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Comment by fragmede | Hacker News Reader

Where a future hypothetical ketamine prescription could be filled from, I can't say, but clinics charging $1500/session have it in nasal sprays and lozenge form, I'm hopeful that a corner store would eventually be able to fill it easily once one of the pharmaceutical companies manage to package it up in a form they deem lucrative. (Which will involve patenting some part of it, possibly the delivery mechanism, since ketamine itself is past patentable date.)

Depression is an insidious disease, and being able to fill it at the corner store, rather than having to go all the way to hospital (which can be a scary and frustrating experience) might make the difference between having the medication, and not.

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Ketamine is hugely psychologically addictive though. It is like saying that opioids should be available to everyone that is in any pain. The level of addiction caused may be different because the opioid user has to contend with the negative association with withdrawal as well as the allure of the high itself, whereas ketamine is only one of those two. Dependence and addiction are not the same and ketamine is powerfully re-enforcing. I don't mean to trash this - I'm just trying to show a counterpoint and another perspective because there WILL be misuse as soon as prescriptions become available, and people (doctors) will not understand the degrees to which it can draw people to misuse until much later. There is already a black market to supply to the demand. If droves of people start acclimatizing themselves to ketamine, the market demand will increase and the black market will be there to fill that new demand, just like it did with heroin/fentanyl when pain was over-treated with opioids and droves of mom's and yuppies suddenly thought heroin sounded like a pretty good idea because they had already lost their opioid naivety.

So in turn, I put forward that we should hope a discovery of the mechanism of action and a way to put it to use without ketamine. Ketamine's action itself is assumed to _not_ the primary mechanism of action but rather a metabolite is (the experience has a part of it I'm sure - it's pretty fairly a psychedelic but the yin to LSD's yang) and scientists are working to find a drug that will have the same effect without the psychedelic dissociative qualities of ketamine (and it's monstrous allure which some people notice and fall for - but many don't)

Seems to me that only certain personalities thirst for ketamine after experiencing it. But that will all come to view in time because the black market is ready to supply to an increase in demand and it will happen that way once people start diverting ketamine. The black market will compete in that market. It will offer a product of similar quality (most clandestine on the street is close to 100% purity) but will find its competitive advantage is price and availability.

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