Debunking Ketamine Myths – The Reality of Ketamine Therapy

As a family physician with years of experience in mental health treatment for severe mental health issues, I’ve seen firsthand how misconceptions can cloud our understanding of innovative therapies. Ketamine, a medication that’s been around for decades, is one such therapy that’s often misunderstood, with many myths about ketamine contributing to the confusion

Ketamine was synthesized in the 1960s and was originally used as an anesthetic agent. It proved invaluable in operating rooms and on battlefields due to its unique properties. Fast forward to today, and we’re unlocking its potential in an entirely new ketamine application: mental health.

From “it’s just a horse tranquilizer” to “it’s a dangerous party drug,” I’ve heard  all the myths about ketamine. These misconceptions not only muddy the waters of public perception but can also prevent people from considering a potentially life-changing effective treatment option.

Myth #1: Ketamine is a horse tranquilizer.

Yes, ketamine is used in veterinary medicine, including for horses. So are other medicines like ​​Furosemide (Lasix) and Ivermectin. But that’s not the whole story. Not even close.

Ketamine is what we call a dissociative anesthetic. It’s been used in human medicine since the 1970s in emergency rooms, in pediatrics, and even in war zones. Why? Because it’s an effective and safe anesthetic for humans.

Here’s a fun fact: The World Health Organization put ketamine on the List of Essential Medicines. That’s right – it’s considered one of the most effective and safe medicines needed in a health system. Not just for horses, but for people.

Myth #2: Ketamine is only a recreational drug.

I hear this one a lot. Ketamine has been used as a party drug.

Ketamine is a controlled substance, and yes, it has potential for illicit use. But in a clinical setting, under mental health professional supervision, it’s a different story entirely.

Ketamine-assisted therapy is worlds apart from recreational use. In Field Trip Health clinics, we use precisely controlled doses in a safe, monitored environment. We’ve helped patients with treatment-resistant depression make breakthrough progress with ketamine-assisted therapy. The goal isn’t to get high – it’s to facilitate healing and growth.

Myth #3: Ketamine is an illegal club drug.

This is a tricky one because it’s partly true. Recreational use of ketamine is indeed illegal. But that’s not the whole picture.

Ketamine is classified as a Schedule I controlled substance under Canada’s Controlled Drugs and Substances Act (CDSA). That means it’s legal for medical use when prescribed by a licensed healthcare provider. It’s similar to how many other potent medications are regulated.

At Field Trip Health, we use ketamine off-label for mental health treatment. “Off-label” might sound scary, but it’s a common and accepted medical practice. It simply means we’re using a medication for a purpose other than what it was originally approved for, based on emerging research and clinical experience.

The legal status of ketamine allows us to explore its healing potential for various mental health disorders while maintaining strict controls to prevent misuse.

Remember, the key here is professional oversight. Ketamine treatment should always be administered by trained medical professionals in a controlled setting. It’s not something to experiment with at home or to seek out illegally like a street drug.

Myth #4: Ketamine is highly addictive.

In recreational settings, where ketamine is used frequently and in high doses and in combination with other substances, there is a risk of psychological dependence. However, such extreme cases do not occur in controlled medical settings.

Clinical trials have shown that ketamine, when used as directed for treating depression, has a low risk of addiction. The doses we use are much lower than those used recreationally, and the frequency of treatment is carefully managed to prevent physical dependence. The doses used are ¼ to 1/10 than the anesthetic doses that are used daily in hospital settings. 

Here’s an analogy I often use: Think of ketamine like a power tool. In the wrong hands, it can be dangerous. But in the hands of a skilled professional, it’s a precision instrument that can help build something beautiful.

Myth #5: Ketamine treatment is dangerous.

The idea of using an on label anesthetic for mental health treatment might sound scary. But let’s look at the facts.

Ketamine has been used safely as an anesthetic for decades. Its safety profile is well understood and preferred for that reason. In ketamine-assisted therapy, we use much lower doses than those used for anesthesia, ¼ to 1/10 than the anesthetic doses. 

