Ketamine Insights
We demystify mental health and psychedelic medicine. Our episodes give practical insights from experienced patients, helping everyone better understand depression, OCD, bipolar disorder, and psychedelic medicine. From the practical (like a guide to accessing therapeutic ketamine), to the profound (like spiritual awakenings brought on by psychedelics), we share patient-centered knowledge to help people and their families better understand the psychedelic landscape today.
Co-hosts Molly Dunn and Lynn Schneider are old friends who usually live on opposite sides of the world. Molly, a disabled writer from Chicago with treatment resistant depression and other chronic illnesses, has been a ketamine patient for several years. Lynn, our resident genius empath, is a longtime friend, relative, and ally of people who struggle with mental health challenges. Together, we fight stigma, go on tangents, and crack each other up.
We are not trained mental health experts. We provide context to help you do your own research.
Hit us up at ketamineinsights@gmail.com and https://ketamineinsights.com/ and @ketamineinsights on Instagram.
~~If you or someone you know is experiencing a mental health crisis, please get help. In the US, dial 988. You are never all alone.~~
Remember to advocate for yourself, and never ration your joy.
Ketamine Insights
Finding Ketamine Care: A Guide
Explore various ways to access ketamine care in the US. Hosted by a long-term ketamine patient, this episode covers the gold standard (talk therapy and ketamine treatment combined in one practice), the services offered by ketamine clinics, and the evolving option of at-home ketamine administration. Learn about the costs, benefits, and potential pitfalls of each approach, and gain valuable insights to help you navigate your mental health journey. For more resources, including a written version of this episode, visit our Patreon and Substack pages. While you're there, take a moment to contribute if you can.
ketaminetherapyformentalhealth.com is a wonderful resource for patients and prospective patients.
Articles we mention in this episode
https://www.nytimes.com/2023/02/20/us/ketamine-telemedicine.html
https://psychedelic.support/resources/coming-to-terms-ketamines-addictive-potential
Our music is by Solid State Symphony.
Email us at ketamineinsights@gmail.com. We love to hear from you!
Our Instagram is @ketamineinsights
You can also find all of our episodes on YouTube
Join our community on Substack or Patreon
If you or someone you know is experiencing a mental health crisis, please get help. In the US, you can dial 988. You are never all alone.
Theme Song: [00:00:00] She's sometimes sad, she's sometimes happy. She's doing things to make her life less crappy. Trying a treatment that's new on the scene. Let's sit back and talk about Ketamine.
Molly: Hello, everyone. Welcome to Ketamine Insights. Today, we're going to talk about the different ways to access ketamine care. As regular listeners know, I'm not a mental health professional.
I'm a patient. I've been using therapeutic ketamine to treat depression for about five years now. As the therapeutic ketamine options have proliferated over the years, I've tried almost all of them. All of the info in today's episode comes from my own experience and a little bit of research on the different ways to access ketamine care in the U.S. in 2024. For good ketamine care, you really need two things, a prescriber and a [00:01:00] therapist. The prescriber authorizes your use of the ketamine and the therapist helps you make the most of your ketamine journeys. Right now in the US. the landscape for therapeutic ketamine is really piecemeal and in most cases the prescriber is not the therapist so you usually have to find them separately and cobble together good care.
Today I'm going to talk you through your options. It's kind of complex so in addition to talking you through it I wrote an article with links to To examples and resources that article is available on our Patreon page, as well as our Substack. And Hey, while you're there, take a moment to sign up as a follower or a donor that really helps us keep the podcast going.
Okay, let's get into it. We'll start with the gold standard. This is the one, the only one where you do not have to cobble together care because it's all ready for you in one place. This is available when psychiatrists or therapists provide [00:02:00] talk therapy and ketamine therapy together in their own offices.
This is how I do infusions now. I go into the office of the therapist trained in ketamine assisted therapy. And his therapy practice has brought in a nurse anesthetist who prescribes and administers the ketamine treatments in the therapist's office. It's really great. Um, there are also cases where a psychiatrist will prescribe the ketamine and provide the therapy, whether you're in a psychologist's office or a psychiatrist's office.
