With Pressure To Scale, Some Ketamine Clinics Could Be Doing Harm. Here’s What Consumers Need To Know.

Forbes Leadership ForbesWomen With Pressure To Scale, Some Ketamine Clinics Could Be Doing Harm. Here’s What Consumers Need To Know. Megan Bruneau Opinions expressed by Forbes Contributors are their own.

Therapist and Executive Coach here to like yourself and life a little more. Follow me on Instagram @meganjbruneau Following May 28, 2023, 09:53am EDT | Press play to listen to this article! Got it! Share to Facebook Share to Twitter Share to Linkedin In the last few years, ketamine has had a massive rebrand. Once reserved for operating rooms and underground warehouse parties, the medicine is now being used to treat substance use, depression, anxiety, PTSD, OCD, eating disorders, and chronic pain.

Seeing the potential behind the apparent wonder drug’s effect on mental health, investors have taken notice. Between July of 2021 and July of 2022, ketamine-related startups raised $236 million —and the psychedelic therapeutics industry, valued at $3. 6 billion in 2021, is prospected to be valued at $8.

3 billion by 2028 . Psychedelics are known to facilitate profound healing experiences; yet if misused, they also have . .

. [+] the power to harm. Merlin Light Painting As a therapist and executive coach who’s passionate about mental health, the growing industry is equal parts promising and alarming to me.

On the one hand, there appears to be so much possibility: a fast-acting alternative to side-effect heavy antidepressant and anxiety medications. Yet on the other hand, it seems like a recipe for mismanaging power: with pressure to scale, venture-backed startups are now faced with the ethical dilemma of growing at the cost of quality care. One of the challenges of scaling any mental health service is the challenge of depth versus breadth: prioritizing one usually means sacrificing the other.

Adequate mental health interventions require a certain degree of depth , often only achieved through repeat experiences of one-on-one or small group support; however, scaling a startup means prioritizing breadth —acquiring and retaining as many customers as possible, often at a rapid pace to prove a viable business model to investors. To illustrate this tug of war: in a race to reduce burn and increase customer acquisition, some clinics are offering at-home treatments—a model they claim makes treatment more accessible for those constrained by location or finances. This initiative was made possible by the Covid-19 related suspension of the Ryan Haight Act , which previously limited the prescribing of controlled substances to in-person visits.

However, the at-home treatment model has received pushback from experts who have serious concerns about lack of adequate support and risk of misuse and addiction . Critics also argue offering at-home treatment suggests the medicine in itself is sufficient— without emphasizing the importance of continued care . MORE FOR YOU Ozempic As A Pill Drug Makers Race For Cheaper Weight Loss Drugs Without The Shots Why A Bill Called The HALT Fentanyl Act Has Some Lawmakers Split The Best Online Prescription Glasses A Comprehensive Buying Guide “When you give someone a psychedelic medicine alone without this safety and containment, it has the potential to go sideways,” explains Dr.

Jenny Cundari , a naturopathic physician and somatic therapist who’s had ample experience treating patients with psychedelic medicines. “Sometimes ketamine experiences can be very pleasant, and sometimes they can assist in an excavation of traumatic psychic material. This can be potent for transformation, but can also be challenging if there isn’t any support or guidance available.

It can sometimes make things worse before they get better. ” She goes on to warn that, despite its tendency to rapidly decrease suicidal ideation, ketamine can also increase suicidal ideation in some instances. “With its dissociative quality, it can take some people to a place where they feel as though nothing matters.

For some, the space of meaninglessness can be very helpful and for others, this can create hopelessness and suicidal thoughts. This is why it is important to work with a trained practitioner, in conjunction with therapy, when working with this medicine for healing purposes. ” Even with the addition of cost-effective Telehealth services, many ketamine startups have been unable to demonstrate viability: Earlier this year, Field Trip Health closed five of its locations in an attempt to stay afloat.

Ketamine Wellness Centers closed all thirteen of its locations. And Michael Brotherton, an investor and cofounder Dragonfly 44 Capital , anticipates “massive consolidation in the space” when the Ryan Haight Act is revisited in late 2024. Despite the challenging economic climate, one company that is currently refusing to compromise the comprehensiveness of their services is Numinus, a Vancouver-based company with additional clinics in Arizona, Utah, Ontario, and Quebec.

