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Opioid Use DisorderPhase 2NCT07369089

Targeting Treatment-Resistant OUD With Ketamine-Assisted Mindfulness Oriented Recovery Enhancement

A Phase 2 study testing Ketamine, Mindfulness-Oriented Recovery Enhancement (MORE) and Support Group in people with Opioid Use Disorder, run by University of California, San Diego at 2 sites in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The goal of this clinical trial is to examine the usefulness of Mindfulness-Oriented Recovery Enhancement combined with Ketamine-Assisted Psychotherapy (KetaMORE) for individuals with opioid use disorder who are receiving medication treatment. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Opioid Use Disorder
What is being tested?
Ketamine, Mindfulness-Oriented Recovery Enhancement (MORE) and Support Group
Could I receive a placebo?
No, everyone receives an active treatment
How many people
88 participants
Where
2 sitesUnited States
Study dates
1 Jul 2026to Apr 2028
Phase
Phase 2
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • English-speaking .
  • DSM-5 criteria for Opioid Use Disorder (OUD).
  • Documented evidence (by urine toxicology) of current illicit drug use (upon screening) or by self-report on the Addiction Severity Index (ASI).
  • Men/Women >/= 18
  • Current prescription of a buprenorphine-containing product.
  • Have a support person that would be able to escort the subject home on the evening of the ketamine dosing session. The use of ride services will not be permitted (e.g., Uber, Lift, taxi, etc.).
  • Agreement to adhere to Lifestyle Considerations

Who cannot join

  • 1. A primary DSM-5 Axis I diagnosis of schizophrenia, schizoaffective disorder, dissociative identity disorder, or bipolar I/II disorder as determined by psychiatric evaluation.
  • 2. Has baseline hypertension (≥160 SBP or ≥100 DBP), after repeated measurements. Note: Participants with hypertension that has been controlled by medication down to <160 Systolic blood pressure (SBP) and <100 diastolic blood pressure (DBP) will be allowed participate.
  • 3. Has baseline abnormal resting heart rate (>100 or <60). 4. History of cardiovascular disease, including but not limited to clinically significant coronary artery disease, cardiac hypertrophy, cardiac ischemia, congestive heart failure, myocardial infarction, angina pectoris, coronary artery bypass graft or artificial heart valve, stroke, transient ischemic attack, or any clinically significant arrhythmia.
  • 5. Has QTcf >450msec for men or women on EKG. Note: Participants may qualify for the study if QTc 450-480 msec on one EKG, but then <=450 msec on repeat EKG. If QT-prolonging medications are started or increased in dose after enrollment and prior to ketamine administration, a repeat EKG must be done >12-hours after this change in order to assure continued safe enrollment in the trial.
  • 6. Active suicidal intent or suicidal or non-suicidal self-injurious behaviors, as defined by a "yes" response to question 4 on C-SSRS within the past 6 months at screening or prior to dosing (Active Suicidal Ideation with Some Intent to Act, with or without Specific Plan).
  • 7. Suicidal behaviors within the last 6 month. 8. History of allergy or hypersensitivity reaction to ketamine. 9. History of ketamine use disorder. 10. History of intracranial bleeding or stroke. 11. Current intracranial mass. 12. Seizure within the last 6 months prior to screening visit. 13. Baseline oxygen saturation <95%. 14. Current significant liver disease. 15. Meets the following laboratory parameters:
Show all 16Show fewer
  • Any significant liver diseases or symptoms of liver disease regardless of liver enzyme levels.
  • Asymptomatic alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >=5x upper limit of normal (ULN).
  • Symptomatic ALT or AST >= 2x ULN.
  • AST/ALT >3 upper limit of normal (ULN)
  • Total bilirubin > 1.5x ULN (Gilbert syndrome is allowed).
  • Alkaline phosphatase (ALP) >2x ULN.
  • Renal insufficiency (i.e., estimated glomerular filtration rate (eGFR) < 30 milliliter/minute (mL/min) /1.73 m^2 (using the 2021 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) Creatinine Equation), Creatinine Clearance (CrCl) < 30 mL/min (using the Cockcroft-Gault Equation), or current dialysis)).
  • 16. Currently pregnant or breastfeeding. 17. Has uncontrolled insulin-dependent diabetes and has had a hospitalization for diabetes-related complication within 6 months of signing ICF.
  • 18. Diagnosed cognitive impairments, including dementia, mild cognitive impairment, traumatic brain injury, or developmental delays, that would prevent the participant from completing the study protocol, as identified by self-disclosure when asked in eligibility screening question.
  • 19. Individuals prescribed monoamine oxidase inhibitors.(see Appendix 1) 20. Individuals prescribed medications that are CYP2B6 inhibitors or inducers (see Appendix 1) 21. Patients taking >2 mg of lorazepam-equivalents per day.

