The ketamine-assisted Suboxone Induction (KASI) is the cutting edge of addiction treatment. When someone needs to start medication for opioid use disorder (MOUD induction), I’ll present the options, and I will usually say something like “methadone sucks every day—Suboxone only sucks once,” but still, that rough start is enough to turn off many people from choosing buprenorphine as their path to recovery.
Enter ketamine, which is a highly effective treatment for opioid withdrawal symptoms—but that’s not the whole story—ketamine sensitizes opioid receptors that have become desensitized from chronic fentanyl use, which opens the door for us to do a buprenorphine (aka bupe, aka Suboxone) induction in patients who (1) are worried about precipitated withdrawal and (2) are worried that they do too much fentanyl to be managed by buprenorphine.
Most people don’t need KASI, and an old-fashioned or a new-fashioned routine Suboxone induction will suffice. During our consult, we can explore if KASI is right for you, but there are many ways to induce buprenorphine.
Why KASI Exists
For people starting Suboxone (buprenorphine/naloxone sublingual films), the process goes smoothly if you are able to abstain from opioids long enough to go into withdrawal. You stop opioids, wait until you’re in mild withdrawal, take your first dose, maybe an hour later you take another dose, and within a few hours you feel stable again. I’ll usually prescribe you some other meds to make you comfortable, and sometimes this is easy. A lot of times it’s not easy though.
If you’ve been using fentanyl or other high-potency opioids, you may already know — it’s not that simple anymore.
Even when you “do everything right,” buprenorphine can sometimes trigger precipitated withdrawal — a sudden, intense wave of withdrawal symptoms that feels unbearable.
That’s where KASI (Ketamine-Assisted Suboxone Induction) comes in.
KASI is for patients who can’t tolerate traditional Suboxone starts — a calm, science-based way to stabilize without the chaos of withdrawal.
How It Works
If you’ve read our Ketamine for Depression page, you already know ketamine has unique effects on the brain.
At low, carefully controlled doses, ketamine can:
✅ Calm the nervous system
✅ Reduce anxiety and pain
✅ Ease withdrawal intensity
✅ Induce feelings of calm & wellbeing
✅ Support emotional stability during early recovery
When combined with Suboxone, ketamine helps your body and mind move through withdrawal more gently, making induction safer and more comfortable.
What to Expect
KASI is a supervised medical procedure, not a take-home treatment.
1. Preparation
You’ll meet with one of our medical providers to review your history, medications, and goals. The first time we talk can be over telehealth. We want to remove the barriers and get you into recovery. You’ll come to the Happy Healthy New York clinic in Ridgewood, Queens, we’ll make get you situated, take your vital signs, etc. There are some support meds that we might recommend you take in order to help things go smoothly.
2. Ketamine administration
A small dose of ketamine is given by IV or IM in a calm, monitored environment. You’ll be continuously observed for safety and comfort.
3. Suboxone induction
Once your body is ready, we begin Suboxone. Withdrawal symptoms usually soften within minutes to hours.
4. Observation & follow-up
You’ll rest in our clinic until stable, and our team will follow up closely to ensure a smooth transition.
Who It’s For
KASI is reserved for people who:
- Have had failed or difficult Suboxone inductions
- Are at risk for precipitated withdrawal
- Are detoxing from fentanyl, methadone, or other long-acting opioids
If you’ve tried to start buprenorphine before and couldn’t get through it — this may be a safer way forward.
Safety First
All KASI sessions at Happy Healthy New York are performed by licensed medical providers in a closely monitored environment.
- Continuous heart rate, blood pressure, and oxygen monitoring
- Comfortable recovery environment
- No driving the same day — plan a ride home
- Your clinician has years of experience in addiction and critical care. HHNY’s office is over-equipped and prepared for emergencies because that is how we roll.
What Makes HHNY Different
We don’t believe recovery should mean suffering.
Happy Healthy New York is founded and staffed by an addiction specialist with years of experience in critical care, but HHNY’s framework is not the cold medical model you’ll encounter at ketamine clinics run by clinicians with backgrounds in emergency medicine and anesthesia.
The Happy Healthy New York approach combines addiction health, mental health, and integrative health in a single, trauma-informed setting.
You’ll receive support for:
- Medication management (Suboxone, Sublocade, Brixadi, and beyond)
- Mood stabilization
- Sleep, anxiety, and trauma recovery
- Access to therapy and harm-reduction education
- Holistic care that addresses your mental and physical health
Next Steps
If you’ve struggled to start Suboxone — or fear precipitated withdrawal — you’re not out of options. Together we can break the cycle and start your recovery.
Reach out to us today to learn if KASI is right for you.
📞 Text : 833HAPPYNY (833-427-7969)
📧 Email: info@happyhealthyny.com
Evidence-based care for whole-person health. 