Part #1 - Therapeutic Ketamine
In the summer of 2022, I visited a renowned Psychedelic therapy center in Beverly Hills to explore Ketamine therapy. I did not have a good experience.
The center itself was exactly as one might imagine for being situated in a posh neighborhood: adorned with vintage furniture, a koi pond, and trendy artwork lining the walls. My consultation took place in an upstairs room where two psychotherapists interviewed me about my past traumas. Needless to say, I passed with flying colors. However, the questions were so banal I am curious what it would take to fail and not be prescribed Ketamine. Considering the cost of $500 per session and the suggested six sessions, it's clear that financial incentives play a significant role in their operations. This is a systemic issue, not a reflection on the kindness & professionalism of the individual therapists I met.
I arrived for my appointment and, after a short wait in the family room area of the center — a converted residential-style house — I was escorted upstairs. There, I lay down on a couch and was connected to an IV. The effects of the Ketamine were immediate.
I delayed doing a trip report on my experience with therapeutic ketamine because frankly, there’s not much to share. The experience felt more like anesthesia than any Psychedelic journey I've undertaken. Shortly after receiving the IV, I remember merely floating through an immense darkness of space, a stark contrast to the colorful sacred geometry that typifies a Psychedelic voyage. There were no vivid images from my childhood, nor were there any revisitations of past traumas — a notable aspect often associated with Ketamine therapy. It was just an expanse of blackness.
The most notable part of the experience occurred when the attending therapist woke me up. Still bewildered as the effects of the medication gradually subsided, I asked her, "How long was I out, ten, fifteen minutes?" To which she responded, "No, 45." It's conceivable that I confronted some inner demons during this subdued state; however, if that happened, I have no memory of it. And without any recollection, integrating the experience becomes impossible.
After getting back home, I tried to watch a movie but was overwhelmed by fatigue (even though it was only around 5 pm) and ended up sleeping for 13 hours. The next day, I was left feeling groggy. One of the main reasons I stopped drinking alcohol wasn't because I disliked being drunk, but rather because I couldn't stand the hangovers. The day after the Ketamine therapy bore an uncomfortable resemblance to a hangover. Similarly, MDMA induces a next-day comedown, but the payoff is significantly more rewarding and thus worth it for me. Consequently, I decided to cancel my upcoming appointments, concluding that Ketamine therapy was not suitable for me.
Part #2: Recreational Ketamine
The next summer, while relaxing by the pool, a friend suggested I try Ketamine again. Given my lackluster initial encounter, I was hesitant, but I also knew the importance of set & setting. I wondered if a more casual, recreational context might reveal the appeal I had missed.
Recreational use of Ketamine typically involves insufflation. Having begun my career in NYC as a stockbroker, I thought my days of snorting substances were well in the past. Yet, much like the immediate effect of the IV-administered Ketamine, its impact was instant when insufflated, albeit in a much subtler manner.
Recreational Ketamine presented as an unusual blend reminiscent of low doses of Psilocybin, MDMA, and LSD. The sensation was unsteady, akin to experiencing the effects of multiple substances simultaneously. Making sense of it proved challenging. At moments, it was intensely Psychedelic; the pool transformed into a luminous shade of blue, allowing me to perceive every ripple in the water. However, these visual distortions were fleeting, soon replaced by bursts of energy that echoed MDMA's vitality. There were instances when the Ketamine seemed to act as an aphrodisiac, but this too was transient. The rapid shifts in mood, energy, and sensory perception prevented me from fully immersing in the experience.
The entire episode spanned roughly twenty minutes. Uncertain of my feelings towards it, I insufflated another dose to determine if a higher quantity would anchor the experience. It did not; it merely prolonged the sensations. To this day, I question why someone would choose Ketamine over, for example, a microdose of Psilocybin or MDMA. The former failed to spark any deep insights, joy, bliss, or shifts in perspective. Overall, it was a peculiar experience, yet undeniably intriguing.
Part #3 - The War on Drugs
Whenever I've expressed skepticism about Ketamine, I've been met with an outpouring of messages challenging my views, extolling its virtues, and highlighting its therapeutic benefits as a godsend. I don't deny any of those claims. Having reviewed the research, there indeed appears to be a strong evidence-based case for the positive effects of Ketamine.
Additionally, I have consistently advocated for the legalization of all drugs. A society that does not have sovereignty over its own consciousness is not free. My critique, however, is the government is ostensibly anointing Ketamine a winner by making it the most easily legally accessible.
To illustrate my point further — imagine you had the option to visit a therapy center and safely use one of the following Psychedelics under the guidance of a facilitator:
Psilocybin
Ketamine
MDMA
I believe this proves my point. While some might opt for Ketamine, the proliferation of Ketamine clinics, reminiscent of Starbucks' expansion in the 90s, isn't driven by a widespread preference for Ketamine. Instead, it's largely due to the relatively simple process by which individuals with a therapy license can open a Ketamine clinic, thus tapping into a lucrative market. However, Ketamine poses greater risks than Psilocybin and, for many, proves less effective than MDMA. This situation highlights the fallacy of the war on drugs. Humans are all pleasure-seekers & we will opt for whatever drug is most accessible.
In "Chasing the Scream," Johann Hari presents a compelling critique of the war on drugs. He draws an analogy that sheds light on the current situation with Ketamine, using college football games as an example. Every fall, stadiums fill with tens of thousands of students eager to support their teams. With many students underage, the sale of alcohol is prohibited in these venues. But do these 80,000 students forgo alcohol? Far from it. Instead, they smuggle in miniature bottles, consuming an unknown quantity. The scenario would be significantly safer if they could openly purchase and consume a beer or two. In this context, Ketamine has emerged as the societal equivalent of those concealed airplane bottles, thriving in a culture that maintains the illegality of certain Psychedelics.
The way we frame this conversation perpetuates the illegality of these substances. The prevailing argument is structured as follows: "Making X legal means more individuals will engage in using X." This assertion has been reiterated ad nauseam by even the most logical minds. I acknowledge that legalizing X might lead to an increase in its usage. However, the crucial point is that legalizing X could deter people from engaging with Y, which is beneficial if Y poses a greater risk than X. The prohibition or restriction of a substance does not alter human inclinations or behavior, underscoring the argument for the legalization of all drugs. Legalization allows for regulated, tested, and taxed frameworks. Implementing sensible regulations, such as DUI laws, age restrictions, and screenings for pre-existing mental health conditions, should accompany this shift towards legalization. Ultimately, legalization paves the way for harm reduction.
The growing popularity of Ketamine underscores humanity's unrelenting quest for pleasure. Reflecting on the words of the late Matthew Perry, who tragically passed away under the influence of Ketamine among other substances, "reality is an acquired taste." This poignant statement highlights a truth about human nature: there has been a long history of experimenting with mind-altering substances. It's crucial that we acknowledge this enduring aspect of human behavior and develop policies grounded in reality rather than in absurdity.
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Great topic. My first therapeutic Ketamine experience was quite a bit like what you describe. I did finish the sequence of six, and do have a more positive view of the substance than you seem to, but I agree, it's an odd "trip." And I would probably prefer the other substances that you offer up as choices in your thought experiment. So what I agree most about here is that it is not clear at all to me why Ketamine seems to be winning the legalization race.