Ketamine becomes new option for pain treatment

Prescriptions for the mind-altering drug have soared

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 forprofit clinics and telehealth services offering the medication as a treatment for pain, depression, anxiety and other conditions. The generic drug can be purchased cheaply and prescribed by most physicians and some nurses, regardless of their training.

With limited research on its effectiveness against

pain, some experts worry the U.S. may be repeating mistakes that gave rise to the opioid crisis: overprescribing a questionable drug that carries significant safety and abuse risks.

“There's a paucity of options for pain and so there's a tendency to just grab the next thing that can make a difference,” said Dr. Padma Gulur, a Duke University

pain specialist who is studying ketamine's use. “A medical journal will publish a few papers saying, `Oh, look, this is doing good things,' and then there's rampant off-label use, without necessarily the science behind it.”

When Gulur and her colleagues tracked 300 patients receiving ketamine at Duke, more than a third of them reported significant side effects that required professional attention, such as hallucinations, troubling thoughts and visual disturbances.

Ketamine also didn't result in lower rates of opioid prescribing in the months following treatment, a common goal of therapy, according to Gulur.

Her research is under review for medical journal publication.

Ketamine was approved more than 50 years ago as a powerful anesthetic for patients undergoing surgery. At lower doses, it can produce psychedelic, outof-body experiences, which made it a popular club drug in the 1990s.

With its recent adoption for pain, patients are increasingly encountering those same effects.

Daniel Bass, of Southgate, Kentucky, found the visual disturbances “horrifying.” His doctors prescribed

PHOTOS BY MATT KELLEY — THE ASSOCIATED PRESS Equipment used to customize ketamine infusions is seen at the Duke Specialty Infusion Center. Ketamine was approved more than 50years ago as an anesthetic for surgery. At lower doses, it can produce psychedelic, out-of-body experiences.

Dr. Padma Gulur, a Duke University pain specialist, says more than a third of ketamine users who were tracked for a study reported significant side effects.