At Field Trip Health clinics, every ketamine treatment session is carefully controlled. We monitor vital signs throughout the process. There’s always a medical professional present. It’s a far cry from recreational use or self-medication that may result in adverse reactions.

Ketamine research has shown that, when used properly, it’s generally well-tolerated. Yes, there are mild and transient potential side effects. But serious adverse effects are rare when ketamine is administered in a clinical setting.

Myth #6: Ketamine causes psychosis.

This is a big one, and I’m glad we’re addressing it. Ketamine can indeed cause altered perceptions and even hallucinations. But calling it psychosis isn’t accurate.

Ketamine is a dissociative anesthetic. That means it can create a sense of detachment from one’s environment and self. Some people experience dream-like states or unusual thought patterns during treatment.

These effects are temporary and expected. They’re not signs of psychosis, which is a severe mental state characterized by a disconnect from reality.

In fact, the altered state induced by ketamine is often an integral part of its therapeutic effects. It can help patients gain new perspectives on their thoughts and emotions. Many describe the experience as profoundly meaningful.

That said, we always screen patients carefully for any history of psychotic disorders. For some individuals, ketamine may not be appropriate. It’s all about personalized care and making sure the treatment is right for each individual.

Myth #7: You’ll fall into a “k-hole”.

A “k-hole” refers to an intense dissociative state that can occur with high doses of ketamine. It’s often described as a feeling of complete detachment from reality. In recreational usage, it can be scary and disorienting.

But here’s the thing: in therapeutic settings, we’re not aiming for a “k-hole.” The doses we use are carefully calibrated to promote a mild to moderate dissociative state – enough to facilitate therapeutic insights, but not so much that it becomes overwhelming.

Think of it like this: we’re not trying to launch you into outer space. We’re just helping you get a new perspective on things, like viewing your life from a gentle hill rather than from ground level.

During ketamine infusion therapy, you’re always under strict medical supervision. If the dissociative effects become too intense, we can adjust the dosage or stop the treatment.

Many patients describe their experience as floating, or as if they’re watching a movie of their thoughts. It can be strange, yes, but also profoundly insightful. And remember, you’re always in a safe, controlled environment.

In the end, ketamine therapy isn’t about escaping reality. It’s about seeing your reality from a new angle, one that might just help you make positive changes in your life.

Myth #8: Ketamine is a cure-all for mental health disorders.

If only mental health were that simple! While ketamine has shown remarkable promise, it’s not a magic wand we can wave to make all mental health issues disappear.

Let’s talk about what ketamine does well. Its rapid onset antidepressant effects are truly impressive. I’ve helped patients who’ve struggled with depression for years experience significant relief within hours or days of their first ketamine treatment.

Ketamine can provide quick relief, but it’s not a cure for depression. It’s a tool – a powerful one, but still just one tool in our mental health toolbox.

Ketamine also performs remarkably well for PTSD treatment. For some patients, it helps process traumatic memories and reduce their emotional impact. But again, it’s not a standalone cure.

Myth #9: Ketamine works the same for everyone.

Wouldn’t that make our jobs easy? But the human brain is wonderfully complex, and so is its response to ketamine.

I’ve seen patients experience profound shifts after a single ketamine session. I’ve also seen patients who need several ketamine treatments before they notice a change. And yes, I’ve seen patients who don’t respond to ketamine at all.

This variability is why ketamine clinics like ours focus on personalized treatment plans. We don’t have a one-size-fits-all approach. Instead, we tailor the treatment to each individual’s needs, adjusting dosages and frequency based on their response.

Myth #10: Ketamine is a one-and-done treatment.

If only it was that simple! While some patients do experience significant relief after a single ketamine treatment, for most, it’s more of a process than a single event.

A typical course of ketamine treatment often involves a series of ketamine infusions or other forms of administration like oral ketamine over several weeks. This initial treatment phase helps to establish and stabilize the antidepressant effects. After that, many patients may benefit from periodic maintenance treatments.

Ketamine treatment isn’t just about recommending ketamine infusions. It’s about integration – taking the insights and relief provided by ketamine and using them to make lasting changes in your life.

