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A Fraught New Frontier in Telehealth: Ketamine

A client breaking through limiting beliefs through a Ketamine Assisted Psychotherapy treatment in Los Angeles at Shakti Therapy and Healing Services.

Mental health continues as you move into a new era post-pandemic. People are desperately seeking relief from chains of depression, anxiety, and deep-rooted trauma that takes over any amount of peace in the soul. The use of mental health medications is more commonly prescribed as a resource for some, and a bandage for others. There is a growing concern with the use of Ketamine, a dissociative anesthetic used to induce and maintain anesthesia, as well as treat mental health conditions such as depression and anxiety, that is coming forward in regards to the trend of overuse and the safety of use. The New York Times article talks about the dangers of online ketamine assisted psychotherapy (KAP) and the importance of in-person ketamine treatments in its article, "A Fraught New Frontier in Telehealth: Ketamine."

The New York Times interviewed Greg Rice, a potential user of ketamine. Greg Rice found ketamine as a life-altering experience for his mental health. Ketamine is a safe and widely used medicine that has been approved for use as an anesthetic during times of surgery for decades. Recently it is being used off-label for mental health management. Depression is just one of many mental health diagnoses that are being treated with ketamine. In the article, Rice discloses trying various mental health medications since he was a teenager to manage crippling depression. In an attempt to manage his crippling symptoms, he experimented with LSD (Lysergic acid diethylamide), hallucinogenic mushrooms, and other psychedelic medicines. After several years of various experimentations to decrease the struggles of depression, at the age of 38 years, Rice turned to ketamine to manage feelings of anxiety, loneliness, confusion, sadness, and hopelessness.

He said that he still took traditional medications “sometimes,” and struggled with finding a ketamine supplier. That is, until last year, when he learned about the wild world of telemedicine. He was needing ketamine treatments for depression and couldn’t find it, so telemedicine was his best option. Rice scheduled a video call with a physician who was more than 2,500 miles away from his home in California. A 30-minute video consultation yielded enough prescriptions of ketamine for a month's worth of medication with the comfort of being in his home.

Just a few years ago, such an agreement with telemedicine would have been against medical law and unimaginable. At the same time, it is important to note that ketamine is strictly regulated by the Drug Enforcement Administration (DEA) due to its recreational abuse potential, which, according to the DEA, is slightly lower than t opioids such as oxycodone and fentanyl. Ketamine has recently been prescribed off-label for mental health disorders such as treatment-resistant depression in Los Angeles and across the nation with a doctor's consultation. With this type of virtual setup, integrative therapy for ketamine is limited to infusions at clinics and does not meet the standards of traditional therapy.

In 2020 when the pandemic was at its all-time high, the Trump administration made it more accessible to provide treatment to patients via telemedicine, even if that meant prescribing controlled substances. President Joe Biden has kept these policy changes in the law in place. This has allowed the cost and availability of medical services, including mental health treatment in Los Angeles, to become more affordable and accessible.

The recent popularity and increase in the use of ketamine use have raised concerns. The drug has strong effects, and mentally vulnerable people are drawn to it due to the news and media highlighting its benefits for relief from mental health symptoms. Many of these people suffer from treatment-resistant depression or other mental health problems in Los Angeles and haven't responded to standard treatment recommendations. Patients are taking ketamine more often and for longer periods than ever before. This is leading to an increase in tolerance and usage with limited long-term safety data on ketamine use. Additionally, it is becoming more challenging to comprehensively evaluate patients when they are not going to clinics, but instead, are prescribed ketamine via telemedicine only.

The New York Times talked to more than 40 patients who said that telehealth made getting their ketamine prescription attainment easier. They spoke to two dozen doctors and medical experts, and also reviewed scientific papers, case reports, and data from researchers, government agencies, and commercial analytics companies to have a deeper understanding of what was going on.

Several of the patients shared that ketamine changed their lives; it was the one medicine that allowed their painful symptoms to decrease so quickly. Still, some users reported major side effects, like addiction and bladder damage. People who use ketamine recreationally have known about these effects for a long time, but its medical supporters tend to play them down.

Risks of Online Ketamine Therapy

Patients who have taken ketamine have compared it to pressing the "reset" button on their brains. During therapy, many people said they had happy images, often accompanied by a sense of going beyond their own identities and becoming one with the Universe. After that, they began to feel that their regular problems weren't as significant, providing patients relief from their day-to-day anxieties and depression.

Ketamine treatments may affect brain receptors in a way that regular antidepressants do not. this is a big reason for the drug's expansive popularity. Many people are coming around to believing that psychedelic experiences are crucial to the drug's curative power. According to The New York Times, patients said that the first powerful effects of therapy began to wear off after 6 months. Many sought higher dosages, took several days' worth at once, or tampered with the drug to get a bigger rush or trip due to tolerance buildup. Those who received ketamine at home also reported having uncomfortable, frequent urination after starting the drug. The scores of people who spoke about their experiences with ketamine at-home treatments captured both its well-acknowledged benefits and its less often addressed hazards.

The drug's rapid effectiveness in alleviating depressive symptoms has drawn attention in early-stage trials. The quick recent increase in the use of ketamine is concerning, with patients taking it more often and for longer periods of time, which directly impacts tolerance and dependence. Because there isn't enough long-term safety data on ketamine use, it's hard to evaluate patients through telemedicine only, making online ketamine therapy highly risky. Ketamine's benefits and side effects, like addiction and bladder damage, are well-known. Because tolerance builds up, some users change the drug for a bigger rush or trip. So, people considering ketamine therapy online should be careful and talk to mental health professionals who can assess their mental health needs and give them integrative therapy in person for better care.


Based on the information presented in The New York Times article, it is clear that the use of ketamine for the treatment of mental health issues is a multifaced and complex issue with potential risks and benefits. Shakti Therapy & Healing Services, a holistic mental health group practice that offers in-person ketamine assisted psychotherapy, aligns with the concerns raised in the article regarding the dangers of online ketamine therapy.

Shakti Therapy understands that ketamine therapy should be administered in a controlled, safe setting and environment with licensed medical professionals to monitor and ensure the patient's well-being. In-person KAP provides a complete picture of the patient's physical and mental health, which is critical for determining how much and how frequently ketamine should be administered.

It is essential to set safety standards for Ketamine therapy to prevent patients from accessing the drug without proper medical supervision, especially through online channels. In-person Ketamine therapy sessions at a licensed medical facility, like Shakti Therapy, give patients the highest level of safety and care while minimizing potential risks.

Ketamine therapy can be life-changing for some patients. Shakti Therapy recognizes the importance of safety standards and emphasizes the need for in-person Ketamine Assisted Therapy with a licensed medical professional to ensure the safety and well-being of patients.

Ektha Aggarwal is an experienced licensed clinical social worker (LCSW) and Founder of Shakti Therapy and Healing Services.

Shakti Therapy offers a holistic and psychotherapeutic approach to help clients realize that we are an integral part of the vast and complex web of life - that the health of the whole is intimately connected with the health of the individual.

Shakti Therapy combines both ancient Eastern and the most up to date scientific modalities, to create a basis of connection - mind to body, human to nature, individual to community, physical to spiritual, past to present to future.

To learn more about Shakti Therapy and Healing services, please visit or email Ektha at info@shaktitherapyhealing.


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