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I think there are some interesting treatment opportunities, but I also really don’t like the direction this is all going.

Locally, ketamine treatment clinics are popping up all over the place. We have so many in my city that they’re now competing with each other in radio advertisements, inviting people to come on down and get some ketamine for their depression, anxiety, PTSD, or even vague symptoms like stress. One of them even had a frequent visitor pass - Buy five ketamine sessions and the sixth is free! Another was shut down for a while when they were caught leaving patients unattended and one injured themself while on a high dose of ketamine. They were found to not even be performing screenings of patients - Anyone who showed up with cash got ketamine.

But it doesn’t stop there. Internet prescribers are taking advantage of the temporary COVID rules changes for telehealth controlled substance prescribing to give ketamine over the internet. I won’t name the company, but one specific provider is known for providing prescriptions for exorbitantly high doses of ketamine. From what I saw, nobody is turned away. If you’re willing to pay, you get a prescription for a lot of ketamine and you don’t even have to leave your house.

What makes this all worse is that ketamine is very much not a cure for depression. The antidepressant effects of ketamine are famously short-lived, so it’s used as a way to jump-start traditional therapy in normal settings. Not so at these ketamine clinics, which prefer you return to them for more and more expensive treatments each time it wears off, at least until you have such a high tolerance that it doesn’t do anything at all for the depression any more.

Whatever you think about the substances, I am not excited for a wave of “growth hackers” at psychedelic startups brainstorming ways to get people to pay for more and more ketamine or psychedelic sessions to improve their numbers. I hope the regulatory bodies step in and steer this back to sanity before these startups cause so many problems that these substances become untouchable again.

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"We are strongly prejudiced against psychedelic drugs which cause such mind-body separation, as we are against any drug which causes separation from feelings and emotions. However, we acknowledge that the ketamine state can be highly instructive for researchers trying to understand the functions of the human mind."

"A major concern regarding safe use of Ketamine is its very high potential for psychological addiction. A fairly large percentage of those who try Ketamine will consume it non-stop until their supply is exhausted. I've seen this in friends I've known for many years who are regular psychedelic users and have never before had problems controlling their drug consumption. And I've seen the lives of several people who developed an addiction to Ketamine take downward turns." "After about two years of once-per-week Ketamine use I even found that I had developed an addiction. Although it was less severe than what I've described above, it took considerable effort to break the cycle of repeatedly using it, even though I was aware of detrimental effects that it was causing. Since that time I've used Ketamine only occasionally, but find that I must continually exercise a high degree of will power to prevent myself from falling into a pattern of regular use. Amongst those I know who use Ketamine, I've seen very few who can use it in a balanced manner if they have access to it."