This approach tends to be much more comfortable and less medical. You get the benefit of medical observation during the experience while also being able to have a therapy session immediately following your ketamine journey. In my experience, this option is also nice because the people who provide ketamine this way tend to appreciate the importance of the therapy part of ketamine treatment.
It's a more holistic approach where they understand the [00:03:00] delicacy of the situation and they try to make sure that you have a good mindset and a good setting. So that's the gold standard. If it's not available near you, that's not the end of the world. There are still lots of options that we'll talk about today, but it is worth trying to find a place that combines ketamine administration with therapy from people trained in psychedelics.
And if you're a provider listening to this, Start a practice that does both. We need more of them and we also need it to become a recognized and accessible best practice. So depending on where you live, each ketamine session will be between 300 and 600. While the ketamine is usually not covered by insurance companies in the U.
S. The therapist's time is billable to insurance. So if you do have an insurance company that covers therapy, then this method ends up costing you the same amount as your in clinic option, which is what we'll talk about next. The second way to purchase ketamine is at a ketamine clinic. The [00:04:00] medical professionals at the clinic prescribe and administer the ketamine, but they do not provide the wraparound therapy that's so important.
So you have to find a therapist separately and work with them on the scheduling so that you can hopefully see the therapist soon after your ketamine treatment. If you'd like to know more about why the talk therapy part is so important, you can check out our second episode from season one. It's worth doing research before you choose a ketamine clinic because they vary widely in their quality.
Some of them are honestly just money grabs set up by irresponsible medical practitioners. I've had wonderful and terrible experiences at different clinics in Chicago, so I recommend reading lots of reviews and calling first with a list of questions. Don't be shy. Different clinics prescribe ketamine in different forms.
Some clinics offer ketamine as an IV. Some offer it as an intramuscular injection. Some clinics offer Spravato, which you spray up your nose like [00:05:00] an allergy medication. And many offer all three. Spravato is the method that is covered by some insurance plans. To learn more about each of these options, you can check out our very first episode ever, which is called Five Ways to Take Ketamine for Mental Health.
To hear more about the Ketamine Clinic experience step by step, you can listen to Episode 5 from Season 1. From what I've seen, each visit to a Ketamine Clinic costs between 300 and 600, again, depending on where you live. If you don't have insurance, the therapist can cost anywhere from 90 to 200 per hour and more.
So far we've covered two ways to purchase ketamine treatment in a therapist's office and in a ketamine clinic. , the next one we'll talk about is totally different. It's at home. Here you purchase ketamine lozenges or quick dissolve tablets and then administer them yourself at home. If you can, [00:06:00] I'd just say ask for the quick dissolve tablets instead of the lozenges.
The dosing tends to be more consistent with the tablets and they dissolve quicker so the taste is less of a pain in the ass. Today I'll use the two terms interchangeably. Before we get into how to access ketamine at home, we gotta talk about how much ketamine these places prescribe. At home ketamine comes at drastically varying doses, from 50mg all the way up to 400mg for people who have built up some tolerance.
Honestly, it seems like the dose depends more on your prescriber than on your personal needs. Some prescribers tend to prescribe more ketamine as a baseline, and some prescribers are more cautious. I've had prescribers who wouldn't go above 50mg, and others who didn't prescribe below 200mg. If that sounds odd, I don't know man, you're right, it's wild out here.
These different dose levels have wildly different effects on the body. At 50 milligrams, you're not [00:07:00] tripping. , at 200 milligrams, you almost definitely are tripping. So , before taking at home ketamine, talk to your prescriber about what dose is best for you. When I started using lozenges for maintenance in between infusions, I found 50 milligrams helpful.
I took 50 milligrams. About three times a week for 18 months. I felt like I'd built up a tolerance at that point. And then we increased my dose. That said, I've known people who have been prescribed much higher doses and used them very often at home. So these folks are tripping at home several times a week.
