“Ketamine Prescriptions Surge Amid Concerns Over Safety and Effectiveness”
WASHINGTON — As U.S. doctors scale back their use of opioid painkillers, a new option for hard-to-treat pain is taking root: ketamine, the decades-old surgical drug that is now a trendy psychedelic therapy. Prescriptions for ketamine have soared in recent years, driven by for-profit clinics and telehealth services offering the medication as a treatment for pain, depression, anxiety, and other conditions. However, with limited research on its effectiveness against pain and significant safety and abuse risks, some experts worry that the U.S. may be repeating the mistakes that led to the opioid crisis.
Dr. Padma Gulur, a Duke University pain specialist who is studying ketamine’s use, voiced concerns about the widespread off-label use of the drug without sufficient scientific evidence. In a study she conducted with her colleagues, they found that more than a third of ketamine patients reported significant side effects such as hallucinations, troubling thoughts, and visual disturbances. Additionally, ketamine did not lead to lower rates of opioid prescribing in the months following treatment, contrary to common goals of therapy.
Ketamine, which was approved as an anesthetic for surgery over 50 years ago, is now being used to treat depression and other issues. It can produce psychedelic experiences at lower doses and has gained popularity due to its potential therapeutic effects. However, the drug’s psychological effects and the extent to which they contribute to its therapeutic benefit remain unclear.
The increasing demand for ketamine has caused shortages of manufactured versions, leading to higher sales of compounded ketamine. The drug is primarily prescribed for pain, although the use for depression has been steadily rising. The lack of evidence for many conditions, including back pain, migraines, fibromyalgia, and cancer pain, raises concerns about the hasty prescribing practices and questionable effectiveness of ketamine as a treatment option.
The business model behind ketamine prescriptions is clear: physicians can purchase the drug for a low cost and charge significant fees for treatment. Venture capital investors have contributed to the recent boom in ketamine clinics, and telehealth services have also entered the market, providing remote prescribing and delivery of the drug. The current landscape of ketamine prescriptions has been described as the “wild west” with limited regulation and oversight.
Safety concerns exist regarding the high doses of ketamine causing bladder damage and potential long-term neurological effects. The FDA has warned against compounded versions of ketamine, including lozenges and pills, due to safety concerns and their lack of regulation. However, compounding pharmacies, overseen by state officials rather than the FDA, continue to produce and dispense these versions of the drug.
The FDA has limited leverage over physicians promoting ketamine, and the existing regulations on drug promotion do not apply to them. The lack of regulation and oversight raises concerns about exaggerated or misleading claims made by physicians regarding ketamine’s benefits.
In conclusion, the surge in ketamine prescriptions for pain and other conditions raises concerns about its safety, effectiveness, and potential for abuse. With limited scientific evidence supporting its use and significant side effects observed, experts warn against repeating past mistakes that led to the opioid crisis. The current regulatory landscape surrounding ketamine prescriptions is insufficient, and greater oversight is needed to ensure patient safety and appropriate use of the drug.