News from the Pacific Northwest Node: Low-Dose Ketamine Reduces Fentanyl Withdrawal Symptoms

A new Addiction Science and Clinical Practice paper co-authored by Pacific Northwest Node researchers Crystal Smith and Cindy Grande describes a new, reliable strategy that allows fentanyl users to start treatment without prolonged suffering: low-dose ketamine.

Fentanyl continues to cause the majority of drug overdoses in the U.S. Buprenorphine, a medication used to treat opioid use disorder (OUD), is effective and saves lives, but people often avoid it for fear of painful opioid withdrawal symptoms that can occur when starting the medication.

The paper, published in early February, reports on a (non-CTN) study that found an extremely low intramuscular dose of ketamine before starting patients on buprenorphine led to a rapid and significant reduction of withdrawal symptoms in nearly all patients using fentanyl — with no side effects. Most patients could then immediately start buprenorphine without a return of withdrawal symptoms.

In emergency departments, a high dose of ketamine, causing intense drowsiness, has been shown to reverse withdrawal symptoms after starting buprenorphine. This study was the first to find that an undetectably low dose of ketamine could both relieve fentanyl withdrawal and prevent renewed symptoms after starting buprenorphine.

Read the paper, published in Addiction Science and Clinical Practice

Posted on March 3, 2026