At help clinic: ‘I saw God’
Ketamine increasingly used to treat severe depression and PTSD
ALBANY — The effects of the infusion were immediate for Faline O’Bannion. The 39-yearold’s husband even told her that her voice had changed.
The Ithaca resident started visiting ketamine infusion clinics in 2020 in Rochester and Syracuse, and now travels to Albany for maintenance sessions.
O’Bannion has struggled with mood disorders since she was 14. Recently, her bipolar symptoms and obsessive compulsive disorder became debilitating, forcing her to quit a career as a paralegal.
Ketamine has changed her life, O’Bannion said.
“Before the treatment, I felt that I was depression — that’s all there was to me. Now I can feel that the depression is separate from who I am. It’s not my entire being.”
While ketamine has a history of use in hospital settings as an analgesic and a nasal-spray form of the drug won U.S. Food and Drug Administration approval in 2019 for use in treatmentresistant depression, ketamine infusion clinics and wellness centers take advantage of a federal loophole that allows off-label use of FDA-approved drugs. Facilities have proliferated across the country in recent years, including in New York.
Known in its illicit form as “special K,” ketamine is a dissociative drug that can provide rapid and effective relief for severe depression, pain and PTSD, studies show.
In the Capital Region, Dr. Philip Hansen — an Albany Med-trained anesthesiologist — has been administering ketamine infusions since 2018, drawing patients like O’Bannion from across the state.
Ketamine is billed as an al
ternative mental health treatment at a time proponents argue the traditional mental health infrastructure is failing. But critics say there is a danger of misuse and the industry should be better regulated.
Its rise coincides with a burgeoning movement in the U.S. to legalize psychedelics like magic mushrooms and LSD for medicinal purposes. Both substances have long been classified by the FDA as Schedule I drugs, which indicates that there are no therapeutic uses for them and there is a high risk of misuse.
Ketamine is classified as a Schedule III drug, making it a controlled substance presumed to have fewer risks. It is not considered a psychedelic, although experts say it can have psychedelic effects.
It is used intravenously in hospital emergency rooms for instant pain relief, especially in pediatric patients with broken bones that require setting.
Before starting his practice, Albany Ketamine Infusions, Hansen trained for two years under Dr. Glen Brooks, an early practitioner of ketamine infusion therapy, who has tried to standardize the treatment.
Hansen had some early challenges with a former business partner and initially encountered skepticism from the medical establishment.
“At that time, most of the people who were doing it were anesthesiologists ... we knew the ins and outs of ketamine and the proper dosages,” Hansen said. “Psychiatrists pooh-poohed it and would discourage patients from trying it, because it had a reputation as a horse tranquilizer and a street drug.”
The drug gained acceptance in the mental health sector in 2019, when the FDA approved Spravato, a nasal spray for treatmentresistant depression that contains esketamine, a derivative of ketamine.
Now many of those skeptical doctors are prescribing Spravato, Hansen said.
By early 2021, the calls were rolling in. Hansen recently moved his practice to a larger location in Colonie and has hired an on-site licensed mental health counselor.
Ketamine used therapeutically is not like the version available on the street, known for producing a “k-hole,” a ketamine effect that immobilizes the user for several hours, according to Hansen. Street drugs also tend to be mixed with other substances like MDMA, amphetamine or cocaine.
Patients may experience disassociation or believe they have died, but they can reframe those feelings with the help of a counselor, according to Hansen.
“They can turn it around and think, ‘yes, I died and came back and now I’m really able to embrace life,’” he said.
Hansen’s clients range from military veterans to teenagers who have attempted suicide. Many are referrals from local
“At that time, most of the people who were doing it were anesthesiologists ... we knew the ins and outs of ketamine and the proper dosages. Psychiatrists pooh-poohed it and would discourage patients from trying it, because it had a reputation as a horse tranquilizer and a street drug.”
— Dr. Philip Hansen
psychiatrists and facilities that treat mental health disorders like Four Winds and Ellis Hospital.
Hansen also accepts walk-ins who have already tried traditional therapy and medication, according to Kemi Campbell, who manages the clinic.
