WHAT IS KETAMINE?
Ketamine, when used therapeutically, can be a unique, beautiful, psychospiritual medicine. Often evocative of a creative, dreamwork, Jungian-type process of making contact with the unconscious mind. Acting as a pattern interrupter, it guides the mind away from rumination and instead towards a state of mindful observation. Lightening and heart-opening in small doses, it can also evoke deep, dualistic experiences in larger doses.
Fostering neuroplasticity, ketamine can facilitate the creation of new neural pathways, that can pave the way for positive behaviour change post-experience. By offering a sanctuary from everyday worries, the experience can facilitate a deep sense of connection and universal understanding. Users may transcend physical boundaries, having experiences of being out-of-body and out of bounded time and space.
Originally utilised as a surgical anaesthetic in the 1960s, ketamine boasts an excellent safety profile, unlike traditional anaesthetics, as it maintains respiratory and cardiovascular functions. While ketamine can induce psychedelic effects, it may differ from classical psychedelics by inducing dissociation, allowing individuals to explore a detached, transpersonal realm that challenges a person’s perceptions of reality and consciousness. These sort of experiences can hold profound spiritual meaning, especially for those who may be facing the end of their life.
Some consider ketamine to be a gentler introduction into the world of psychedelics, compared to the potent tryptamines like psilocybin, 5-MeO-DMT and ayahuasca.
Ketamine is a tiny molecule that easily passes through the blood-brain barrier. It is a glutamate modulator that acts on the NMDA receptors in the glutamate pathway. This is a different mechanism of action from the classic hallucinogenic psychedelics, which act on the serotonergic system. This makes it a useful medicine for working with people who have disorders such as Bipolar Type 1, which is believed to have a physiological dysfunction of the serotonin system.
It is crucial to distinguish between the therapeutic and recreational use of ketamine. The recreational use of ketamine in our society, particularly among young people, is causing significant issues. When taken in this manner, ketamine can become an extremely dangerous and addictive substance.
THE LEGALITIES
Ketamine, with its unique legal status for anaesthesia, stands out among psychedelic medicines. It holds a valid medical licence in many countries, allowing those with prescribing privileges to use it for psychological use off-label. This approach places the responsibility on individual prescribers, typically medical doctors, psychiatrists, or nurse prescribers, for any related adverse outcomes. This makes it uniquely positioned as a potent hallucinogenic agent which is legal to prescribe and administer. It offers us the valuable opportunity to study psychedelic, transpersonal, and dissociative experiences without the bureaucratic hurdles associated with other psychedelic substances.
In the UK and other countries, fully legal ketamine clinics operate under the oversight of medical professionals. These clinics cater primarily to patients with chronic treatment-resistant depression, accessible through referrals from GPs or psychiatrists. Services like the one provided by Oxford Health NHS UK offer comprehensive ketamine treatment, including psychiatric assessments, albeit as a paid service outside the NHS. Northamptonshire Healthcare Foundational NHS Trust extends ketamine therapy for severe conditions like major depressive disorder, catatonia, and mania, potentially free for Northamptonshire residents with psychiatrist referrals.
Recent developments in the UK showcase a shift in ketamine clinic practices, now open to self-referrals for individuals suffering with anxiety disorders, PTSD, chronic pain, eating disorders, and various substance addictions, including alcohol.
Some of the UK clinics include:
ROYAL FREE LONDON PRIVATE PATIENTS
https://www.royalfreeprivatepatients.com/treatments/ketamine-infusion/
SAVE MINDS UK
COGNACITY
NORTH LONDON PSYCHIATRY PRACTICE
LONDON TMS CENTRE
THE PAIN TEAM
NORTHAMPTONSHIRE HEALTHCARE FOUNDATONAL TRUST NHS
OXFORD MINDS NHS KETAMINE TREATMENT SERVICE
Luxurious retreats abroad are now offering comprehensive and holistic ketamine-assisted psychotherapy packages for those who can afford it. You can search for these online.
HOW IS THERAPEUTIC KETAMINE ADMINISTERED?
Different ways of administering ketamine offer varying levels of bioavailability, impacting how effectively the medicine reaches the brain.
These administration methods include:
– **Intravenous:** Administered through an intravenous cannula.
– **Intramuscular:** Injected into the muscle.
– **Nasal:** Delivered as a spray into the nose.
– **Oral:** Taken by mouth.
– **Transbuccal:** Placed in the cheek.
– **Sublingual:** Placed under the tongue.
– **Transdermal:** Absorbed through the skin.
HOW IS KETAMINE USED THERAPEUTICALLY?
It is widely believed that there is not one correct way to use ketamine, as different people are best served by different treatment strategies. The different paradigms for administering ketamine include:
– **Psychotomimetic**: In this treatment strategy, the psychedelic side effects are considered undesirable, and the antidepressant effects of ketamine are attributed to its biochemical properties. This is fundamentally a Western or medical model.
– **Psycholytic**: Low doses are administered with greater frequency. The goal of the work is not ego-dissolution or self-transcendence; rather, it is for a client to experience a non-ordinary state of consciousness while remaining in touch with the present moment and in a relationship with their therapist. This approach draws on the more conventional approach of talking therapy, where the client and therapist are both present in the process of work.
– **Psychedelic**: Here, ketamine may be used to purposefully induce mystical and psychedelic experiences. Participants must be carefully selected and prepared for this kind of experience, as it can get overwhelming and frightening without adequate preparation and support. The participant may temporarily enter into a state of conscious sedation or altered consciousness that is concordant with full anesthesia and may include temporary partial paralysis. When working in this way, it is considered a psychedelic and shamanic paradigm, in which the mystical visions are valued. The role of the clinician is to ensure the physical and psychological safety of the participant, then to help them construct meaning from their visions and identify the actions that they can take to manifest positive change.
The different paradigms of ketamine treatment can actually overlap and blend together. When administering a psychedelic ketamine journey to a patient, considerations encompass the therapeutic alliance, the significance of visions, and the chemical impact on the brain simultaneously.
Notably, ketamine has shown to exhibit significant efficacy in alleviating chronic depression. In the UK, depression ranks as one of the primary reasons individuals seek mental health care. Global mental health data from 2013 identified depression as the second leading cause of disability-adjusted life years.
The benefits of ketamine therapy extend beyond depression, showcasing positive outcomes that can potentially be enduring. Many individuals undergoing ketamine treatment no longer associate themselves with being depressed, after a few months. Moreover, Ketamine shows promise in addressing various conditions like pain syndromes, mania, catatonia, anxiety disorders, PTSD, OCD, addictions, and Bipolar Type 1. Its application in end-of-life care is also being explored.
Emphasising the importance of preparation and integration, the safe use of ketamine is associated with a comprehensive process of psychological support before, during, and after the treatment, as is the case with all psychedelic use. As Peter Levine aptly stated, “Even a magic bullet leaves a wound that requires a period of recovery.”
While hailed by some as a groundbreaking treatment for mental illnesses, including depression, ketamine’s accessibility remains a challenge due to its high cost, limiting its availability to those with financial means. Despite this limitation, ketamine therapy holds immense potential for individuals grappling with severe mental health conditions, where conventional medicine has failed them.
PLEASE NOTE: This blog is intended for information only and does not substitute medical advice. I do not advocate the illegal use of substances.