Companies Are Mailing Patients Ketamine—But Not Everyone Is On Board Reports DoubleBlind

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One morning, a plain brown box arrived on my doorstep. According to the sender, the contents inside should be handled carefully, because they could change my life. “EMPOWER YOUR INNER HEALER” was printed on the box’s inner flap—a savvy marketing mantra from a company taking ketamine therapy out of clinics and into your living room. A strange feeling of transgression came over me as I ripped open the packaging, uncovering a strip of ketamine lozenges—bright blue, candy-like tablets stamped with the company’s floral logo. They reminded me of giant ecstasy pills.

I wondered: how is this even legal?

Ketamine therapy is a burgeoning industry built on novel legal grounds. While ketamine is a controlled substance first synthesized as an anesthetic in the 60s, conversations about it as a mental health treatment only began gaining traction in the 2000s, when a wave of research showed its potential as an antidepressant. This led to a spike in consumer demand for ketamine as a therapeutic treatment, and a cottage industry of clinics grew around providing access to the drug as a wellness tool—often charging hundreds of dollars per session and thousands for the recommended full course of sessions. Then, during the pandemic, Congress passed provisions that allowed clinicians to prescribe medications virtually, a legal shift that transformed both the ketamine industry and healthcare at-large.

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This article in the Washington Post is also worth a read

This doctor prescribes ketamine to thousands online. It’s all legal.

People can take the drug at home, thanks to federal action during the pandemic. Some experts worry it’s now too easy to get.

In the past two years, Scott Smith has become licensed to practice medicine in almost every U.S. state for a singular purpose: treating depressed patients online and prescribing them ketamine.

The sedative, which is sometimes abused as a street drug, has shown promise in treating depression and anxiety. But instead of dispensing it in a clinic or under the strict protocols endorsed by the Food and Drug Administration, the South Carolina physician orders generic lozenges online for patients to take at home. He says this practice, though controversial, has benefited more than half of his 3,000 patients. “People are beating a path to my door,” he said in an interview.

Smith is part of a wave of doctors and telehealth start-ups capitalizing on the pandemic-inspired federal public health emergency declaration, which waived a requirement for health-care providers to see patients in person to prescribe controlled substances. The waiver has enabled Smith to build a national ketamine practice from his home outside Charleston — and fueled a boom among telehealth companies that have raised millions from investors.

As the urgency around covid-19 subsides, many expect the waiver to expire. Companies are lobbying to extend it, and patients are bracing for a disruption to purely virtual care.

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