Grayken lessons: a multidisciplinary approach to care for a patient with severe ketamine use disorder

Non-medical ketamine use is becoming increasingly common in the United States (US), but awareness remains limited among US healthcare providers. Here we present the case of a young woman who developed severe ketamine use disorder in the setting of an acute exacerbation of chronic post-traumatic stress disorder (PTSD). She also demonstrated symptoms concerning for two known complications of chronic ketamine use: gastrointestinal toxicity and ketamine-induced uropathy. Informed by best practices established by specialists in club drug use from the United Kingdom (UK), a multidisciplinary care plan was implemented. The plan included specialist referrals for suspected physical complications and connection with a psychiatrist and psychologist to address underlying mental health conditions driving ketamine use. With individualized, multidisciplinary support, she was able to significantly reduce ketamine use, for a period of time. US healthcare providers must be aware of non-medical ketamine use and associated harms, including ketamine use disorder, in order to provide effective counseling and treatment to increasing numbers of people using ketamine. In the UK, a multidisciplinary clinic was established to serve people struggling with ketamine and other club drug use, providing a model for effective, patient-centered care that can inform our approach to building systems of care for people who use ketamine and other club drugs in the US.