quote:

Originally posted by 1s1k:

quote:

Originally posted by mrvmax:
Abusing it by who's standards? It's not FDA approved, it's not a legal pharmaceutical so there are no set doses. So how do you determine @abusing it"? The way he reacted is exactly what numerous others described online when quitting it. Maybe they all just happened to be abusing it as determined by some standard that hadn't been set.

I have no idea how much he was using but he didn't have much money so it couldn't be too excessive. Then again, what is an excessive amount?

If I use it I will use 3-4 grams one hour before lunch and one hour before dinner. That's typically 6-8 grams in a day if I was having a bad pain day. I broke my back 20 years ago and did some spinal cord damage that causes my spinal cord to fire haphazard electrical signals to different parts of my body. It's very intense pain that no pain pill I have ever tried even touches. Even if there was I can't take any type of opiate because it screws up my entire system so bad it's not even worth it. For me Kratom has been a total game changer when I am having one of those days with constant misfiring.

Your buddy will probably not tell you the truth but when I read about people getting into trouble with it they are typically over 50 grams a day or using powerful extracts for several years. You can buy it very cheaply from tested companies online so him not having much money isn't much of a roadblock.

By your standards no one can abuse alcohol or many other things since there are no recommended standards?

I get what you are saying, I have no idea how much he was using but until he told me, I had no idea. We all know about how much alcohol people can consume without it affecting things like speech, eyes, reactions etc. I have no idea how much kratom he could take before it was noticeable.

It’s obvious when some is abusing alcohol, it’s been around for a few years so everyone is familiar I with that. Kratom on the other hand is fairly new and I would guess that many people have never even heard of it.

To reiterate, the intent for starting this thread was medical, not sociological. We should really try to keep the discussion scientific, or maybe it will get locked.

[ETA I see you deleted your post. Thank you.]
[BTW my reply to your PM bounced.]

A relative has recently started Ketamine infusions for chronic pain that was not well controlled by any other medical treatment. So far it has worked well. She also reported that her mental state has improved, whether that was due to no longer being in pain or the Ketamine giving her a “high” I don’t know. This is a medically supervised infusion covered by her insurance.

Matthew Perry’s Death Darkens Ketamine’s Startup Glow
Clinics, online providers prescribe the anesthetic to treat range of mental-health conditions

This Matthew Perry’s death from the effects of ketamine brought new scrutiny to the booming business to prescribe the powerful anesthetic to patients in clinics and online.

Perry was receiving ketamine infusions for depression and anxiety before he was found unresponsive in the pool at his Pacific Palisades, Calif., home on Oct. 28. Drowning, coronary artery disease and effects of buprenorphine, a medication used to treat opioid-use disorder, contributed to his accidental death, the autopsy report released on Friday said.

The high level of ketamine in his blood when he died at 54 years old couldn’t have come from his last known treatment at a clinic a week-and-a-half before his death, the report said. Traces of the drug usually linger in the blood for a few days. It isn’t known whether Perry purchased more ketamine from another provider or the illicit market.

“This really should be a wake-up call that ketamine needs to be used appropriately,” said Dr. Gerard Sanacora, director of Yale University’s depression-research program.

He noted that the Food and Drug Administration’s approval of a version of ketamine for treatment-resistant depression requires that the drug be given under a healthcare professional’s observation in a clinical setting. The treatment approved in 2019 requires follow-up reporting to track adverse events, and it isn’t approved for at-home use.

The FDA didn’t respond to a request for comment.

With safeguards in place, the treatment has been shown to be safe and effective, doctors said. But regulators and doctors have expressed concern over ketamine’s expanding use and the dangers of taking it at home without supervision.


A blister pack of ketamine lozenges. Regulators have expressed concern over the drug’s expanding use. PHOTO: COLE BURSTON/AGENCE FRANCE-PRESSE/GETTY IMAGES
“It’s still a very risky drug to use without the proper procedures,” Sanacora said.

Ketamine has been used in hospitals and clinics for decades to numb people during surgeries. It is also a common party drug, nicknamed Special K, that has hallucinogenic properties and creates an out-of-body feeling.