It's important to note here, the ketamine does have side effects and the chances of those side effects increase the more ketamine you take. And one of those side effects. is permanent bladder issues. I will link to New York Times article that discusses the side effects that ketamine has. I'll also include an article discussing whether ketamine can be addictive.[00:08:00]
I don't know whether those higher doses several times a week are actually more effective in lifting mood. What I've found is that for me, it works best to spread out my high dose ketamine trips. That way , I know I'll have time to integrate any insights, let the learning settle. And think about my intention for the next trip.
Okay. So now we'll talk about how to access ketamine at home. There are three different ways. The first option is, you can often get a prescription for at home lozenges from the same clinic where you got your IV, IM, or Spravato. So the ketamine clinic will send that prescription to a compounding pharmacy, and the compounding pharmacy makes the lozenges and mails them to you for your at home use.
For this one, you just have to ask at the desk where you get your ketamine infusions and see what pharmacy they recommend. Second, there are physicians and registered nurses [00:09:00] who have practices that will prescribe ketamine tablets. Generally with these, you make an appointment and meet the physician or RN, either online or in person to review your history.
Then they write the prescription for ketamine lozenges and send it to a compounding pharmacy, which again, mails you the lozenges. Here, you have to pay the prescriber each month for ongoing visits and you have to buy the lozenges. Together, you can expect this method to cost between 200 and 400 a month.
The final way to get lozenges at home is from an online mail order place like Mindbloom or Joyous or BetterUCare. com. I haven't tried any of these. What they do is, they meet with you virtually, they prescribe the ketamine, and mail it to you in a packet. They often include a fancy eye mask to make it seem like you're at a spa.
These options are usually cheaper than any other method. Also, they generally don't provide any [00:10:00] form of therapy. Instead, they check in on you virtually. For example, some of them will text you surveys to monitor your progress. There have been some major concerns about whether patients, especially patients with suicidal ideation, are monitored properly.
The New York Times article that I'll link to describes a situation where a joyous patient texted the company for 10 weeks telling them that she was experiencing suicidal ideation. Each time she received a canned response with no follow up.
There are ways these companies can be useful though, when combined with additional care. For example, some people sign up for these online mail order companies and then enlist the help of a ketamine trained therapist to oversee their intention setting, their integration, et cetera. So what they're doing here is they're using the lozenges they receive in the mail for ongoing maintenance of their mood while they rely on their therapist for the wraparound [00:11:00] care that these online companies don't provide.
This can be a good way to cobble together more affordable care, especially if you have health insurance that can help pay for the therapist. If you choose to go with an online ketamine company, I recommend that you also be in weekly therapy, preferably with a therapist trained in psychedelics. If possible, it's best to have someone to provide support throughout the process.
They can help you set intentions and do the work of integrating the insights that you gain during your ketamine journeys. If you don't have access to therapy, I recently found a workbook that walks you through these processes step by step. It will help you come up with an intention, integrate your experience, et cetera.
You can find this workbook at the website ketaminetherapyformentalhealth.com, which is a really helpful resource. Ketaminetherapyformentalhealth.com also provides tons of [00:12:00] other information. There's a list of providers by state and a place for patients to review those providers, which is really important.
All right. That's it, everyone. Those are the ways in a therapist's office, in a ketamine clinic, and at home. Now, before we go, I want to encourage you to seek out the support you need. Mental illness is not something we can tackle alone. Please ask for the help you need. We all need help sometimes. And if you know someone is struggling, don't be shy to offer support.
We need each other. If you would like to read the information from this episode, please go to our Patreon page or our Substack. You can use either of those platforms to contribute to Ketamine Insights. And if you have the means, please do help us keep the lights on. It's the only way we stay afloat since we've got no advertisers and no outside support.
I really hope you enjoyed this episode. And if you did, [00:13:00] please rate and review the show on Spotify or wherever you're listening and forward the show to a friend. Ketamine Insights is produced by Molly Dunn and our music is by Solid State Symphony. Don't forget to advocate for yourself and never ration your joy.