Americans suffering from depression are increasingly turning to ketamine for treatment, but concerns are growing about how people get hold of the controversial drug.
Ketamine has been used in hospitals to put people to sleep for decades. The Food and Drug Administration (FDA) approves it for use in humans and animals. The drug, famous in partisan circles, is called “Special K” and is known to induce hallucinatory abilities outside the body.
Now, the Wall Street Journal reports that psychiatrists are increasingly concerned about the number of people buying ketamine off-label online in unregulated digital marketplaces. Recent studies have shown that ketamine has positive effects on people suffering from major depression and can be used as a treatment when other drugs have failed, but ketamine is not generally approved for that condition.
Johnson & Johnson created a chemically similar drug called esketamine in 2019 for treatment-resistant depression and for use by adults with major depression who are suicidal. The drug, given by nasal spray under the name Spravato, was approved by the FDA, but is only available in licensed doctors’ offices and clinics because of its potential for abuse. After administration, patients must be observed for 2 hours.
Online sellers of ketamine do not offer the same type of oversight.
A simple Google search will find many online retailers that offer ketamine that can be picked up at your nearest pharmacy or by mail after a virtual consultation with one of their doctors. Prices at online retailers and pharmacies vary, with one offering a four-month subscription and treatment plan costing up to $2,999.
ClearSpring Pharmacy recommends finding a clinic that administers Spravato, but the website recommends a pharmacy if the patient needs another dose.
“We can provide dosage sizes that may not be commercially available,” says ClearSpring Pharmacy’s website. “If the patient is not at high risk of addiction, they can also take their ketamine in the comfort of their own home.”
Dr. Benjamin Yudkoff, medical director of the ketamine and esketamine program at Brigham and Women’s Faulkner Hospital in Boston, said online prescriptions for ketamine and taking the drug at home can be dangerous for the patient.
“Places that practice virtual ketamine are negotiating a trade-off between access and safety,” Yudkoff told the Journal.
Ketamine can cause slower breathing as well as an increase in heart rate and blood pressure. It can also be addictive if taken too often and in large amounts.
Although virtual stores advise users to take the drug with someone else present and instruct patients to follow a list of instructions, the environment cannot be controlled. The risk of abuse is high, said Dr. Michael Champeau, president of the American Society of Anesthesiologists.
“Administering any such drug can induce anesthesia at home in a completely unsupervised environment,” Champeau told the Journal.