Ketamine Treatments with Little Regulation are Turning New Mental Health Clinics Into the “Wild West”

By: Alyssa Miller | Published: Feb 07, 2024

Ketamine has become an effective treatment for mental health conditions over the last few years. Often being used to treat depression or other mental health conditions like anxiety, PTSD, and OCD, for-profit ketamine clinics have been on the rise in the last few years.

Despite this increasing rise, the lack of rules has turned these mental health clinics into the “Wild West.”

Ketamine Clinics Are on the Rise

Ketamine hydrochloride, a Schedule III drug approved by the FDA in 1970 as an anesthetic, has only recently gained acceptance as a potential treatment for mental health issues, despite being used off-label for the purpose.

A doctors writing on a piece of paper on a clipboard

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While the drug was considered radical just a decade ago, between 500 and 750 ketamine clinics have opened their doors across the U.S.

The Ketamine Business Is Extremely Profitable

The for-profit industry is bringing in a hefty revenue of $3.1 billion in 2022, according to market analysis firm Grand View Research (via NPR). In 2030, these ketamine clinics are believed to make more than $6.9 billion.

A soldier who was injured severely in an earlier accidental grenade blast has his vital signs checked after being given ketamine on July 10, 2014 in Laiza, Burma. After a 17-year ceasefire ended in 2011, fighting between the Kachin Independence Army (KIA) and the Burmese Army has flared up in recent months. The military hospital in Laiza treats KIA soldiers from the Central Division for a variety of wounds with causes ranging from gunshots and explosions to motorcycle crashes.

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While most insurance will not cover ketamine for mental health, patients do not seem to mind paying out-of-pocket for the care.

Insurance Does Not Cover the Treatment

Despite laws requiring parity, insurance plans do cover most mental health services at lower rates than physical health care.

Close-up of digital readout on Alaris infusion pump with the word Ketamine visible, showing medical administration of the medication, San Francisco, California, May 13, 2022.

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Unfortunately, many patients with mental health disorders are desperate for care as they receive little or no care early on, according to Dr. Steven Siegel, chair of psychiatry and the behavioral sciences at the University of Southern California’s Keck School of Medicine.

The FDA Has Not Approved Ketamine Treatments

Most insurance will not cover this treatment for one reason: the FDA has not approved ketamine for mental health treatment. Individual practitioners can still legally prescribe the drug, despite this.

A doctor looking through a microscope

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Unfortunately, this is leading to practitioners developing their treatment protocols. Some favor gradual, low-dose treatments while others advocate larger amounts.

No One Seems To Know How Much to Prescribe

“Ketamine is the Wild West,” says Dustin Robinson, the managing principal of Iter Investments, a venture capital firm specializing in hallucinogenic drug treatments (via NPR). The lack of regulation is leading to a desperate need.

Scattered pills coming out of a pink bottle on a white ground

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Ketamine is a heavily addictive drug. It can cause dependence and withdrawal symptoms with prolonged use.


What Can Ketamine Help With?

Despite offering hope for the 25% of adults diagnosed with severe depression, as reported by the National Institute of Mental Health, ketamine’s antidepressant effects wear off quickly.

A man and a woman holding different color test tubes in a blue room

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A study using ketamine and a regular antidepressant found that people only reported staying in stable remission for 16 weeks.


How Do People Get Prescribed the Drug? 

Most commercial ketamine clinics offer same-day appointments, allowing patients to pay out-of-pocket for a drug for immediate results.

Someone looking into a microscope

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While a typical dose of ketamine to treat depression costs the clinics about a dollar, which is ten times lower than the dosage used in anesthesia, clinics are charging $600 to $1,000 per treatment.


The Treatment Drug Is Haunted By Its Party Reputation

The drug is still being followed by its reputation as a party drug, known as Special K. It primarily acts as a dissociative drug, which allows it to alter the user’s perception and create a sense of detachment from oneself and the environment.

Elon Musk sitting in a chair with his leg across his knee and wearing a suit.

U.S. Air Force/Wikimedia Commons

It was revealed the “Friends” star Matthew Perry died from a large dose of ketamine, and billionaire Elon Musk has not been shy about his use of the drug.


The Effects of Ketamine

The National Institutes of Health actively launched a ketamine study to investigate the drug’s effects when users plunge into a “K-hole,” a dissociative state often described as a bad trip. This can induce psychosis, and lead to hallucinations.

People at a concert with orange lights coming from the stage

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Research in animals and recreational users shows that chronic use of the drug, or abuse of it, can have short- and long-term effects on the brain.


Matthew Perry’s Death Is Not a Result of the Drug

In October, during an initial toxicology screening, ketamine was discovered in the body of Perry, who had earlier been found in his hot tub. NPR discovered that a December report found that Perry received infusion therapy a week before his death.

Matthew Perry during The Museum Of Television and Radio To Honor CBS News's Dan Rather And Friends Producing Team at The Beverly Hills Hotel in Beverly Hills, CA, United States.

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However, a mixture of an opioid and a sedative on the day of Perry’s death seemed to be the fatal blow, not the ketamine itself.


There Are Some Regulations to Protect Patients

The ketamine clinics are not completely unregulated. State medical and nursing boards oversee physicians and nurses who are offering ketamine treatments. The FDA and Drug Enforcement Administration are also regulating ketamine.

Ketamine vials in a spiral

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Unfortunately, Sam Mandel notes that most anesthesiologists don’t have a background in mental health, and psychiatrists don’t know a lot about anesthesia, leading to the various ketamine treatments offered.


The Hope for the Mental Health Treatment

Ketamine is still on its way to becoming a drug that can help with mental health treatment. Hopefully, this psychedelic treatment can have the same effect as mushrooms to help relieve depressive disorder symptoms.

Until then, those who are looking for treatment should be wary about how they go about trying something new to relieve their symptoms.