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Comment by starpilot | Hacker News Reader

I have been looking into Ketamine as there is a clinic which administers Ketamine therapy in my area. The disappointing thing is that it looks like the effects are short lived, and one may need "booster" treatments every 4 weeks, at $400 a shot, for years and possibly forever. I hope with this understanding, we come up with something more permanent.

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$400/month seems a very cheap price for getting your life back.

I agree that $10/session does sound better. That's what you pay (at most) for LSD, the traditional longer-term anti-depressive and anti-anxiety effect being there as well (3-6 months).

But: You have to buy a test kit (an additional $25/kit) and be extremely well informed about what do to and what not to do. And plan everything in detail and very carefully. Don't expect miracles if you're not serious about it.

Who are you agreeing with? This is really dangerous advice.

as much as I love LSD, it's by no means a safe drug for severe clinical depression. bad trips can easily push someone over the edge, especially if they have suicidal ideation.

ketamine, on the other hand, has a MoA that doesn't depend on how well the trip went. it's also a known quantity to doctors and far safer and more predictable.

please do not encourage severely depressed people to try acid.

$325-$350 - Albuquerque $500-600 - Chicago Area $900 - Seattle $1000 - LA

It's actually cheaper to fly in to the cheapest center. Ketamine as a drug is safe and cheap. Probably somewhere around $5 a vial. But the doctors are taking a risk with their license and you they have to put an IV in you.

It's not that expensive on darknet markets.

If I was going to use ketamine, I'd prefer to get it from a reputable source.

Reputation is the key service of darknet markets. If you would prefer to pay $380 extra every four weeks, that's your call.

Are darknet markets still easy to get into? I used SR when it was around, with events in the interim I'm a bit more hesitant.

No, they're in a state of flux right now.

Things aren't as stable as there were in the past but the guides and supporting infrastructure has matured. Read around a bit at reddit.com/r/darknetmarketsnoobs (check out the noob bible especially) if you want to learn more.

By reputable I mean manufactured in an approved facility to Health Canada standards (or equivalent). It seems unlikely that some dude on darknet would meet these standards. It's like saying that your local drug dealer has a good reputation because he hasn't killed too many people with fentanyl.

Darknet stores are mostly distributors not manufacturers of pharmacological products. They are usually sourced from corrupt legitimate medical world supply chains. The economic reality is that there is almost no margin in wholesaling some of this stuff. Starting a yet another factory to make off-patent generic drugs would cost more than the probable medium term profits, especially given that you can more easily acquire from an existing producer. More recent / patented / specialized pharma products are probably harder to synthesize. Therefore, you can rest fairly assured a large-scale supplier with good reputation on the darknet markets is selling real stuff. This is true particularly in the case of generic drugs where, like ketamine, there is already zero patent global production.

> corrupt

Yeah, that's the problem. Are you aware that ketamine is sometimes laced with fentanyl?

https://nowtoronto.com/news/why-is-fentanyl-showing-up-in-st...

Not really something I'd be willing to take the chance on, just to save a few bucks.

> rest fairly assured

No you cannot: http://www.bbc.com/news/av/world-asia-china-33472971/inside-...

mentions illegal manufacturing in China early in the article.

Your advice is dangerous.

To be clear, I live in China and have been here for nearly two decades. You read a BBC article reporting translated third party information on the internet.

I don't think DNM's are the place to direct people experiencing severe depression. It's not only K they might find there. This directive is also potentially damaging to the above-ground progress advocates have been fighting so hard to achieve. I don't think I need to go into the safety issues around self-administration, either.

Even assuming the product is safe, using darknet markets also has legal issues. (I don't agree that it should, but it does.) "Overpaying" $380 to be administered a known safe dose of ketamine in a place surrounded by medical professionals and know you're in the clear legally sure sounds like a fair deal to me when the alternative could end up involving an arrest record and possible prison time, even if everything involved with self-dosing goes just fine.

curious: are you based in the US? Would it not be covered by insurance? $400/shot is a lot for Ketamine.

Insurance absolutely does not cover ketamine therapy in the US

$400 is a fairly typical price. The ketamine itself is cheap, but operating a clinic doing off-label infusions that take an hour or two each is expensive. And nope... no insurance in the US that I know of covers it.

Ketamine is a generic drug and dirt cheap. I just checked and it's under $10 for a vial with enough to use in surgery, not even this setting.

The $400 must be the clinic charge. I'm not sure what administration looks like, but a regular doctor's visit is $100-$150 and if the patient needs to stay for a longer period of time until it's safe to release them, $400 doesn't seem that far off of what you'd expect.

That's on the low end. I've looked into it and seen prices on the order of $1000-1500 per treatment. If you filter those out, many metro areas simply have no provider that charges what would seem to be a justifiable price. Abusive pricing is a big problem for this product it seems. Several advocacy sites that I saw that maintain provider lists make note of this.

Is it abusive pricing or are they covering for potential legal issues, etc? It would be great to hear from a clinician with first-hand experience.

Is it abusive pricing...

Medical clinic in USA? Signs point to "yes".

Most of the expense is that it's an IV, so you need a trained nurse to administer and oversee you having it in and out; at least, that's what the doctor who ran the practice I did this at said, and given the cost of ketamine, it made sense.

It's considered off label use, so insurance won't pay for it.

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