Dr. Padma Gulur, a Duke University pain specialist, stands for a portrait on Friday, Oct. 27, 2023, in Durham, N.C. Prescriptions for ketamine have soared in recent years as doctors adopt the mind-altering drug as an alternative pain treatment. Gulur and other specialists see potential for ketamine as a pain therapy, but warn it also carries risks of safety and abuse. decades-old surgical drug that is now a trendy psychedelic therapy.
When Gulur and her colleagues tracked 300 patients receiving ketamine at Duke, more than a third of them reported significant side effects that required professional attention, such as hallucinations, troubling thoughts and visual disturbances. “No matter how horrific an experience is, if it allows me to be more functional, I will do it,” Bass said.
Patients pay cash because most insurers don’t cover non-surgical uses of ketamine, none of which are approved by the Food and Drug Administration. Mahjoubi’s background is in anesthesiology, not psychiatry or addiction. There is more evidence for ketamine’s use against depression than for pain. In 2019, the FDA approved a ketamine-related chemical developed by Johnson & Johnson for severe depression. The drug, Spravato, is subject to strict FDA safety rules on where and how it can be administered by doctors.
The clinics are facing increasing competition from telehealth services like MindBloom and Joyous, which connect potential patients with physicians who can prescribe ketamine remotely and send it through the mail.