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Is the Ketamine Boom Getting out of Hand in 2020

Is the Ketamine Boom Getting out of Hand in 2020

Walk into Kalypso Wellness Centers in San Antonio, Texas, and you might be treated with one of five “proprietary blends” of ketamine. They’re not cheap—$495 per infusion—and not covered by insurance, but the company offers a “monthly” membership program to cut costs and advertises discounts for members of the military and first responders.

Kalypso promotes ketamine, long used as an anesthetic during surgery and more recently as a club drug, as a treatment for more than two dozen conditions, including depression, chronic pain, and migraines. “Congratulations on resetting your life!!!” it cheerily tells patients on a form they’re handed after an infusion.

Starting with just one office 19 months ago, Kalypso has expanded rapidly to meet surging patient demand for Ketamine online and now oversees two other Texas clinics and offices in North Carolina and New York. It recruits customers through online ads and radio spots, and even by visiting support groups for pain patients, people with depression, first responders, and grieving parents who have lost children.

“You name it, we’ve done it,” said clinic co-founder and anesthesiologist Dr. Bryan Clifton.

An investigation by STAT shows that Kalypso’s sweeping claims are hardly uncommon in the booming ketamine treatment business. Dozens of free-standing clinics have opened across the U.S. in recent years to provide the drug to patients who are desperate for effective therapy and hopeful ketamine can help. But the investigation found wide-ranging inconsistencies among clinics, from the screening of patients to the dose and frequency of infusions to the coordination with patients’ mental health providers. A number of clinics stray from recommendations issued last year by the American Psychiatric Association.

STAT interviewed ketamine clinic owners, psychiatrists, and patients and reviewed online staff pages and screening protocols for dozens of ketamine clinics to gauge how patients are selected and treated. Among the findings:

Some clinics don’t thoroughly screen patients, and experts worry they’re offering the drug to anyone who can afford it. Clinics can charge anywhere from $350 to close to $1,000 per infusion and many patients get at least six rounds of the treatment.

In many cases, clinics don’t have a psychiatrist or other mental health professional on staff, though they are working with challenging patients who haven’t responded to other treatments and may have suicidal thoughts. And not all clinics collaborate closely with a patient’s own mental health provider or even require patients to have one throughout treatment.

Clinics sometimes overhype the efficacy of ketamine, offer it for uses that haven’t been well-studied, and tout special blends that experts say aren’t supported by published evidence.

Patients are “getting treatments they may not need or that don’t work, or they’re getting more than they needed,” said Dr. Jeffrey Lieberman, psychiatrist-in-chief of Columbia University Medical Center. One of the biggest risks from the explosion in ketamine use, he added, is “people getting fleeced.”

Clifton said Kalypso works closely with referring physicians or mental health providers and makes sure that anyone who seeks treatment for suicidal thoughts “has adequate mental health care.” Other clinics told STAT that they try to work with a patient’s mental health provider or another physician.