The sulphurous ketamine is becoming commonplace against depression in American homes

The use of ketamine took off during the pandemic in the United States as a self-administered treatment for people with depression.

The use of ketamine, an anesthetic and also a psychedelic drug, took off during the pandemic in the United States as a self-administered treatment for people with depression, despite skepticism around its effectiveness and unclear long-term risks.

Philip Markle, a 36-year-old New Yorker, has struggled with depression since he was a teenager. He tried psychology, and various drugs, including other psychedelics like LSD. But he says only ketamine has given him a sense of clarity and the ability to accept himself better, unlike the all-too-brief improvements experienced so far with other treatments – and without the side effects of other substances.

“It seems to me that if there is a drug that can be sent in the mail, if there is a psychedelic that can help you change your life all on its own, it is this one,” the comedian told AFP. AFP. Ketamine was already used in the United States to treat depression, anxiety or chronic pain, but patients had to go to the hospital in person for intravenous injections.

“It has to be implemented slowly”

During the pandemic, health restrictions led authorities to allow doctors to prescribe drugs remotely, including this psychotropic drug with a sulphurous reputation.

Companies, some of which were already specialized in clinical treatments, then embarked on the evaluation of potential customers, online, and in sending doses of drugs to people considered to be good candidates. Mr. Markle thus followed a protocol from home thanks to Mindbloom, one of these start-ups.

But some pro-ketamine experts worry that this unregulated boom could lead to incidents that could then tempt authorities to backtrack. Because studies on the medical impact of this drug in the long term are rare.

“It has to be put in place slowly,” said Boris Heifets, a professor of anesthesiology at Stanford University. “The risk is that you’re rolling out a band-aid instead of the solution, which requires a much more comprehensive approach to mental health.”

Ketamine is a so-called “dissociative” anesthetic for its hallucinogenic effects, which has also made it a popular drug at rave parties. Other psychedelics, such as LSD and MDMA, are classed as having no medical use and a high risk of abuse, even though they are attracting renewed interest for their health potential. mental.

In November 2020, the state of Oregon legalized the therapeutic use of psilocybin. But the legal system that will regulate its consumption is still under study. For companies that dispense ketamine, on the other hand, there are no national rules specific to this substance.

The risk of lawsuit, not to be ruled out

“If you look closely at the type of risks of abuse, you realize that they exist, of course, but also that we create a protocol of care that makes them quite unlikely”, assures Juan Pablo Cappello, the boss. of Nue Life, a start-up in this sector launched a year ago.

For example, clients are supposed to be supervised by a “babysitter,” another adult who watches them for the approximately 90 minutes that the session lasts. Cappello also points out that people who just want ketamine can find it cheaper on the street.

If they go through Nue Life, they have to pay $1,250 for a package that includes six sessions on ketamine. And the service encourages them to combine the drug with traditional psychotherapy sessions. “The telemedicine model is actually safer and more efficient for patients, I think. Because it allows a wider variety of patients to benefit from these therapies,” argues the entrepreneur, adding that more than 3,000 people have already used his service.

According to a scientific study, intravenous ketamine treatments in clinics – with higher doses than those allowed in telemedicine – helped most patients. But around 8% of them said their symptoms got worse as a result. “We have very few elements on the effectiveness of ketamine on a large scale”, underlines Boris Heifets, who took part in this study.

He adds that the risk of litigation is not to be ruled out, because “the American public wants access (to drugs) but has an extraordinarily low tolerance for risk and a natural propensity to solve problems in court”.

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