Founder and CEO Payton Nyquvest was compelled to start the mental health company following his own life-saving psychedelic experience, and is thus determined to prioritize patients’ care. He believes it is the preparation and “integration”—the therapeutic work done with a trained professional in the days and weeks following the psychedelic journey—that really effects change. “Yes, psychedelics are really exciting tools, but if you don’t have that model of community and care wrapped around it, it can be ineffective and even harmful,” he stresses during our conversation for The Failure Factor podcast .

He goes on to reveal that Numinus has become a safe harbor for “ketamine refugees” whose treatment has been mismanaged by other providers. Numinus Health founder and CEO Payton Nyquest believes ketamine treatment without proper therapeutic . .

. [+] support can be harmful. Numinus Health Nyquvest and his team are exploring alternative sources of low-overhead revenue that don’t compromise care: for the past year, Numinus has also been offering a rigorous accredited practitioner training program.

Their goal is to reduce the harm caused by untrained “guides” unequipped to support individuals on their psychedelic journeys. Nyquvest believes that as the industry continues to grow, and legislation decreases stigma and increases access to these medicines, it is imperative that we have enough trained practitioners to ensure safe and effective treatment. The training includes foundational and advanced courses in ketamine, MDMA, and psilocybin-assisted therapies.

What does a consumer need to know? Psychedelics have the potential to transform the way we approach mental health. When used wisely, they can elevate consciousness, heal relationships, and save lives. Yet if the industry prioritizes profit over ethical care, we risk mass malpractice and resultant legislative and regulatory constraints.

And how is a vulnerable prospective patient supposed to navigate the potential dangers of an unstable industry prioritizing conversions over care? I spoke to Dr. Reid Robinson, Numinus’ Chief Clinical Officer, to get a better understanding of how to be a better informed consumer. Robinson explained that it’s important to first understand the three types of ketamine experiences available to the public: “Psychedelic” (aka ‘mind manifesting’): ketamine is given, often by injection but can be administrated via other methods (i.

e. sublingual or intranasal, at the right doses for the individual), with preparation beforehand and integration after. The dosing day usually involves eye shades, headphones with music, and a supported setting for the journey.

“Psycholytic” (aka ‘mind loosening’): a low dose of ketamine is given (usually via lozenge) before a talk therapy session to facilitate openness, perspective and insight during the session. “Psychiatric”: ketamine and esketamine (Spravato) are given as fast-acting interventions” for treatment-resistant depression, or depression with suicidality. The ketamine is meant to be a bridge to other treatments (such as talk therapy or even longer term medications if needed), that can help people in a time of crisis.

In this case, Dr. Robinson emphasizes the importance of involving experienced mental health practitioners: “The medicine itself is only part of the equation. ” Look for these “green flags” when selecting a ketamine clinic: Dr.

Robinson echos Dr. Cundari’s concerns and advises looking for clinics with experienced team members, ideally with certified mental health professionals on the team such as psychiatrists, psychotherapists, and psychiatric nurse practitioners. He also recommends looking for clinics offering “ketamine-assisted psychotherapy” (KAP) or “ketamine assisted therapy” (KAT) rather than simply “ketamine infusions.

This implies the clinic has an emphasis on the preparation and integration. He notes most states have databases in which you can look up your healthcare provider to ensure their license is in good standing. .

. . And these “red” ones: Dr.

Robinson cautions against working with clinics offering virtual care, clinics without mental health practitioners on the team, and clinics that do very brief evaluations at the beginning of a course of treatment. Dosing is also important. “At higher doses, ketamine can bring you into a dissociative or anesthetic space and it’s not always workable.

” says Dr. Cundari. “Some people may not remember their experience, which isn’t always constructive.

It is important to start low and go slow. ” Not a magic pill Finally, it’s important to manage expectations when working with ketamine or any other psychedelic medicines. “Ketamine is a tool.

It is not a panacea, it is not a cure-all. Yes, it has potential for deep healing. But there is more to be considered when working with it for healing purposes.

” says Cundari. Listen here to hear my full interview with Numinus founder and CEO Payton Nyquest. Follow me on Twitter or LinkedIn .

Check out my website or some of my other work here . Megan Bruneau Editorial Standards Print Reprints & Permissions.