All Points North (APN) released its 2023 Future of Mental Health: Ketamine Therapy Report, which examined opinions and experiences with ketamine therapy, including at-home ketamine treatments.1 Researchers surveyed 2,000 adults and found that 64 percent of those taking ketamine said it helped with their mental health symptoms; however, 55% of all Americans and 58% of millennials who tried ketamine therapy at home reported accidentally or intentionally using more than the recommended dose. Additionally, 26% agreed that they would rather use ketamine than antidepressants or anti-anxiety meds.
When researching or suggesting a new mental health treatment, patient care and an assessment of its benefits in tandem with the current treatment plan and goals should come first. When it comes to ketamine-assisted therapy, there are telehealth options that make psychedelic use seem harmless and easy to do at home, unsupervised, but these companies too often take a back seat when it comes to the therapeutic aspect. , often leaving patients to fend for themselves, which leads to accidental misuse or abuse of the drug, said Noah Nordheimer, founder and CEO of APN, an addiction treatment center in Colorado.
The report recommended that ketamine therapy be used only in combination with psychotherapy under the supervision of a doctor, as the risk increases exponentially when patients self-medicate: 1 in 5 (21%) of respondents reported having used ketamine or other psychedelic drugs for the purpose of self-treatment of anxiety, depression or other mental illness.
Ketamine is a Schedule 3 controlled drug and has a long history of diversion and abuse with significant adverse health consequences. Ketamine is not FDA-approved for any psychiatric disorder, only as an anesthetic, said John J. Miller, MD, editor-in-chief of Psychiatric Times. Esketamine, an active component of ketamine, was approved by the FDA in 2019 for treatment-resistant depression. For this indication, the FDA requires a rigorous risk assessment and mitigation strategy (REMS) due to potentially serious adverse events, including dissociation and hypertension, as well as the risk of abuse. Esketamine must be administered in person by a qualified healthcare professional. Home use of ketamine bypasses this safety net and puts people at risk, undermining the FDA’s REMS protocol to minimize risk and maximize safety and prevent hijacking and abuse/misuse.
Nordheimer echoed this sentiment. Patients seeking the help of psychedelics should look for options that include clinical supervision and a trusted team of therapists, starting with an in-person assessment and assessment of the patient’s unique needs and goals.
Millennials and members of Gen Z and Gen X are more likely to try ketamine than baby boomers; they are also more likely to abuse or misuse ketamine. Approximately 2 in 5 Gen Zs (41%) reported self-medicating with ketamine or other psychedelics, and 1 in 3 Millennials (29%) reported using ketamine or other psychedelic drugs recreationally or experimentally.
Mental health therapies should be used only as peer-reviewed studies for clinical validation have found them safe, Nordheimer said. Even then, we should carefully weigh who is best suited for which treatments, as mental health is not one size fits all. Oversimplified homemade ketamine offerings can lead patients to irresponsibly self-medicate or become addicted; it’s also less likely to help them in the long run.
1. Future of Mental Health 2023: Ketamine Therapy Report. apn. 2023. Accessed March 8, 2023. https://plusapn.com/wp-content/uploads/2023/02/2023-Future-of-Mental-Health-Ketamine-Therapy-Report-by-APN.pdf
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