Trial locations and contacts

2 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Hannah Pfeffer, LMSW contact

619-500-4668

hapfeffer@health.ucsd.edu

Kelly Hendrickson, MS contact

kehendrickson@health.ucsd.edu

United States2 sites, 2 recruiting
  • University of California, San Diego

    La Jolla, California, 92093

    Hannah Pfeffer, LMSW, 619-500-4668, hapfeffer@health.ucsd.edu

    Kelly Hendrickson, MS, kehendrickson@health.ucsd.edu

    Recruiting
  • University Of Utah

    Salt Lake City, Utah, 84112

    Hannah Pfeffer, LMSW, 619-500-4668, hapfeffer@health.ucsd.edu

    Gina Gregovitch, Gina.Gregovich@hsc.utah.edu

    Recruiting

Other trials in United States

About this study

Official title: KETAMORE: TARGETING TREATMENT-RESISTANT OUD WITH KETAMINE-ASSISTED MINDFULNESS-ORIENTED RECOVERY ENHANCEMENT

The goal of this clinical trial is to examine the usefulness of Mindfulness-Oriented Recovery Enhancement combined with Ketamine-Assisted Psychotherapy (KetaMORE) for individuals with opioid use disorder who are receiving medication treatment. The main question it aims to answer is whether individuals with opioid use disorder who receive Mindfulness-Oriented Recovery Enhancement in combination with Ketamine-Assisted Psychotherapy will demonstrate greater reductions in opioid use and craving than individuals who receive Ketamine-Assisted Psychotherapy with a non-mindfulness support group.

Participants will be randomly assigned to receive either Mindfulness-Oriented Recovery Enhancement combined with Ketamine-Assisted Psychotherapy or Ketamine-Assisted Psychotherapy combined with a support group control condition. Researchers will compare these groups on days of opioid use, time to first opioid use lapse, craving, and mood, assessed using ecological momentary assessments and standardized measures collected during treatment and follow-up.

Read the detailed description

This study is a Phase II, two-arm, parallel randomized controlled trial designed to evaluate the efficacy of Mindfulness-Oriented Recovery Enhancement combined with Ketamine-Assisted Psychotherapy (KetaMORE) compared to Ketamine-Assisted Psychotherapy paired with a support group control condition for individuals with opioid use disorder receiving medications for opioid use disorder (MOUD), including buprenorphine.

Participants will be randomized in a 1:1 ratio to one of two conditions: (1) Ketamine-Assisted Psychotherapy combined with Mindfulness-Oriented Recovery Enhancement, or (2) Ketamine-Assisted Psychotherapy combined with a support group providing nonspecific therapeutic support without mindfulness training. Both groups will receive identical ketamine dosing and psychotherapy components; the conditions will differ only in the adjunctive behavioral intervention.

Mindfulness-Oriented Recovery Enhancement is a manualized, evidence-based intervention integrating mindfulness training, cognitive reappraisal, and savoring techniques to reduce craving, negative affect, and maladaptive reward processing associated with substance use. The support group control condition is designed to match therapist contact and group support while excluding mindfulness-based content.

Participants will complete assessments at baseline, during treatment, post-treatment, and follow-up. Primary outcomes will include number of days of opioid use and time to first opioid use lapse. Secondary outcomes will include opioid craving and mood symptoms. Ecological momentary assessments will be used to capture daily fluctuations in substance use, craving, and affect throughout the study period.

Being tested
Ketamine, Mindfulness-Oriented Recovery Enhancement (MORE), Support Group
Keywords
Mindfulness, Ketamine, Opioid Use disorder
Medical subject headings
Opioid-Related Disorders

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • KetamineDrug

    Ketamine will be administered as part of ketamine-assisted psychotherapy under medical supervision according to the study protocol. Ketamine dosing and administration procedures will be identical across study arms.

  • Mindfulness-Oriented Recovery Enhancement (MORE)Behavioural

    Mindfulness-Oriented Recovery Enhancement is a manualized, evidence-based intervention integrating mindfulness practices, cognitive reappraisal, and savoring exercises to reduce craving, improve emotional regulation, and support recovery from opioid use disorder. MORE sessions are delivered in a group format and coordinated with ketamine-assisted psychotherapy sessions.

  • Support GroupBehavioural

    The support group intervention consists of therapist-led group sessions focused on emotional support and discussion of recovery-related experiences. This condition is designed to match the MORE intervention in duration and therapist contact while excluding mindfulness-based or structured skills training.