Clinics have opened across the country to administer it off-label to treat severe depression, other mental-health conditions and chronic pain. Researchers are studying whether ketamine could help treat substance-use disorders and doctors sometimes prescribe it for that purpose. Others don’t prescribe it to people with a history of addiction.



Online providers started prescribing the drug for home use during the Covid-19 pandemic, thanks to relaxed federal rules on remote prescription. Also, telehealth providers can advertise drugs in ways many pharmaceutical companies can’t. Ads by Mindbloom, one online ketamine provider, have noted that ketamine has “minimal side effects” without listing them, and claimed that ketamine works more effectively than antidepressants.

Mindbloom said its ketamine treatment has helped thousands of people with depression and that its safeguards include monitoring during sessions. It didn’t comment on its advertising but in the past has said its ads comply with all applicable regulations.

Safety concerns with ketamine include increases in blood pressure, respiratory depression and bladder problems, according to the FDA. People can also get into accidents if taking the drug unsupervised, doctors said.

Ketamine clinics often use intravenous infusions or injections and have medical staff monitor patients during treatment. At home, patients use oral lozenges or nasal sprays. The FDA has warned about the use of compounded ketamine, including lozenges and sprays. Its warnings in 2022 and this October said the lack of monitoring when the drug is prescribed online and used at home puts patients at risk.

The FDA said in October that it had received a report of a patient in April 2023 who had slowed breathing after taking oral ketamine to treat post-traumatic stress disorder outside a clinical setting. The level of ketamine in the patient’s blood appeared to be twice the level usually used for anesthesia.


Peak Health Global, an online ketamine provider, closed in late 2022. PHOTO: TARA PIXLEY FOR THE WALL STREET JOURNAL
Mindbloom and other online providers often instruct patients to have someone monitor them at home while they take the drug.

The American Society of Ketamine Physicians, Psychotherapists and Practitioners said it is working on ethical and scientific standards for providers to use, including for at-home prescribing, and educating on best practices.

“While the evidence of its efficacy is overwhelming, ketamine as a mental-health treatment is still off-label and unregulated,” Dr. Sandhya Prashad, the group’s president, said earlier this month. “This has created a ‘Wild West’ dynamic.”

At the Cleveland Clinic, doctors are working to standardize ketamine dosages, said Dr. Pavan Tankha, an anesthesiologist who has been prescribing it for a decade to patients suffering chronic pain.

“We owe it to them to monitor them closely to make sure it’s safe,” Tankha said.

Tracy Hawse worked as a clinician for Peak Health Global, an online ketamine provider that closed in late 2022. She said some patients who had previously used online providers including Mindbloom had been taking larger doses than Peak would normally prescribe.

Peak providers sometimes continued the higher doses until the company brought in a doctor, who stopped that practice.

“He had to rein us in and make sure doses didn’t go above a certain amount,” Hawse said.

Former Peak leaders didn’t respond to requests for comment.


Ketamine clinics often use intravenous infusions or injections, and the medical staff monitors patients during treatment. PHOTO: TARA PIXLEY FOR THE WALL STREET JOURNAL
Write to Rolfe Winkler at Rolfe.Winkler@wsj.com and Brianna Abbott at brianna.abbott@wsj.com

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This will have no more of an effect on legitimate ketamine use than Michael Jackson's death did on propofol. It has nothing to do with the drug and everything to do with the druggie.

Irresponsible drug use always catches up to the user, in one way or another.

Other than Michael Jackson and some physicians, I have never seen people with Diprovan addiction.
I do think that regular folks will probably think twice before using ketamine to treat depression.

quote:

Originally posted by ZSMICHAEL:
Other than Michael Jackson and some physicians, I have never seen people with Diprovan addiction.
I do think that regular folks will probably think twice before using ketamine to treat depression.

To me treating an addict with drugs that make you feel good enough that people love to use them recreationally seems like a terrible idea.

^^^^^^^^^
Yep. Expect to see some lawsuits here.

quote:

Originally posted by 1s1k:
To me treating an addict with drugs that make you feel good enough that people love to use them recreationally seems like a terrible idea.

I keep seeing alcoholics who got lured into psilocybin "micodosing" relapse once they say "fuck it" and have a few good trips. I'm right there with you.