# Ketamine-assisted integrative treatment for Veterans with chronic low back pain and comorbid depression

> **NIH VA IK2** · VETERANS HEALTH ADMINISTRATION · 2024 · —

## Abstract

Background: Chronic low back pain (CLBP) and depression are the two most common causes of disability in
America. When they occur together, patients have more functional limitations, higher healthcare spending, and
treatment is more likely to fail. Ideal treatments would address pain interference with function and improve
mood in patients with both CLBP and depression. Ketamine is an anesthetic with rapid analgesic and
antidepressant properties. Unfortunately, its effect for both pain and depression fades over time, necessitating
maintenance dosing. Thus, non-invasive treatments that enhance and sustain its benefits are needed.
Significance/Impact: This application proposes a career training and research plan to develop a narrative
intervention designed to be administered shortly after a series of ketamine infusions, conduct initial pilot
testing, and complete a small feasibility randomized controlled trial (RCT). A narrative intervention, [designed
to be delivered in the days after receiving ketamine,] could be particularly helpful [in reducing pain
interference] for patients in whom formal psychotherapy may not be acceptable. Narrative interventions reduce
distress by helping people organize difficult experiences (such as chronic illness) into a cohesive story; this
process results in the perception that the experience is more manageable. Commonly used in palliative care,
narrative interventions have demonstrated effectiveness for both pain and depression and are highly
acceptable. This research agenda is well-aligned with the Clinical Science Research and Development priority
research focus on both chronic pain treatment alternatives to opioids and mental health conditions highly
prevalent in Veterans (e.g., depression). Short-term, results will lead to a Merit Review proposal to test the
intervention in an adequately powered RCT. Long-term, Dr. Powell will gain skills broadly applicable to (a)
complex intervention development (e.g., those combining pharmacologic and behavioral components) and (b)
designing and conducting high quality clinical trials of these treatments in Veterans with chronic illnesses. Dr.
Powell is a VHA palliative care physician and research scientist whose long-term goal is to become an
independent investigator focused on improving outcomes for Veterans with chronic pain and psychosocial
distress.
Innovation: This study will be the first to test a narrative intervention as a strategy for enhancing ketamine’s
benefits, with an emphasis on pain interference with function. It focuses on Veterans with both CLBP and
depression – a population that stands to benefit from ketamine’s analgesic and antidepressant actions.
Specific Aims: Study Phase I aims to develop and refine a targeted narrative intervention for Veterans with
CLBP and co-occurring depression using a modified ADAPT-ITT approach. The initial aim involves the
identification of relevant components of existing narrative interventions followed by semi-structured
interv...

## Key facts

- **NIH application ID:** 10915879
- **Project number:** 1IK2CX002646-01A2
- **Recipient organization:** VETERANS HEALTH ADMINISTRATION
- **Principal Investigator:** Victoria Diane Powell
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2024-07-01 → 2029-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10915879

## Citation

> US National Institutes of Health, RePORTER application 10915879, Ketamine-assisted integrative treatment for Veterans with chronic low back pain and comorbid depression (1IK2CX002646-01A2). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10915879. Licensed CC0.

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