Brave New Therapy World?

Imagine this.  You go to see a new therapist, Amanda, whom you’ve only met once before.  In her waiting room, you ingest some sort of hallucinogenic drug designed to cause you to dissociate, which Amanda has helped you to obtain. 

When Amanda comes out to greet you, you head to her office and lie down on her couch.  She hands you an eye shield to put on so that you are in total darkness. 

As the drug takes effect, you talk with her about your dissociative, hallucinogenic experience that is supposed to lead you to greater growth and healing.   A few hours later (and several hundred dollars poorer), you say goodbye, hoping that you can manage to walk and drive safely home.

What could possibly go wrong here?

If you are thinking that this is a plot for the latest horror movie, sadly this is real life.  I have described the latest therapy:  Ketamine Assisted Therapy, or KAT.

Ketamine is a hallucinogenic that was banned for human use until recently.  It was only allowed for usage as a horse tranquilizer.  (No, I’m not making this up.)

 It was resurrected a few years ago and used in test trials for intractable depression and severe chronic pain. Studies found Ketamine effective, and recommendations were to use it sparingly and carefully and only in serious cases.

Well, you know how that goes.  First a medication is used for intractable problems and the next thing you know, prescribers are giving it to people with mild issues, such as low self-esteem or work stress.

Suddenly I am hearing from tons of therapists that they are now providing KAT.  There are training programs popping up.  Therapists are joining group practices, websites, or doing it on their own.  And, yes, there is a lot of money to be made.

Rather than get a paltry reimbursement rate from annoying insurance companies, therapists (and nurses) can make several hundreds dollars from just one KAT treatment.  One local therapist charges about $700 to sit with someone for 3 hours on Ketamine. 

Side note here:  remember the tragic case of Matthew Perry, the beloved actor in Friends.  You heard that he died of a drug overdose, but you might not know what drug it was.  Yup, you named it:  Ketamine. To be fair, he overdosed on it. But still. .. 

Because of Perry’s death,  there was supposed to be a crackdown on Internet sites and doctors prescribing Ketamine.  But it hasn’t happened. Why?  I don’t know but it probably has something to do with money talking.  

If someone has intractible depression or severe chronic pain, Ketamine should be considered, under doctor’s close supervision.  But the websites I checked out said that KAT is suitable for almost everything, including low self-esteem and PTSD.  Given that PTSD can cause flashbacks, I’m not sure why a hallucinogenic drug is the treatment of choice.

As you can see, I’m not signing up to become a hallucinogenic/psychedelic guide, though I get plenty of solicitations frequently. Should you want to, however, there are plenty of people out there ready, willing,  and able to help you — at a very big price.  Hopefully, the price will only be financial, since no one knows the long-term side effects of Ketamine.