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The Stigma Surrounding Ketamine

The misuse of ketamine and the history of recreational use in the club and rave scene has led to the development of a bad reputation for this medicine. This has made it problematic for health care providers who clearly see the utility of this medicine for the treatment of depression, anxiety, PTSD, pain, and other mental illness when used in the appropriate fashion. Ketamine has been used since the early 2000s to treat these conditions and has been proven to be a powerful tool with significant efficacy and safety. Traditional anti-depressants such as SSRI’s have been associated with serious side effects, and have less than optimal efficacy rates (approximately 30%) for the treatment of depression. Ketamine, on the other hand, has impressive efficacy rates of upwards to 70% with a much more favorable safety profile. Ketamine has been shown to have such positive effects for other mental illnesses that in some cases, many providers have begun using it off-label for the treatment of conditions despite not having full FDA approval.

Here at Innerbloom Ketamine Therapy we want to clear the air of misinformation and the stigma of ketamine.

Stigma #1: Ketamine can be addictive and cause bladder problems

Ketamine addiction is extremely rare, and it has not been found to cause any physical dependence. Ketamine is a very rapidly metabolized medication that is cleared by the body in essentially 3 hours. The mechanism of action via glutamate differs from opioids and does not involve serotoninergic and dopaminergic processes associated with pleasure and addiction. Therapeutic doses for treatment of mental illnesses are substantially less than those associated with recreational use. Therapeutic doses for depression typically starting at 0.5 milligrams per kilogram of body weight whereas reported doses of recreational use can be upwards to 1000 milligrams.

Bladder problems related to ketamine use, especially ketamine-associated ulcerative cystitis is only associated at extremely supratherapeutic doses and frequent use. Ketamine associated ulcerative cystitis is not a concern for therapeutic doses used in a professional setting for the treatment of mental illnesses. According to assistant director general for Health Systems and Innovation of the World Health Organization Marie-Paule Kieny, “The medical benefits of ketamine far outweigh potential harm from recreational use.” Not only is the risk for addiction for ketamine extremely low, but ketamine has also been used to treat addiction disorders and has had promising results for alcohol dependence and abuse.

Stigma #2: Ketamine is a horse tranquilizer

Ketamine is a popular anesthetic that has been used in veterinary medicine since the 1960s and was then approved by the FDA for human use in 1970. It is a favored anesthetic agent in a veterinary setting because it does not cause respiratory difficulties and cardiac instability, thus animals do not require supplemental oxygen or intubation. Ketamine was a lifesaving medication on the battlefield in the Vietnam War given its ease of use, safety, and again, because it does not require a breathing tube insertion that is commonly required for other anesthetic agents. In addition, doses of ketamine for the treatment of depression and other mental illness are approximately 1/100th the amount a patient would receive as an anesthetic agent. Many other medications used in veterinary medicine are also common in human use including anti-inflammatories and antibiotics.

The misinformation and stigma of ketamine needs to be cleared and it is time that we rethink the use of ketamine and how useful it can be for many patients suffering mental illness worldwide. Over 16 million Americans, or approximately 7% of the US population age eighteen or older suffer from depression, with 840,000 that will try to commit suicide. Help is on the way with ketamine becoming a key player and an invaluable tool for mental health.

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