Ketamine-Assisted Recovery for Methamphetamine Use Disorder & HIV

Inclusion Criteria: * Age 18-69 * Moderate or severe methamphetamine use disorder * Interest in reducing or stopping methamphetamine use * Insured by MediCal, MediCare, or Healthy San Francisco * Used methamphetamine ≥7 out of the 30 days prior to screening OR enrolled in a residential drug treatment program * Have a diagnosis of HIV OR taken PrEP over the last 90 days OR engaged in ≥1 risk behavior for HIV acquisition/transmission over the last 90 days (i.e., anal sex under the influence of methamphetamine, condomless sex with a partner of serodiscordant or unknown HIV status, or any shared use of injection drug supplies) * English speaking * Permanently housed for ≥30 days OR enrolled in residential drug treatment for ≥5 days * Have a text-capable cell phone or access to email (if not enrolled in residential treatment) * Able and willing to provide informed consent and adhere to visit schedule * If necessary, willing to be contacted on a daily basis by one of the therapists for 7 days after each ketamine session * Prior to scheduled ketamine sessions, agree: (a) abstain from using methamphetamine and cocaine for ≥48 hours, (b) abstain from using non-prescribed opioids, cannabis products, benzodiazepines, or alcohol for ≥24 hours, (c) consume no more than a modest quantity (e.g., 1 cup) of caffeine (e.g., coffee or tea) in the morning; (d) continue usual regimen of routinely prescribed opioid-based medications throughout trial; and (e) continue any routine behavioral or pha…