could be possible after further research. Ideally, he said, the trial needed to prove its results over a longer period.
The £2.4 million programme will be funded by the National Institute for Health and Care Research, which is funded by the Department of Health, and from Awakn Life Sciences, a biotech firm specialising in addiction.
Babies born addicted to drugs
More than 1,100 babies have been born dependent on substances in the past five years, leading to calls for better alcohol and drug services in Scotland. The Liberal Democrats have urged the Scottish government to support babies with neonatal abstinence syndrome. The condition means the children show signs of drug addiction because of the mother’s misuse of substances in pregnancy. Freedom of information requests show 1,123 babies were born with NAS in Scotland since 2017. The Scottish government said: “We are increasing investment to women and families.”
