Brief report: Ketamine-assisted "bridge therapy" for opioid tapering in complex cases.
Mariana C De Oliveira, Cláudia C De Araujo Palmeira, André B Negrão, Ziyad A Hadi, Julia R Arana, Rita De Cássia Ferreira Duarte, Joice L P Da Silva, Gustavo K Matsui, João F D Rapozero, Douglas H Crispim, André Malbergier, João M Castaldelli-Maia
The American journal on addictions January 28, 2026 DOI: 10.1111/ajad.70131 via PubMed
Summary
AI-generated from the abstractA 25-year-old woman with opioid use disorder, chronic pain, and major depressive disorder received eight weekly intravenous ketamine infusions (0.5 mg/kg) alongside a gradual reduction of her methadone dose. After the protocol, her methadone dosage was cut by 50%, and she experienced better control of pain and cravings, fewer withdrawal symptoms, and increased participation in psychotherapy. The report suggests that ketamine-assisted bridge therapy may help support opioid tapering in patients with multiple co-occurring conditions.
Study at a glance
| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | 25-year-old woman with opioid use disorder, chronic pain, and major depressive disorder |
| Intervention | Intravenous ketamine infusions |
| Dose | 0.5 mg/kg weekly |
| Duration | 8-week protocol |
| Citations | 1 |
| Key finding | Ketamine-assisted bridge therapy enabled a 50% reduction in methadone dosage with improvements in pain, cravings, withdrawal symptoms, and psychotherapy engagement. |
Abstract
Opioid use disorder (OUD) presents major challenges, especially when combined with chronic pain and psychiatric comorbidities. A 25-year-old woman with OUD, chronic pain, and major depressive disorder underwent an 8-week protocol of intravenous ketamine infusions (0.5 mg/kg weekly) as an adjunct to opioid tapering. Methadone dosage was reduced by 50%, with improved pain and craving control, reduced withdrawal symptoms, and greater psychotherapy engagement. Ketamine-assisted "bridge therapy" treatment may support opioid tapering in complex cases. This is a novel report to document a multifaceted improvement in this specific comorbidity cluster.