Three weekly infusions of ketamine (0.8 mg/kg) helped people with severe alcohol use disorder stay abstinent more days over six months than placebo infusions did. The ketamine group averaged 10.1% more days abstinent than the placebo group. Combining ketamine with mindfulness-based relapse prevention therapy produced the largest improvement, with 15.9% more abstinent days compared with placebo plus alcohol education. No serious adverse events occurred. Relapse rates did not differ significantly between ketamine and placebo groups. The findings suggest ketamine is safe and may support abstinence, especially when paired with psychological therapy.
Some investigational drugs, such as ketamine, psychedelics, and cannabis, exist simultaneously in regulated clinical trials and unregulated street or online markets, where they are accessible without clinician oversight. The authors propose the term "parallel-access compounds" for this category and argue that research ethics should formally recognize these substances. Non-psychoactive examples also exist, like retatrutide, an investigational weight-loss drug that has been illicitly manufactured and sold despite being intended only for trial participants.