Mindbloom Joins DoD-Funded VA Ketamine Research for Veterans

What the Award Is

The award comes from the Pharmacotherapies for Alcohol and Substance Use Disorders Alliance (PASA), a research consortium funded by the Department of Defense (also now styled the Department of War) through its Congressionally Directed Medical Research Programs. PASA funds early-stage clinical research on medications for alcohol and substance use disorders, especially when they occur alongside PTSD or other mental health conditions, and it calls trials that include service members and veterans highly desirable.¹

In August 2026, PASA's Consortium Steering Committee selected the project for a planning award of $147,000, a short-term grant for mapping the path a treatment would need to take toward FDA approval for alcohol or substance use disorders. A planning award is expected to produce that development strategy, a protocol for the first clinical study, and FDA input on both.¹ The lead investigator is Dr. Christopher Verrico of Baylor College of Medicine and the Michael E. DeBakey VA Medical Center in Houston. Over a nine-month planning period, his team will work with VA researchers in Houston, Atlanta, and Minneapolis on a protocol for a VA clinical trial of at-home subcutaneous ketamine for veterans with treatment-resistant depression and co-occurring PTSD or alcohol or substance use disorders.

PASA's peer reviewers called the application "highly compelling" and the team "exceptionally qualified," and they described Mindbloom as "an industry-leading partner for telehealth-assisted ketamine therapy." All three reviewers gave the team a perfect score on personnel. Personnel is one of the criteria every PASA application is scored on.¹

Mindbloom is the industry collaborator on the project, and the trial design will adapt Mindbloom's clinical model. It is Mindbloom's first federal research collaboration. Award negotiations are underway, work could begin as early as January 2027 pending final approvals, and the team plans to seek additional PASA funding to run the first trial.

Why Veterans With Depression and Addiction Are So Hard to Treat

Depression, PTSD, and substance use rarely arrive one at a time. In the U.S., 45% of adults with PTSD also have problems with drugs or alcohol, and veterans who have had PTSD are twice as likely to have alcohol problems and three times as likely to have drug problems as veterans who have not.⁴ People living with both PTSD and a substance use disorder also face a higher risk of depression, anxiety, and suicide.⁴

Among veterans who served in a combat zone, about 1 in 8 had an alcohol use disorder in the past year, a higher rate than among those who did not.⁶ In 2023, about 1.0 million veterans had both a substance use disorder and a mental illness.⁷ Alcohol use disorder is also the most common substance use disorder in the military.¹

Left Out of the Evidence

This is the group research most often leaves out. In a review of 170 placebo-controlled antidepressant trials published over two decades, 80% excluded patients with an alcohol use disorder, and substance use disorders were the most commonly excluded psychiatric condition (Zimmerman et al., 2016).⁵ The treatments that emerged from those trials were tested largely on people whose depression came without addiction.

Left Out of Newer Treatments

The same gap shows up in care. The VA's national protocols for intravenous ketamine and for esketamine, the ketamine-derived nasal spray, both exclude veterans with a current moderate or severe substance use disorder.²⁻³ They also advise clinicians to prioritize other strategies for treatment-resistant depression in anyone with a history of substance use disorder.³ The VA's ketamine protocol names the underlying problem directly: ketamine "has also not been adequately studied in people with co-occurring conditions."² Those rules reflect real safety concerns and the limits of today's evidence. They also mean the veterans who may need a new option most have the least research to guide their care.

That is the gap this trial is being designed to study.

Why At-Home Ketamine, and Why Now

Ketamine has been studied as a treatment for addiction for more than two decades, with early but encouraging results. A 2026 meta-analysis of 15 randomized trials (798 participants) across substance use disorders found that, in the seven trials reporting abstinence, ketamine improved abstinence in the first month after treatment, although the effect was not statistically significant at one to six months and the authors called the evidence not yet sufficient to settle efficacy or safety (Fang et al., 2026).⁸ In a pilot trial of 40 adults with alcohol use disorder, a single ketamine infusion paired with motivational enhancement therapy led to higher abstinence and a longer time to relapse than an active control over the following three weeks (Dakwar et al., 2020).⁹ A later trial in 96 patients with severe alcohol use disorder found more days abstinent at six months, though relapse rates did not differ (Grabski et al., 2022).¹⁰

What's missing is a medication built for the overlap. The Department of Defense's addiction research program describes co-occurring alcohol use disorder and PTSD as "conditions currently lacking efficacious pharmacotherapies."¹¹ PASA structures its planning awards around a path to FDA approval, including a pre-IND meeting with the FDA and FDA review of the first study protocol.¹ Ketamine is also new territory for the consortium: as of September 2026, PASA's published portfolio includes preclinical research on a ketamine metabolite, but no clinical studies of ketamine.¹²

Why At Home

Access is the other half of the problem. Under the VA's esketamine protocol, each dose is self-administered under direct observation in a certified medical facility, and the drug "cannot be dispensed directly to a patient for use at home."³ The protocol calls for twice-weekly doses during the first month, which can mean frequent trips to a VA facility for veterans who live far from one.³

This trial is being designed to study an at-home subcutaneous model instead, adapted from the protocol Mindbloom uses today. Because ketamine can be misused, whether an at-home model can be delivered safely to people with an active substance use disorder is one of the questions the trial has to be designed to answer. The model itself already has peer-reviewed outcomes. Among adults with clinically significant PTSD symptoms who received at-home subcutaneous ketamine through Mindbloom, more than 3 in 4 (76.7%) had a significant drop in PTSD symptoms and more than half (56.7%) reached remission over a six-session course (Parks et al., 2026).¹³ Side effects were infrequent (2.8 to 3.2% per check-in) and generally mild, and serious adverse events occurred at 0.08%.¹³

Response = a 10-point or greater drop in PCL-5 score; remission = a 10-point or greater drop with a final PCL-5 score below 33. These results come from Mindbloom's own patients, not from this trial, which has not yet begun. Individual results vary.

What This Means for Veterans Today

This award does not change who can receive ketamine therapy today, at the VA or at Mindbloom. The trial is still being designed, eligibility criteria will be set during the planning period, and it is not enrolling. At Mindbloom, an active moderate to severe substance use disorder typically rules out treatment or requires individual clinical review, and that remains true while this research moves forward.

If you're a veteran living with PTSD or depression and also struggling with alcohol or drugs, treatment that addresses both exists now. Every VA medical center has a PTSD-SUD specialist trained to treat the two together, and research shows PTSD and substance use can be treated at the same time.⁴

For veterans whose depression, anxiety, or PTSD hasn't improved with other treatment and who don't have a substance use disorder, Mindbloom offers clinician-guided at-home ketamine therapy. Mindbloom also partners with the Special Forces Foundation to support Green Beret veterans and their families, and offers dedicated pricing for veterans and service members.

If you're a veteran in crisis, call 988 and press 1 to reach the Veterans Crisis Line.

What Comes Next

The planning period is where the trial takes shape. Over roughly nine months, the team is expected to build a clinical development strategy, hold a pre-IND meeting with the FDA, submit the first study protocol for FDA review, identify study sites and a budget, and complete a review by a Data and Safety Monitoring Board.¹ The finished protocol then goes to PASA's Consortium Steering Committee for funding consideration, depending on available funds.¹

Work on this project could begin as early as January 2027. If the first trial is funded, PASA-supported trials register on ClinicalTrials.gov, report their results there, and follow PASA's procedures for timely publication of findings.¹ We'll share updates as the design comes together and, if the first trial is funded, as it moves toward enrollment.