Methadone is a first-line, evidence-based treatment for opioid use disorder (OUD).
Unfortunately, retention and adherence in methadone treatment is a major challenge. OUD
patients frequently present with co-morbid depression (OUDCD), a risk factor for poor OUD
treatment outcomes, overdose, and suicide. The last two decades have seen an exciting and
transformational development in the treatment of depression - ketamine. As a safe,
rapid-acting anti-depressant deliverable within the context of methadone maintenance
treatment, ketamine could feasibly change the landscape of treatment for OUD patients with
comorbid depression. This proposal seeks to evaluate implementation outcomes (feasibility and
patient acceptance) as well as preliminary efficacy of ketamine on methadone treatment
outcomes for OUD patients (n=6) with comorbid depression and depressive symptoms presenting
for methadone treatment.