Ketamine is relatively new to the average American. What can you share with them as a mental health clinician?
Ketamine-assisted therapy has generated a lot of attention over the last decade as researchers uncover new therapeutic applications. While ketamine was once viewed as a recreational drug for students and partygoers, ketamine-assisted therapy is anevidence-based treatment that can alleviate the symptoms of various mental health conditions, including anxiety, depression, posttraumtic stress disorder, obsessive-compulsive disorder, trauma, and more.1
Researchers have explored the potential behavioral health applications of psychedelics for several decades and found ketamine's dissociative and analgesic properties extend to painful emotions and memories. When used in a clinical setting, ketamine acts as a therapy incubator, allowing patients and their therapists to gain a deeper level of trust and understanding. Patients can feel safe letting their guard down to access distressing memories without overwhelm, rapidly paving the way for future success.
Promising Results, Despite Initial Hesitancy
Ketamine treatments are still relatively new to the average American—a recent survey by APN found that only 20% of Americans have heard of ketamine therapy and are open to trying it. Like many other emerging mental health treatments, stigma and misinformation can contribute to hesitance; 45% of survey respondents reported that they could not be persuaded to try ketamine-assisted therapy, even if their doctor or therapist recommended it.2
Still, many mental health professionals have helped their patients find long-term success with therapeutic ketamine treatments; 64% of survey respondents agreed that ketamine-assisted therapy helped with their depression and anxiety symptoms.
Alcohol Use Disorder & Cocaine Use Disorder
Now, researchers and clinicians are exploring additional applications beyond anxiety and depression—new research shows therapeutic ketamine may help people with severe alcohol use disorder (AUD) and cocaine use disorder (CUD), among other conditions.3
A University of Exeter trial found participants who received ketamine-assisted therapy stayed completely sober for 162 of 180 days following treatment. The 87% abstinence rate was “significantly higher than any of the other groups,” according to researchers; the ketamine therapy group was more than 2.5 times more likely to stay completely abstinent at the end of the trial than those in the control group.3 These outcomes show great potential for treating AUD, which has become increasingly more common after the pandemic fueled higher levels of alcohol abuse in the US.4
A recent study by researchers at Case Western Reserve University found ketamine treatments may also help patients struggling with CUD; patients receiving ketamine treatments for pain or depression experienced remission rates 2 to 4 times higher than the control groups, even without concurrent psychotherapy.5 While this study substantially strengthens the argument for therapeutic ketamine as a treatment for CUD, researchers emphasized that additional clinical trials are required to assess the potential impacts more thoroughly.
How to Responsibly Refer Patients
Decades of research and long-term patient outcomes have already established ketamine-assisted therapy as a safe and effective treatment for anxiety, depression, and trauma when administered responsibly as a part of a comprehensive treatment plan. Still, health care providers must understand the differences in treatment options before referring patients for services.
Like any other emerging mental health treatment, ketamine is most effective and safe when administered by professionals. Medical professionals and therapists can better protect client safety and treatment efficacy by evaluating each client’s medical history, background, and goals ahead of treatment. Ketamine is unsafe when administered outside of a clinical environment.
Many companies prescribe ketamine virtually, marketing it as a wonder drug and shipping pills with little to no regard for patient safety. Without proper supervision and follow-up from trained medical professionals, patients can misuse ketamine at home, increasing the likelihood of dependence on a controlled substance.
APN’s survey found that over half (55%) of respondents who tried at-home ketamine treatments admitted to either accidentally or purposely using more than the recommended dose. The risk was even higher among the younger generations (ages 24 to 42); nearly 6 in 10 millennials used more than the recommended dose when trying ketamine at home.2
Virtual prescribers position themselves as behavioral health companies, but most are just tech startups that took advantage of COVID-related relaxed public health regulations meant to prevent disruptions in medical care.6 These “trendy” ketamine companies are often no better than online drug dealers, capitalizing on loopholes that allow reputable telehealth companies to prescribe drugs virtually as part of medication management plans. Their negligence increases the likelihood of irresponsible at-home use and generates valid criticism from health care providers concerned with patient safety, treatment efficacy, and long-term behavioral health outcomes.
The Bottom Line
Ketamine-assisted therapy can be a promising healing modality for many, but only if medical professionals thoroughly evaluate each treatment provider. A reliable treatment center should conduct a thorough, in-person intake process ahead of treatment and only approve ketamine-assisted therapy on a case-by-case basis as part of an extensive, comprehensive treatment plan.
Health care providers have a duty to their patients. With some research and thorough evaluation, you can connect your patients with safe treatment options that improve their behavioral health and support their overall wellness goals.
Mr Thompson is the President of Plus by APN.
1. Drozdz SJ, Goel A, McGarr MW, et al. Ketamine assisted psychotherapy: a systematic narrative review of the literature. J Pain Res. 2022;15:1691-1706.
2. 2023 Future of mental health: ketamine therapy report. Plus by APN. 2023. Accessed April 10, 2023. https://plusapn.com/wp-content/uploads/2023/02/2023-Future-of-Mental-Health-Ketamine-Therapy-Report-by-APN.pdf
3. Ketamine and psychological therapy helped severe alcoholics abstain for longer in trial. ScienceDaily. January 11, 2022. Accessed April 10, 2023. https://www.sciencedaily.com/releases/2022/01/220111091401.htm
4. LaMotte S. Pandemic fueled alcohol abuse, especially among women, but there are treatment options. CNN Health. December 18, 2022. Accessed April 10, 2023. https://www.cnn.com/2022/12/18/health/alcohol-treatment-options-lisa-ling-wellness/index.html
5. Ketamine could be effective treatment for cocaine-use disorders. Neuroscience News. February 20, 2023. Accessed April 10, 2023. https://neurosciencenews.com/addiction-ketamine-treatment-22532/
6. Fact sheet: COVID-19 public health emergency transition roadmap. US Department of Health & Human Services. February 9, 2023. Accessed April 10, 2023. https://www.hhs.gov/about/news/2023/02/09/fact-sheet-covid-19-public-health-emergency-transition-roadmap.html