Ketamine for OUD and Comorbid Depression (OUDCD)

Exclusion Criteria

• •From NHS prescreen (no contact, Study Day 0): Patients transferring from another program of opioid agonist treatment
• •From NHS prescreen (no contact, Study Day 0): Electrocardiogram (ECG) findings of tachycardia, prior myocardial infarction, myocardial ischemia, or aberrant conduction
• •From NHS prescreen (no contact, Study Day 0): Self-report of recent prescribed or illicit benzodiazepine use ("Xannies", or "bars")
• •From NHS prescreen (no contact, Study Day 0): Urine screen positive for pregnancy
• •From NHS prescreen (no contact, Study Day 0): Stage 2 hypertension, defined by a systolic blood pressure (SBP) \> 140 mmHg or a diastolic blood pressure (DBP) \> 90 mmHg
• •From NHS prescreen (no contact, Study Day 0): Clinically significant abnormal laboratory values, physical exam findings or self-reported medical conditions for which a transient increase in blood pressure could be significantly detrimental (e.g., cardiovascular disease), as determined by the evaluating intake physician
• •From NHS prescreen (no contact, Study Day 0): Any clinically significant abnormal findings from intake health and physical examination
• •From NHS prescreen (no contact, Study Day 0): Any indication of serious mental illness or psychiatric disorder from the attending's evaluation notes
• •From Liver Function Screen (Study Contact Day 2): Baseline alkaline phosphatase \> 2.5 times the upper limit of normal
• •From Liver Function Screen (Study Contact Day 2): Baseline aspartate aminotransferase \> 3 times the upper limit of normal
• •From Psychiatric Evaluation (Study Contact Day 2) Current or previous recreational use of ketamine or PCP
• •From Psychiatric Evaluation (Study Contact Day 2): Subjects who meet DSM-5 criteria for current bipolar disorder
• •From Psychiatric Evaluation (Study Contact Day 2): Past or current presence of psychotic symptoms, or diagnosis of a lifetime psychotic disorder including schizophrenia or schizoaffective disorder
• •Subjects who meet DSM-5 criteria for current or history of psychotic spectrum disorders