Ketamine for the Treatment for Alcohol Use Disorder in the ED

Inclusion Criteria: * English speaking adults aged 18 and above * Diagnosed with DSM5 alcohol use disorder, severe * Admitted to BWF inpatient withdrawal management unit (Addiction Recovery Program) Exclusion Criteria: * Any psychotic disorder, bipolar disorder, active suicidality or homicidality * Inability to perform consent due to impaired mental status * Clinical Institute Withdrawal Assessment (CIWA) score \> 20 at any point in the ED * Alcohol withdrawal seizure prior to or during the ED visit * Systolic blood pressure persistently elevated above 180mmHg, or heart rate \>130bmp, in the ED * History of hypersensitivity to ketamine, or experience of emergence reaction * History of any illicit or recreational use of ketamine * Receipt of ketamine treatment for depression in the past 3 months * History of DSM5 hallucinogen use disorder, intracranial mass or bleed, porphyria, thyrotoxicosis, seizure disorder other than from alcohol withdrawal, liver cirrhosis, renal failure, obstructive lung disease, or sleep apnea * History within 6 months of head trauma, stroke, or myocardial infarction * Liver dysfunction with LFTs \>3x upper normal limit * Current use of medications with known drug-drug interactions with ketamine (i.e., St. John's Wort, theophylline, opioid analgesics, CNS depressants other than benzodiazepines or phenobarbital) * Pregnant