That’s why we often recommend combining ketamine with psychotherapy. The rapid relief ketamine provides can create a window of opportunity for psychotherapy to be more effective. It’s like ketamine clears away the fog, allowing you to see and work on the underlying issues more clearly.

Myth #11: Ketamine is only for severe depression.

While it’s true that ketamine has made headlines for its efficacy in treatment-resistant depression, its potential reaches beyond that.

At Field Trip Health clinics, we’ve seen powerful results using ketamine for a range of other mental health issues including:

●     Depression

●     Anxiety

●     Post traumatic stress disorder

●     Trauma

●     Alcohol Use Disorder

●     Chronic Pain management

●     Eating Disorders

●     OCD

●     Suicidal ideation

●     Bipolar depression 

Anxiety disorders, for instance, may respond well to ketamine treatment, validated in clinical trials. The dissociative effects can help some patients step back from their anxious thoughts and gain a new perspective.

PTSD is another area where ketamine shows promise. Many patients also report that ketamine helps them process traumatic memories with less emotional pain, making it easier to work through these issues in therapy.

We’re even seeing interesting research on ketamine’s potential in treating obsessive-compulsive disorder (OCD) and certain types of chronic pain conditions.

Myth #12: Ketamine isn’t psychedelic.

Now, this is a tricky one. The term “psychedelic” often conjures images of 1960s counterculture, but in medical terms, it has a specific meaning.

Psychedelics are substances that alter perception, mood, and cognitive processes. Ketamine certainly does that. It can induce profound changes in consciousness, altering how we perceive ourselves and the world around us.

Ketamine is what we call a dissociative psychedelic. It can alter perception, mood, and cognitive processes, creating a sense of detachment from one’s body or environment. This is different from classical psychedelics like psilocybin or LSD, but it still firmly places ketamine in the psychedelic category.

In the context of therapy, these psychedelic properties can be beneficial. The altered state of consciousness that ketamine induces allows patients to examine their thoughts, emotions, and memories from a new perspective.

Many patients report that this dissociative state helps them break free from negative thought patterns or confront difficult emotions with less fear. The vivid imagery or profound insights that often accompany ketamine sessions aren’t just side effects – they’re frequently central to the therapeutic process.

This experience can be intense, which is why we always provide careful preparation, support, and integration. The goal isn’t to “get high,” but to use this unique state of consciousness as a tool for healing and growth.

Ketamine’s classification as a psychedelic isn’t something to be feared or hidden. When used responsibly in a therapeutic context, it’s precisely these psychedelic properties that can catalyze profound positive changes in mental health treatment.

Myth #13: Ketamine-assisted therapy is not supported by medical science.

Let me be clear: the scientific evidence supporting ketamine-assisted therapy is robust and growing.

The use of ketamine in mental health treatment began in the early 2000s when researchers noticed its rapid antidepressant effects. Since then, we’ve seen an overwhelming amount of studies examining ketamine’s potential.

A landmark study in 2000 showed ketamine’s rapid and significant antidepressant effects in patients with major depression. This kicked off two decades of intensive scientific research.

In 2019, the FDA approved a ketamine derivative, esketamine, for treatment-resistant depression. This approval came after rigorous clinical trials demonstrating its efficacy and safety.

But the research doesn’t stop there. There are many many studies on ketamine’s potential in treating PTSD, anxiety disorders, and even addiction like alcohol use disorder. The evidence is so compelling that major institutions like Yale, Stanford, and Johns Hopkins have established ketamine research programs.

Myth #14: Ketamine therapy is purely symptom management.

Out of all the common myths about ketamine, this one really gets to the heart of what ketamine therapy is all about. Yes, ketamine can provide rapid relief from symptoms like depression and anxiety. But to say it’s “purely” symptom management misses the bigger picture.

Ketamine’s potential therapeutic benefits go beyond symptom management. Ketamine has the potential to facilitate deeper therapeutic processes. How? Well, it’s not just about changing brain chemistry (although it does that too). Ketamine can create a mental state that’s particularly conducive to psychological healing and growth.

Many patients report that ketamine helps them access and process emotions or memories that they’ve struggled managing with conventional treatments .

