Mind-altering ketamine becomes new pain treatment despite little research or regulation

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The decades-old surgical drug ketamine has found a new use — as an alternative to opioids for patients with chronic pain.

The decades-old surgical drug ketamine has found a new use — as an alternative to opioids for patients with chronic painPrescriptions for ketamine have soared in recent years, driven by for-profit clinics and telehealth services offering the medication as a treatment for pain, depression, anxiety and other conditions. The generic drug can be purchased cheaply and prescribed by most physicians and some nurses, regardless of their training.

Still, he credits ketamine with reducing his pain during the year that he received twice-a-month infusions. Mahjoubi’s practice is typical of the burgeoning industry: He offers IV ketamine for alcohol addiction, chronic pain, anxiety and post-traumatic stress disorder. The ketamine doses for those indications are well below those used for surgery, but Mahjoubi favors higher doses for pain than for psychiatric conditions.

Demand for ketamine has sent prescriptions soaring more than 500% since 2017, according to Epic Research, which analyzed the trend using a database of more than 125 million patients. In each year, pain was the No. 1 condition for which ketamine was prescribed, though depression has been rising quickly.

While the science behind ketamine is murky, the business model is clear: Physicians can purchase ketamine for less than $100 a vial and charge $500 to $1,500 per infusion. In May, federal regulators were scheduled to roll back the COVID-era policy that allowed online prescribing of high-risk drugs like ketamine and opioids. But the Drug Enforcement Administration, facing backlash for telehealth companies and physicians, agreed to extend the flexible approach through 2024.

 

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