On Nov. 27, 2023, on a drizzly Wednesday afternoon, Christopher lounged in an overstuffed reclining chair, relaxing with a cozy blanket draped over him after his latest infusion at the Ketamine Healing Clinic of Los Angeles.
Diagnosed with anxiety at age 19, Christopher (not his real name), now a 35-year-old college student, has struggled to overcome what is now treatment-resistant anxiety.
He checked off the treatments, standard and alternative, that he’s tried: Lithium. Wellbutrin. Paxil. Other antidepressants. Mushrooms. Meditation. Cognitive behavior therapy.
Nothing provided long-term relief, and he felt some medications blunted his emotions. “I became more robotic, less social,” he said.
Ketamine, he said, is different. He’s found some relief, some self-acceptance, and is much less hard on himself. He’s finding it easier to exercise and be social, two recommended ways to alleviate anxiety.
The expense of the treatments ($700 for a single session here), used off-label and typically not covered by insurance, is worth it, he said. And much better, he said, than another option — buying ketamine for use at home through a telehealth platform. No thanks, he said. “You don’t know where it comes from.”
Over the past few years, ketamine and access to it have become more common but also more controversial in the U.S. No one knows exactly how many clinics like the one Christopher goes to operate, but experts believe the number is around 700 to 800. The number of patients with a ketamine prescription increased more thanfivefold from 2017 to 2022. Online access to ketamine through telemedicine has grown since the beginning of the pandemic, when the Drug Enforcement Administration loosened restrictions for prescribing Schedule III controlled substances such as ketamine through telemedicine. Now that flexibility has been extendedthrough 2024.
The FDA has issued a warning about compounded ketamine, researchers have found widespread misleading marketing practices on telemedicine platforms that offer it, and doctors who prescribe it or advocate for its use are struggling to find ways to navigate a system that’s largely unregulated.
It has become, many say, a Wild West that needs taming, regulation, oversight, and possibly even a registry.
The question no one knows how to answer is: How to do that?
Ketamine is a Schedule III controlled substance that’s FDA approved only for general anesthesia, not for any psychiatric condition. The DEA notes ketamine’s potential for abuse and potential for addiction and that it is used a party or club drug, where it is known as K or Super K, among other names.