Moreover, ketamine appears to enhance neuroplasticity – the brain’s ability to form new connections. This “brain flexibility” can make it easier for patients to break out of rigid thought patterns and behaviors.

At Field Trip Health clinics, we often see ketamine therapy catalyze profound insights and personal growth. Patients might gain new perspectives on their lives, relationships, or past experiences. These insights can lead to lasting changes that go far beyond simply providing relief.

That’s why we always emphasize the importance of integration – the process of making sense of the ketamine experience and applying those insights to daily life. Without this integration work, we’d be missing out on much of ketamine’s therapeutic potential.

Myth #15: Ketamine is too new, experimental, or untested.

I hear this one a lot, and I understand where it comes from. The use of ketamine in mental health treatment feels new and cutting-edge. But here’s the thing: ketamine itself is far from new.

Ketamine has been around since the 1960s. It was first synthesized in 1962 and approved by the FDA for use as an anesthetic in 1970. That’s over 50 years of safety data in clinical settings. It’s been used extensively in emergency rooms, on battlefields, and in operating theaters around the world.

Now, its use for mental health conditions is more recent, that’s true. But even that isn’t as new as you might think. The first studies on ketamine for depression were published in the early 2000s. That’s over two decades of research and experience in clinical settings.

Since then, we’ve seen an explosion of research. Hundreds of studies have been conducted, exploring ketamine’s effects on depression, anxiety, PTSD, and other mental health conditions. We’re talking about rigorous, peer-reviewed research published in top medical journals.

So while ketamine therapy might feel new and experimental, it’s built on a solid foundation of long-term use and rigorous scientific study. It’s not a flash in the pan or a fad treatment. It’s a well-researched option that’s earned its place in modern psychiatry.

Where to Find Credible Ketamine Information

With all the information and ketamine myths out there, it can be tough to know where to turn for reliable facts about ketamine. Here are some tips to help you navigate the sea of information:

1. Peer-reviewed journals: If you’re comfortable reading scientific papers, journals like the American Journal of Psychiatry, JAMA Psychiatry, and Nature are excellent sources. They publish the latest research on ketamine and other psychiatric treatments.
2. Government health websites: In Canada, look to Health Canada for official information on ketamine’s legal status and approved uses. In the U.S., the FDA and NIMH (National Institute of Mental Health) websites offer reliable information.
3. Professional medical associations: Organizations like the Canadian Psychiatric Association or the American Psychiatric Association often provide balanced, evidence-based information on treatments like ketamine.
4. Reputable ketamine clinics: Many clinics (like ours) have educational resources on their websites with links to published research and engage in research themselves. Look for clinics affiliated with major medical institutions or run by board-certified psychiatrists.
5. Books by experts: There are several good books on ketamine therapy written by researchers and clinicians in the field. The Ketamine Papers by Phil Wolfson is a great overview. Look for authors with strong clinical or research backgrounds.
6. Be wary of: Personal blogs, forums, or websites selling ketamine-related products often mix fact and opinion. Use these cautiously and always cross-check information with more reliable sources.

Remember, ketamine’s legal status can be complex. In Canada, it’s a controlled substance, legal for medical use when prescribed by a licensed healthcare provider. Always ensure you’re working with licensed, reputable healthcare providers like Field Trip Health if you’re considering treatment options like ketamine treatment.

About the Author

Dr. Mario Nucci MD CCFP is a licensed Family Physician with a passion for mental health and the development of new therapies. He is actively engaged in research with a faculty associate professorship at Northern Ontario School of Medicine, and research collaborations with the University of Ottawa, University of Calgary, Lakehead University, Concordia University and Vancouver Island University.

Dr. Nucci is the founder of Bay and Algoma Health Centre in 2019, a walk-in and addiction medicine clinic. He founded the Canadian Centre for Psychedelic Healing in 2019, now operating as Field Trip Health, providing cutting edge mental health care in  Toronto,  Montreal,  Vancouver,  Ottawa,  Hamilton,  Kitchener-Waterloo, Thunder Bay, Sault Ste. Marie, and at-home.