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Liz Kost “had never experimented” with ketamine, an anesthetic with a reputation as a party drug. But she decided to try it when her employer offered it to her. “It was amazing,” she says.
The experience was not for fun, but for therapeutic reasons. Dr Bronner’s, the California-based organic toiletries company where Kost is marketing operations manager, offers fully paid ketamine therapy as part of its employee benefits package.
The offering coincides with a “dramatic growth in interest in ketamine-assisted psychotherapy in recent years,” says Jeffrey Zabinski, assistant professor of psychiatry at Columbia University Medical Center.
Ketamine has been approved by the US Food and Drug Administration for use as an anesthetic since the 1970s. But more recently, specialty clinics have begun promoting it as a mental health treatment. While it has not been widely approved by the FDA, it is legal for doctors, psychiatrists or, in some states, nurse practitioners to prescribe the drug “off-label” for these new purposes.
The benefit came at a “desperate time” for Kost. “I went through a pretty traumatic time as a child. I had bottled up my emotions, but when Covid hit. . . “That uncertainty brought my traumas to light.” He had anxiety attacks and couldn’t sleep. “He was stuck in a trauma loop.”
Kost initially sought more conventional psychotherapy, but after seeing his company’s founder, Mike Bronner, talk about the new benefit, he decided to give it a try. “He had been open about depression in the past and [spoke about] how ketamine had helped.”
Patients typically have three to six sessions at a specialty clinic, sometimes after being referred by another medical professional. Kost had six in a couple of weeks, with a booster session later. After a consultation with Flow Integrative, a ketamine therapy provider, the service was overseen by Enthea, a health insurance administrator that offers employers psychedelic treatment for staff.
This comes as more companies look to help employees with mental health, offering access to therapy or apps. Sally Maitlis, a professor at Saïd Business School, says employers’ interest in ketamine is motivated, at best, by “real concern” for depressed employees. But she warned it could also be part of a “scattered approach,” which avoids addressing the complex root causes of mental illness.
Kost first took ketamine in pill form. at home, supervised by a trusted adult and a therapist connected virtually. “She was terrified, she had never done anything like that. Ketamine immobilizes you. When you come out of a trauma, you’re not excited about being immobilized,” says Kost. The home environment was not helpful. “All I could do was think about clothes.”
Then they gave it intravenously at a clinic. “You sit in a big, comfortable chair, they give you a weighted blanket, they hook you up to the IV, and they play music for you. You spend an hour thinking about your life and the people you love.” The practitioners were “kind and caring.” . . “If it was a colder clinical environment, maybe I wouldn’t have done it.”
Ketamine, she says, helped her overcome her tendency to ruminate. “I call it a massage for the soul. It helps you get out of the trauma,” she says. “[I thought] Wow, the universe is a bigger place than I imagined. “It puts you in a positive mood and mindset.” She believes having access to therapy to process thoughts and feelings was essential.
Allan Young, director of the Center for Affective Disorders at King’s College London, says there is compelling evidence that ketamine helps treatment-resistant depression. Among his patients who suffered from it, up to half improved after taking a ketamine-derived nasal spray, which is approved for use in many countries.
Sherry Rais, CEO of Enthea, says the new uses of ketamine are “widely considered normal, safe and effective,” an example of “off-label” prescribing that is already common in cases such as the drug propranolol, approved for heart conditions. but it is frequently prescribed. because of anxiety.
However, ketamine carries risks. He FDA warns of “sedation, dissociation, psychiatric events, or worsening of psychiatric disorders.” Abuse has been linked to bladder and heart problems. Last year, actor Matthew Perry, who had received ketamine-assisted therapy in the past, died accidentally from the “acute effects of ketamine.” according to the Los Angeles coroner. This, Young says, means that ketamine should “be part of a well-formulated care package” after “thorough evaluation” by professionals.
However, while much is still unknown about the long-term effects, Zbinksi says commercial clinics offering the drug for a variety of conditions are emerging faster than new research. “Some places seem to have minimal screening requirements, as if they are willing to treat almost anyone who has the ability to pay.”
It seems unlikely that ketamine will become widespread as an employee benefit. Kost suspects that most companies are too cautious for this to become “a big business trend.” But she is still an evangelist. “It’s definitely worth it.” . . “I don’t want people to think we’re sitting around doing a bunch of party drugs.”