“We don’t promote escapism,” Campbell said. “You would have to have a diagnosis. We have turned maybe 300 patients away in the last year.”
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Donna Smith, a 62year-old from Stormville, who sees Hansen for chronic pain and severe depression, said her first infusion felt like a neardeath experience, but it transformed her.
“I saw God, I saw my loved ones and I was reassured that everything was going to be OK,” Smith said. “Unfortunately, I can’t seem to get to that level again, but I felt so loved ... I was feeling very unloved. I didn’t even love myself.”
Smith said the isolation of the pandemic sent her spiraling into a despair that had her sleeping for days. She was forgetting things and was checked for Alzheimer’s. After each ketamine treatment, she became joyful and her sharpness returned, Smith said.
“If it wasn’t for Dr. Hansen, I probably would have said goodbye to this world,” Smith said.
Not all ketamine experiences are easy. The sessions can be intense as suppressed memories are reactivated, according to Campbell.
“There is crying involved,
there is screaming involved. There are people who see dead relatives. We’ve had rape victims,” she said. “We don’t send anyone home unless they have a ride and they are emotionally OK. We have plenty of relaxation rooms. We have had people stay for lunch.”
Hansen and his staff work with patients on intention setting, select soothing music to accompany the experience, and offer after-care sessions with the counselor at an additional cost.
Some experts have voiced concern that many ketamine providers, which now include wellness centers and online vendors, are not providing adequate follow-up.
During the COVID -19 health crisis, federal regulations were relaxed to enable prescriptions of the drug without an inperson visit to a doctor. This led to a boom in online ketamine providers like Mindbloom, a ketamine subscription service that sends customers a Bloombox containing “everything you need to complete your ketamine treatment from home.”
Subscribers receive ketamine lozenges that are dissolved under the tongue, detailed instructions and have access to teletherapy sessions.
According to Joshua White, founder and executive
director of Fireside Project, which operates a hotline for people struggling to process experiences with psychedelics and other alternative treatments, the hotline has seen a surge in calls about ketamine in the last two years.
To be successful, ketamine requires intention setting and hard work — with most of the work beginning after the treatment, White said. Yet, many providers don’t provide after-care, or provide it at an additional cost.
“Ketamine can cause deep and powerful emotions and traumas to surface,”
White said. “It’s essential that clinics provide patients with robust opportunities to process and integrate whatever has arisen for them. Just as stitches and physical therapy are an essential part of many surgeries, so too is integration a critical part of a ketamine experience.”
The absence of posttreatment counseling reduces the likelihood that the patient will heal, White said.
Ketamine therapy is not cheap. At Hansen’s clinic, it costs about $400 for an hourlong session. Time with the therapist is an additional $100 per hour, though it is sometimes covered by insurance.
Six sessions over the course of a month are recommended for maximum efficacy, according to Hansen. The effects also tend to wear off and most patients will require monthly ketamine boosters.
O’Bannion and Smith said the cost of treatment has been a significant source of stress. For O’Bannion, the price has caused her to delay booster treatments, which has resulted in waves of depression.
Smith said she stopped seeing her regular therapist in order to pay for the infusions.
“I had to find the money,” she said. “I didn’t care how broke I became. I stopped shopping, I stopped everything.”
Hansen said he works with patients on cost by providing prescriptions for less-potent Spravato and at-home treatments that may be covered by health insurance.
For pain management, Smith said she takes daily at-home ketamine tablets that are partially covered by her insurance.
Ketamine is not for everyone, Hansen said. It’s not recommended for people with schizophrenia or seizure disorders. Hansen also won’t treat someone who is addicted to drugs or actively suicidal.
“It’s not a crisis center,” he said. “Those patients need proper care and should be going to the hospital.”
Some Type A personality types may also struggle with ketamine infusion, according to Hansen.
“People who are very anxious and can’t handle the feeling that your body is not quite your own — it intensifies their anxiety. Those are the people I weed out,” Hansen said. “There is a certain buy-in with the treatment ... you have to understand that this is what’s going to happen and it’s for the good.”
Ketamine can cause deep and powerful emotions and traumas to surface.”
— Joshua White