The Complete Guide to Ketamine for the Reduction of Alcoholic Relapse (KARE) at Klearwell

Why Klearwell?

We are the UK’s leading provider of psychedelic-assisted psychotherapy, combining the proven therapeutic potential of ketamine with psychological therapy to treat Alcohol Use Disorder. We believe care should always be client-centred and want you to be well-informed about the clinic and available therapy options.

This blog provides information about our treatment to help answer some of your questions.

What is Ketamine?

Ketamine is a synthetic drug that has been used extensively in medicine since the 1970s. It is used daily in emergency departments worldwide at high doses as an effective and safe anaesthetic agent for carrying out brief surgical procedures. Indeed, it is so safe that it is often the anaesthetic of choice for children and older people or patients with significant physical health problems. It has more recently been discovered that at much lower doses, it also has both antidepressant and psychedelic effects.

What is Ketamine for the Reduction of Alcoholic Relapse (KARE)?

KARE is the world’s first evidence-based ketamine-assisted psychotherapy, and Klearwell are the only organisation in the world with the license to deliver this treatment for people with alcohol problems.

Many clinics provide intravenous (IV) infused ketamine as an antidepressant drug. Most of these clinics do not use ketamine alongside psychotherapy and do not follow evidence-based protocols in the way KARE does.

Research has demonstrated that ketamine can profoundly enhance the brain’s ability to grow new neural pathways. This means that in the days following the ketamine experience, people can think in new ways about problems they might be facing in their lives. In the KARE protocol, we utilise this enhanced creative state that ketamine provides, alongside an adapted but established model of psychotherapy, to help people find ways to overcome and move on from their problem of drinking.

The efficacy of the KARE treatment protocol has been demonstrated in Phase II Clinical trial, a form of highly regulated clinical trial considered the gold standard of medical research and shown to be considerably more effective than therapy alone.

Who is KARE for at Klearwell?

KARE is an alcohol relapse prevention intervention that has been developed to help people maintain sobriety. This means that to undergo this treatment; clients will need to have reduced their drinking to the levels they can stop safely at the start of treatment.

We realise that many people will still be drinking when they come to us, so in this case, we will support people to access the appropriate services to achieve sobriety before starting KARE.

Enrolment in the Klearwell KARE Course

All patients undergoing KARE must be registered with a UK GP. This is essential for us to communicate medical issues between Klearwell and your GP. You must meet some eligibility criteria before being considered for the Klearwell KARE course.

Some conditions would indicate that Ketamine assisted psychotherapy may not be safe or appropriate for you.

Once you have been assessed and determined that it is safe to progress to treatment, you will be assigned a 1:1 therapist, who will be with you throughout your KARE therapy. Arrangements will then be made to schedule the dates and times for your appointments.

The Structure of the Klearwell KARE Course

Following your initial referral to Klearwell, we will contact you and ask for more information about your medical history. Our medical doctor will review this information, and you will then be invited to attend an Initial Medical Assessment (IMA) for assessment and discussion of treatment options.

If you are deemed safe to undertake the treatment then your therapy may begin with a series of scheduled “support calls”, to assist you in achieving or maintaining abstinence in the weeks before starting therapy. It may sometimes be necessary for you to get extra support from other services, such as your local community alcohol support team or detox and rehabilitation services.

KARE therapy is a seven-session programme with three high-dose injections of IM (intramuscular) ketamine. The programme typically runs at least four weeks, but the time between treatment sessions can be adjusted to fit your schedule.

Each treatment week, you will come into the clinic, where you will have a relapse prevention-based therapy session followed immediately by a ketamine dosing session (this is typically a 1.0 mg/kg intramuscular ketamine injection).

After each dosing session, you will return to our clinic the following day for an integration session to build on any insights or new perspectives you may have gained from the previous day. It will also include further therapy. This pattern runs for the first three treatment blocks of KARE.

In the final week, you will have an evaluation therapy session to consolidate and complete treatment and assess the need for further treatment.

Support During and After Clinic Visits

At every visit to Klearwell, you will be closely monitored and cared for by an attendant nurse and your 1:1 therapist. There will always be help on hand. The whole course will be overseen by a senior medical professional who will ensure you are safe.

It is a requirement of therapy that you can identify a supportive person who can meet you at the clinic after each ketamine-assisted session. It does not need to be the same person each time.

If you are struggling to find someone for this role, you can make use of services that can perform this function, for example, Curam Care Services.

Questionnaires and Outcome Measures

We will ask you to complete baseline questionnaires before the initial medical assessment to find out more about you and your presenting difficulties and assess how well the course works for you. Some of these will be repeated during the course and again at the end of the course to see how you have progressed. We collect anonymised, pooled data for service evaluation and research purposes.

If you do not want your anonymised data to be used, you can opt out via our consent form (given at the initial assessment) and at any time during your treatment.

Frequently Asked Questions

Please visit our FAQ page for more information about our service and the use of ketamine in therapy.