Measuring the psychoactive effects of ketamine in alcohol use disorder: When assessment shapes experience
Addiction March 11, 2026 Christina Mcanulty, Nicolas Garel
A commentary on the KARE trial argues that the study's conclusion—that ketamine's dissociative and perceptual effects do not mediate abstinence outcomes in alcohol use disorder—may be premature due to measurement issues. The authors note that subjective effects were assessed repeatedly during infusions, which could alter the experience, and that non-validated Likert scales were used instead of validated instruments like the Mystical Experience Questionnaire or Emotional Breakthrough Inventory. They highlight that mystical-type experiences, not dissociation, have been linked to therapeutic benefits in other studies of ketamine and psilocybin for addiction and depression. The commentary calls for future trials to minimize in-session interruptions, use validated psychedelic-specific scales after the acute phase, and distinguish dissociation from mystical or transformative experiences before concluding that the altered state is mechanistically irrelevant.