Table 2.

Patient’s substance use treatment history and time to relapse

Year	Treatment	Time to relapse for both alcohol and tobacco use
2010	Admitted for inpatient rehabilitationa for 3 months	2 months after discharge
2013	Admitted for inpatient rehabilitationb for 3 months	1 month after discharge
2014	Admitted for inpatient rehabilitationa for 3 months	3 months after discharge
2017	Admitted for inpatient rehabilitationa for 3 months	4 months after discharge
April to July 2019	Admitted for inpatient rehabilitationb for 3 months; attended out-patient follow-up for 2 months Received oral naltrexone 50 mg once daily for 5 months. After this, he had a naltrexone implant (765 mg) inserted because oral naltrexone was out of stock. He relapsed a week after the implant was inserted Received nicotine replacement therapy and bupropion 150 mg once daily for tobacco use disorder for 3 months	2 months after discharge with naltrexone implant in-situ
February to August 2021	Admitted for inpatient rehabilitationb for 6 months Received naltrexone 50 mg once daily for 6 months Received nicotine replacement therapy for tobacco use disorder for 3 months. He did not receive bupropion because it was out of stock	2 weeks after in-patient treatment while on oral naltrexone A decision was made to try IV ketamine in light of recent evidence showing efficacy for severe alcohol use disorder

^atreatment was conducted in a residential setting that offers therapy based on alcohol anonymous and peer recovery support strategies

^btreatment was conducted in a setting offering medically managed intensive in-patient services