Study groups in NCT07369089
Study groupRoleWhat they receive
Ketamine-Assisted Psychotherapy Plus Mindfulness-Oriented Recovery Enhancement (KetaMORE)ExperimentalParticipants assigned to this arm will receive ketamine-assisted psychotherapy combined with Mindfulness-Oriented Recovery Enhancement (MORE). MORE is delivered as a structured, manualized behavioral intervention designed to reduce opioid use by targeting craving, negative affect, and maladaptive reward processing through mindfulness training, cognitive reappraisal, and savoring techniques.
Receives: Drug: Ketamine; Behavioral: Mindfulness-Oriented Recovery Enhancement (MORE)
Ketamine-Assisted Psychotherapy Plus Support GroupActive comparatorParticipants assigned to this arm will receive ketamine-assisted psychotherapy combined with a support group intervention. The support group provides nonspecific therapeutic support and group discussion but does not include mindfulness training or structured skills from Mindfulness-Oriented Recovery Enhancement.
Receives: Drug: Ketamine; Behavioral: Support Group

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Abstinence

    Abstinence as measured by timeline followback and triangulated by drug screen.

    Measured: From day 15 through 84.

Secondary outcomes (11)
  1. MOUD discontinuation

    Discontinuation of medications for opioid use disorder (MOUD), defined as cessation of prescribed MOUD during the study period using the Timeline Follow-back and biochemically verified use via drug screens.

    Measured: From day 15 to 84.

  2. Opioid Craving (Ecological Momentary Assessments)

    Opioid craving assessed using ecological momentary assessment (EMA) on a 0-10 numeric rating scale (0=no craving, 10 extreme craving).

    Measured: From baseline through week 12.

  3. Opioid Craving (Desires for Drug Questionnaire)

    Opioid craving measured using the Desires for Drug Questionnaire (DDQ), a validated self-report measure of desire and urge to use opioids (0= Strongly Disagree, 6= Strongly Agree)

    Measured: From baseline to week 12.

  4. Quality of life (WHO-5)

    Quality of life assessed using the World Health Organization Five Well-Being Index (WHO-5), a brief measure of subjective psychological well-being. (0= At no time, 5= All of the time)

    Measured: From baseline to week 12.

  5. Depressive Symptoms (Patient Health Questionnaire-9)

    Depressive symptom severity assessed using the Patient Health Questionnaire-9 (PHQ-9). (0= Not at all, 3= Nearly every day)

    Measured: From baseline to week 12.

  6. Post-Traumatic Stress Symptoms (PTSD Checklist for DSM-5)

    Post-traumatic stress symptom severity assessed using the PTSD Checklist for DSM-5 (PCL-5). (0 = Not at all, 4= Extremely )

    Measured: From baseline to week 12.

  7. Anhedonia (Snaith-Hamilton Pleasure Scale)

    Anhedonia assessed using the Snaith-Hamilton Pleasure Scale (SHAPS), a validated measure of reduced capacity to experience pleasure. (1=Strongly Disagree, 4= Strongly Agree)

    Measured: From baseline to week 12.

  8. Psychological Distress (Depression Anxiety Stress Scales)

    Psychological distress assessed using the Depression Anxiety Stress Scales (DASS). (0= Did not apply to me at all, 3= Applied to me very much or most of the time)

    Measured: From baseline to week 12.

  9. Positive and Negative Affect (Positive and Negative Affect Schedule)

    Positive and negative affect assessed using the Positive and Negative Affect Schedule (PANAS). (1= Very slightly or not at all, 5= Extremely)

    Measured: From baseline to week 12.

  10. Pain (PEG Scale)

    Pain severity and pain-related interference assessed using the PEG scale. (0= no pain or interference, 10= Worst imaginable pain or interference)

    Measured: Baseline to week 12.

  11. Momentary affective state

    Momentary affective state measured by EMA on 0-10 numeric rating scale (0=low affect, 10=high affect).

    Measured: Baseline through week 12.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted27 Jan 2026
  2. Study start1 Jul 2026
  3. Primary completionJan 2028 (estimated)
  4. Study completionApr 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Investigator, Outcomes assessor
Enrolment
88 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07369089
Sponsor's protocol ID
177164
Status last verified
Nov 2026
First submitted
23 Jan 2026
Last updated
5 Nov 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: De-Identified participant data will be shared for approved purposes with assigned data access agreement (i.e., meta-analysis)

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Ketamine, Mindfulness-Oriented Recovery Enhancement (MORE) and Support Group in people with Opioid Use Disorder, run by University of California, San Diego at 2 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 16 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 5 Nov 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Hannah Pfeffer, LMSW (619-500-4668, hapfeffer@health.ucsd.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Abstinence (time frame: From day 15 through 84.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 Nov 2026.

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