Ketamine trial could help free patient from alcoholism
Just two months ago, Marcus was drinking up to seven bottles of wine a night and regularly blacking out, sometimes finding himself in police custody.
Now he is taking part in a cutting-edge Ketamine for reduction of Alcoholic Relapse (KARE) trial at the University of Exeter which is currently recruiting people to be involved. Funded by the Medical Research Council, the trial is examining whether a low dose of the drug ketamine in combination with therapy and regular monitoring of participants' alcohol levels via an ankle device, can help reduce high levels of relapse to alcholism.
The trial follows preliminary evidence that the approach can halve the numbers of alcoholics who relapse. Marcus has stayed sober over the difficult Christmas and New Year period, and he is optimistic that he will beat the habit for good.
After starting the trial at the beginning of December, Marcus, 47 and from Exmouth in Devon, has stayed voluntarily clean for the first time in 30 years. He said: "I've taken part in therapy so many times before, and I've always relapsed. It's never felt like it would stick. This time, there seems to be something about the combination of factors that is really helping.
"Often it starts with just one or two drinks when I'm feeling low, and then I feel guilty so I drink more, and before you know it, it's a full binge. I know it's early days but this feels different. I'm confident I'm going to remain sober for the rest of my life."
Participants in the trial receive a low-dose of ketamine by injection once a week for three weeks in conjunction with seven 90 minute sessions of psychological therapy. A control group will receive the same amount of therapy but be given an injection of saline solution instead of ketamine so that the researchers can compare the results.
The trial is still in its early stages and results cannot be determined until all participants have taken part and follow-up has taken place, but for Marcus it is the start of a transformation from the depths of alcoholism over the last three decades. Starting as a social drinker, Marcus and friends began boozing at home in his mid 20s, when they could not afford to go to the pub, and the levels of intake began to rise.
Before long, his drinking had broken his marriage and was disrupting his employment. He got casual work in security, but lost jobs when he went binging on payday. He ended up homeless, sleeping on the streets. "I've sold possessions to buy alcohol – I've cashed in TVs so I can get drunk, and I've been in prison three times for drink driving. I'm not proud of it," he said.
In one recent episode, Marcus bought a car and drove to Wales to visit his mother's grave – all while so inebriated that he had no memory of any of it. "I came to in custody – the police could have told me I'd stolen a Jumbo jet and I've had had to accept it." he said. "I have no recollection whatsoever."
Marcus is relived that nobody has ever been physically hurt during his binges, and he is now working to turn his life around. Now, he has a home after owners of a bed and breakfast he was placed in by social services befriended him and sought him out when their lodging became free. He has a year-old relationship, and accompanies his girlfriend Sharon on missions to feed the homeless in Exeter.
Sharon said: "He's such a lovely guy with a huge heart. On one trip, a young homeless woman was asking for a hoody, but we didn't have one in our bag. Marcus took his off and gave it to her. I could really see the potential in him."
The study aims to recruit 96 recently abstinent volunteers with severe alcohol use disorder, a condition which affects nearly four million people in the UK, often with devastating consequences. Volunteers must not be users of illegal drugs.
Celia Morgan, Professor of Psychopharmacology at the University of Exeter, is working with University College London and Imperial College London on the KARE trial, which is currently recruiting in South West England and London.
She said: "Marcus's story shows how social drinking can escalate to an addiction that can ruin lives. As many people give up alcohol for January, it is an ideal time to raise awareness of these issues. We hope this trial will allow us to examine whether ketamine, combined with therapy, can indeed help people stay abstinent from alcohol".
Previous studies in mice suggest ketamine could produce changes in our brains that make it easier to make new connections and learn new things in the short-term. The team hope this could make the sessions of psychological therapy more effective.
All participants are asked to wear a device on their ankle that will monitor their alcohol intake over the following six months by measuring their sweat levels.
A pilot study found that three doses of ketamine in conjunction with psychological therapy reduced average 12 month relapse rates from 76 per cent to 34 per cent. It is thought that ketamine's antidepressant properties could contribute towards this reduction.
When used in a controlled environment, ketamine is a safe drug and it is not addictive. It is commonly used as an anaesthetic in medicine but when used as an anaesthetic, the dose - which is often given several times over a much shorter period - is much higher than will be used in this particular study.
Participants may experience some effects such as changes in their vision and hearing during the infusion of ketamine, but any changes should be mild and people in other studies given similar doses have not found them to be unpleasant.
To find out more about the trial, including information on getting involved, visit the website.
Follow Professor Celia Morgan's seven top tips for a successful dry January:
- Take it one day at a time
- Try and think of other activities you like doing that don't involve drinking, e.g. exercising, doing something creative, socialising somewhere that doesn't serve alcohol
- Identify times when it will be particularly difficult for you to avoid alcohol, such as dinner parties or after work. Plan in advance how you are going to handle these situations/ What you will do instead of drinking alcohol?
- Plan little rewards for yourself along the way when you pass certain milestones - one day, one week - like cooking a nice dinner or having a relaxing bath
- If you think you use alcohol to relax, try other methods of relaxation like self-hypnosis or meditation
- Get support – sign up to Alcohol Concern's Dry January page
- If you are really struggling with your drinking, and think it is out of control and having a very negative effect on your life, contact your local alcohol services.
Provided by University of Exeter