Over the past decade or so, legal ketamine clinics have popped up to treat depression, OCD, and other mental health conditions. “It has literally saved lives for people who were ready to give up all hope,” Masand said. “I think it’s probably less addictive than opioids, but it’s not without its risks,” says Shatzberg, who is the director of Stanford University’s Mood Disorders Center. Indeed, case studies have described people who showed signs of addiction or abused the drug. Research suggests that though ketamine’s main action is in glutamate receptors, it needs opioid receptors to have its antidepressant effects, too. For psychiatrist Alan Shatzberg, MD, who did some of the research that uncovered this, that’s concerning.

These depend on how much ketamine someone takes, whether it is taken with other drugs, and how often or how long ketamine is used. While ketamine is safe to use in controlled medical practice, it becomes hazardous if someone takes it for recreational use as it may result in potentially life-threatening adverse effects. Yes, ketamine is a controlled substance classified as a Schedule III drug under the DEA Controlled Substances Act. This means that ketamine has a potential for abuse that is less than the drugs in schedules I and II.

But once we started talking, it was like my ego’s defenses eroded and I could see myself from the outside. I analyzed my life as if I were in therapy, suddenly seeing the perspectives of what foods have alcohol in them people I was mad at. We need to modernize and revise the laws and rules governing pharmaceutical marketing and promotion so that they constrain the behavior of companies that currently are making outlandish claims about ketamine’s safety and effectiveness. Unfortunately, you have a drug that’s available for more or less pennies, and there really is not the incentive for manufacturers to go out and do these studies, to say nothing of the challenges of doing the studies and doing them well. Typically, drug companies are restricted to marketing and promoting their products only for FDA-approved indications. But in the case of ketamine, the product is being marketed and promoted by clinics and telehealth companies that aren’t manufacturing the drug.

Near-death experience

Studies to date suggest intravenous ketamine produces substantial reductions in suicidal ideation in patients with unipolar and bipolar depression, in both uncontrolled and randomized controlled trials. Large reductions have been observed in as early as 40 min post-infusion, with improvements maintained for variable amounts of time ranging from 230 min up to 10 d post-infusion93. Price and colleagues94 conducted a randomized controlled trial in treatment-resistant depression, which showed that intravenous ketamine produces rapid reductions in suicidal cognition over and above active placebo. Additionally, a retrospective medical record review of thirty-one cases suggested that ketamine may be a safe, effective, and rapid treatment for clinical depression in patients receiving hospice care95. Overall, ketamine has potential as a rapid treatment for treatment-resistant depression and suicidal ideation and may be a possible model compound for future drug development. However, additional studies are needed to further investigate its mechanism of action, long-term outcomes, and long-term adverse effects (including abuse) and benefits.

1. But in the case of ketamine, the product is being marketed and promoted by clinics and telehealth companies that aren’t manufacturing the drug.
2. It is considered the agent of choice in children and burn victims30.
3. Depression, anxiety, post-traumatic stress disorder, and chronic pain are the big ones, but it’s also being marketed for other uses, ranging from Lyme disease to alcoholism to opioid addiction.
4. NIDA is a biomedical research organization and does not provide personalized medical advice, treatment, counseling, or legal consultation.
5. It is also used to induce anesthesia prior to the administration of other general anesthetic agents and as a supplement to other anesthetic agents.

“The last thing you want is to mix an anxiety episode with a dissociative episode—that’ll freak you out,” Giordano said. Read on to explore the effects of ketamine, signs of ketamine use disorder, and insights on how to get help if you or someone you know is struggling with ketamine use. Insurance disputes have prevented Winograd from getting a booster, even with the nasal spray, though he 2c-b-fly and his health care providers feel that he would benefit from it. Still, he says, the big changes that the first series of treatments brought about have lasted.

Is ketamine a Controlled Substance?

At his clinic, Stewart only sees patients who have referrals from a doctor who diagnosed them with treatment-resistant depression. He starts patients with a research-based six infusions spaced over 3 weeks. The spray has a “black box” warning about the risk of sedation and trouble with attention, judgment, and thinking, as well as risk for abuse or misuse of the drug and suicidal thoughts and behaviors. For treatment-resistant depression, patients usually get the nasal spray twice a week for 1 to 4 weeks; then once a week for weeks 5 to what does flakka smell like 9; and then once every week or two after that. Ketamine causes what doctors call a “dissociative experience” and what most anyone else would call a “trip.” That’s how it became a club drug, called K, Special K, Super K, and Vitamin K, among others. Partiers inject it, put it in drinks, snort it, or add it to joints or cigarettes.

Recreational use

However, further research is necessary to verify the study findings and prove the safety of using ketamine to treat this condition. Ketamine is a medication that doctors use as an anesthetic to induce loss of consciousness. Under the Controlled Substances Act, health experts consider ketamine a schedule III non-narcotic substance.

In clinical trials ketamine therapy is mainly given as intravenous infusion, but may be given as intranasal spray, slow release tablets, sublingual tablets, or other forms. It is a drug of choice for short-term procedures when muscle relaxation is not required.34 The effect of ketamine on the respiratory and circulatory systems is different from that of other anesthetics. Animal studies suggest that neurodegeneration, with possible cognitive sequelae, is a potential long-term risk of anesthetics in neonatal and young pediatric patients23. Numerous animal studies in rodents indicate that ketamine induces neurodegeneration in the developing brain in a dose-depended manner, and the data also suggest that limiting exposure limits the potential for neurodegeneration. Some postnatal pre-clinical studies suggested that ketamine-induced injury in the infant rodent brain was a centrally driven event24,25.