Ketamine has been shown to be an effective treatment for depression, but experts warn that Instagram ads from clinics offering the drug could lead to viewers taking matters into their own hands.

Sara was scrolling through the usual deluge of food and travel photos on Instagram when a sponsored post made her pause. “Guided Ketamine Therapy,” read the ad from a New York-based company called Mindbloom. “A Psychedelic Experience.”

The slick branding, photos of tastefully decorated therapy spaces and the promise of expanding patients’ “human potential” on Mindbloom’s site immediately piqued Sara’s interest. “It looked like The Wing,” she recalls, “but for ketamine.”

When Sara called Mindbloom for a 15-minute consultation, a specialist told her that ketamine had helped clients with everything from relationship problems to trust issues. However, aside from the hefty cost – up to $1,000 (£750) for four sessions – Sara had other reasons to hesitate: “You know when you buy something off Instagram and it turns out kind of shitty? I didn’t want to do that with, you know, my brain.”

Known primarily as an illicit dissociative party drug, ketamine has been used as a legal anaesthetic since 1970. In 2006, research suggesting it could help to treat severe depression led to a handful of clinics in the US offering the drug off-label. But 2019 marked a turning point in public perception, when a new version of ketamine – “esketamine” – was approved to treat depression in both the US and the UK as a nasal spray.

Most clinics, Mindbloom among them, still opt to use intravenous doses of off-label ketamine over esketamine; the latter is much more expensive, at almost $900 (£684) per session.

Unlike conventional antidepressants, which can take weeks, sometimes months, to have an effect, studies have shown that ketamine can have an enduring impact within hours. At a clinic where around 105 patients were treated with ketamine, between 75 to 80 percent felt better, compared to more traditional medications for depression, which tend to have a 35 to 40 percent success rate.

As the drug garners mainstream acceptance, sponsored adverts for ketamine clinics have been springing up on Instagram and other social media platforms. These appear mainly in the US, where ads for pharmaceuticals are legal and ubiquitous, but also in the UK, from London-based clinic Save Minds, whose sponsored post describes IV ketamine therapy as “The Greatest Discovery in Depression Treatment in Years!”

There’s even a US-based digital agency devoted to marketing the medicinal drug, Ketamine Media, which handles the advertising for clinics including Save Minds.

While ketamine shows significant promise in its potential to help sufferers of depression, experts have raised concerns about the way the drug is being marketed online. They fear that the adverts – many of which emphasise ketamine’s potential for self-improvement – could lead to people self-medicating with the street drug equivalent. The UK has witnessed similar issues with Xanax; teenagers self-medicating their anxiety with the powerful benzodiazepine ended up addicted to the drug.

Nick Hickmott, from drug addiction charity We Are With You, says sponsored ketamine adverts are “extremely dangerous” and could inspire viewers to take matters into their own hands. “Particularly during the pandemic, there’s a lot of self-diagnosis for depression, and these adverts appear like a quick fix,” explains Hickmott.

“Seeing the post from Mindbloom reminded me how granular Instagram’s targeting is,” says Sara, “because this kind of ‘self-growth’ experience is right up my avenue.”

Bobbi, from Canada, says she was shown an ad for Klarisana, a ketamine clinic in Texas, after searching for “side effects of ketamine”. “My friends, who take ketamine recreationally, were in town for a party, so I wanted to find out more,” Bobbi explains.

Similarly, Talya, from Philadelphia, started seeing posts for Mindbloom after searching “microdosing LSD for depression”. She says, “The ad made me think of ketamine as more of a psychedelic, which definitely made me more open to trying it.”

Ads from Mindbloom and Florida-based clinic My Ketamine Home market ketamine as akin to psilocybin – the psychedelic compound in magic mushrooms – in its effects.

“We find that the psychedelic experience is not just a side effect of ketamine,” explains Kabir Ali, My Ketamine Home’s communications director, “it is the main experience.” He claims that it “enables us to look at things from a different lens, which allows insights to surface” – and that even more so than psilocybin, “it is a very productive psychedelic”.

However, experts say that marketing ketamine as a wellness drug or a shroom-like psychedelic is misleading and potentially dangerous.

“We’re not talking CBD-infused pillows, hummus or low concentration THC sweets,” says Harry Sumnall, a Professor in Substance Use at the Public Health Institute. “Ketamine is a very powerful dissociative agent, which has been associated with bladder damage and dependent mental health disorders.”

The concern, according to Sumnall, is that these clinics are selling “the ‘ketamine experience’ under the guise of a treatment”.

In response, Mindbloom’s medical director, Leonardo Vando, says: “It’s truly unfortunate that anyone in psychiatry would view psychedelic medicine practised by responsible and rigorously protocol-driven clinicians as anything but sound, research-backed medicine.”

My Ketamine Home’s medical director, Kazi Hassan, says the organisation exercises a “heavy, three-layered” screening process on patients, to ensure people don’t “use the system just to have a drug experience”.

Save Minds’ clinician, Yadhu Rajalingam, rejects the marketing of ketamine as a psychedelic, blaming looser regulations in the US for adverts which misrepresent the drug. “It’s very important to have the dissociation during treatment for it to have an effect,” he says. “You can’t term it as psychedelic… it can be very scary.”

At Save Minds, patients are given ketamine intravenously. According to Rajalingam, if something was to go wrong, the treatment can be stopped at any time and the patient will be “back to normal within five minutes”.

Mindbloom and My Ketamine Home both offer the drug sublingually (under the tongue) so it can be taken at home, which Kazi Hassan says is just as effective as IV, but much cheaper to administer. Hassan adds that the amount ingested is closely controlled, compared to when ketamine is taken recreationally and the dosage is virtually impossible to monitor – especially if it’s been cut with other substances.

The virtual service offered by American clinics like My Ketamine Home and Mindbloom – where the drug is delivered to a patient’s home in doses and consumed in a guided virtual therapy session – would never be allowed in the UK, say Sumnall and Rajalingam, who stress the importance of in-person clinical support.

While these clinics undoubtedly offer a professional service, as Nick Hickmott points out, “Not even 1 percent of the population are going to be able to get their hands on this treatment.” My Ketamine Home costs $1,150 (£880) for six sessions, while Save Minds charges £590 per session (esketamine is currently not available on the NHS).

“This leaves the vast majority of people who have seen these adverts with a [ketamine] black market, which comes with its own dangers,” he adds.

Asked if there is any danger of Instagram adverts inadvertently promoting the use of street ketamine, Mindbloom’s medical director Leonardo Vando says: “Our clients are taking medicine from a licensed pharmacy that was prescribed by a licensed clinician. Taking a street drug is an entirely different equation.”

Kabir Ali agrees, saying: “There is an extreme contrast between what we offer and the illicit version… it is our responsibility to make this clear.” He adds that the hope is to “eventually bring the price even further down, to make ketamine treatment more accessible”.

Save Minds and My Ketamine Home both say the purpose of their ads is to educate people about the benefits of ketamine in a therapeutic context. Similarly, Vando says the aim of Mindbloom’s Instagram campaign is to “destigmatise mental health treatments and promote healthy discussions of mental health in wellness culture”.

“There will always be some abuse,” says Rajalingam, using the example of a morphine prescription for chronic pain leading to heroin addiction. “But, of course, marketing drugs is a very, very fine balance.”

*Names have been changed

Original article at VICE.

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