Ketamine is a dissociative drug, meaning that it produces feelings of dissociation – dissociation from one’s environment and even dissociation from one’s own body. The drug is used in human and veterinary medicine, both as an anaesthetic (to knock the patient out) and as an analgesic (to numb any feelings of pain). Ketamine is also used recreationally in many different contexts. It can be used in small doses to create stimulant effects, and in this way will be used in clubs and at festivals. But many users like to up the dosage in order to fully appreciate ketamine’s dissociative effects. In higher doses, the drug can cause intense hallucinations, and at sufficiently high doses it can cause mystical experiences, such as the separation of mind and body, a loss of ego, and the effects of a near-death experience. This high-dose realm is usually referred to as a “k-hole”.
Some scientists have studied the effects of ketamine and noted that it can actually be quite useful in the context of therapy. Dr Karl Jansen, a psychiatrist based in London, details this potential of the drug in his book, Ketamine: Dreams and Realities. He describes the work of the Russian psychiatrist Evgeny Krupitsky who has given ketamine to over 1,000 patients in order to treat their alcohol addiction. He has called this form of treatment, ketamine psychedelic therapy (KPT).
The treatment has also been extended to cases of heroin addiction and for patients suffering from PTSD. The results have been promising. In the case of those suffering from alcohol dependency, after the KPT, 66% of the group were sober, which is a huge success. When tests were given to determine personality changes, there were significant reductions in levels of anxiety and depression, two mental states which plague those who are addicted to alcohol and trying to give it up.
The treatment has also found that there was an association between long-term sobriety and how negative the ketamine experience was. The more negative the experience, the longer the sobriety. This is due to the fact that during the experience, the horrors of alcohol addiction were stamped into the deepest levels of the mind. These levels of the mind are usually defended, so that the alcoholic is unaware of the harm they are actually doing to themselves. Personality tests revealed that after the treatment, there was a shift in values towards creativity, self-improvement, independence, and an improvement in family and social life. This suggests that ketamine not only helps people overcome negativity in their life but that it can promote positivity as well.
Dr Karl Jansen argues that ketamine can be useful in a therapeutic context because it, like many other drugs with psychedelic effects, can produce altered states of consciousness. According to Jansen, any non-harmful change in our consciousness can be beneficial because it can allow parts of our mind to communicate to each other. Jansen seems to be following in the footsteps of the psychiatrist Carl G. Jung, who believed that mental health problems result from “inner conflicts” in the mind. To overcome these conflicts, mental barriers must be broken down, and the different parts of the mind need to come together to produce a “whole” – he called this process individuation.
Jansen notes that an altered state of consciousness is the most beneficial when the experience is new. In the study on alcoholism in St. Petersburg in Russia, the treatment was found to be effective because the ketamine experience was new, and therefore especially powerful and meaningful. A heavy ketamine user would not get the same benefit from the treatment; first of all, because they would have a tolerance, but also because the experience would almost be like a “normal” state to them. Dr Rick Strassman, in DMT: The Spirit Molecule, found that those who had the most enlightening experiences with DMT had little to no experience with psychedelic drugs.
The famous ketamine psychonaut, John C. Lilly was first given ketamine by Dr Craig Enright in the late 1960s. Lilly was suffering from migraines at the time and was trying ketamine in this instance to get rid of them. Dr Enright gave Lilly an initial dose of 35mg, then 75mg, and finally 150mg of ketamine – then soon after the final dose, Lilly said he could literally feel the pain leaving his head. From that point on, Lilly never suffered from a migraine again. Ketamine has since been studied as an effective treatment for chronic migraines. After Lilly experienced this miraculous cure, he would then start regularly using ketamine as a tool for studying “inner space” and all the metaphysical, spiritual and epistemological conclusions that followed from that. Some argue, however, that at this point Lilly formed an abusive relationship the drug – that he was addicted to it (it is psychologically addictive) and that he was losing his sanity. Lilly nearly drowned in his hot tub whilst on ketamine, and he also became convinced that extra-dimensional entities were watching over and controlling his life. This goes to show that if ketamine is to be used properly in a therapeutic setting, it has to be a controlled and safe setting, always with the patient’s mental well-being in mind.
As I mentioned earlier, ketamine can result in an experience similar to a near-death experience. It has long been noticed that a near-death experience can produce significant changes in someone’s life, often giving them a positive outlook on things when the experience is over. For example, people who attempt to commit suicide are at a high risk of trying it again; whereas those who attempt it, but who have had a near-death experience as well, are not likely to attempt it again. This suggests that artificially creating a near-death experience, in a safe setting, could have some clear benefits to a patient.
In the 50s, the psychiatrist Alberto Fontana Y Col used ketamine and drugs such as LSD, mescaline, and psilocybin, in a therapeutic context. He was not only interested in inducing a near-death experience, but a “re-birth” or “near-birth” experience as well. This feeling of returning to the womb, he argued, was extremely effective in treating depression and anxiety. What he also found was that it was much easier to achieve this “return to the womb” by using ketamine, which made it a superior drug in this sense to the classic psychedelics. This form of treatment was dubbed “death-rebirth psychotherapy”.
Kruptisky’s team in Russia found that if the patient smelled alcohol during a near-death experience, then they would associate alcohol with feelings of death and dying, therefore putting them off the substance. This would also imprint the desire for sobriety deep in the unconscious mind. More recent evidence and studies are now suggesting that ketamine might be the most effective way to relieve the symptoms of depression. After decades’ worth of research, scientists from the Yale School of Medicine published their results in the journal Science. Their conclusion was that small amounts of the drug can immediately relieve the symptoms of chronic depression. What is striking is that this effect of the drug holds true even in patients who have been described as “treatment-resistant”. These findings are consistent with earlier research from 2010 which showed that ketamine can rapidly relieve depression in those suffering from bipolar disorder – these are also patients who have been described as being immune to all treatment.
These kinds of studies are exciting because as it stands, standard anti-depressants can take months to show any signs of causing an improvement in a patient. In addition, one out of three patients who use anti-depressants will receive absolutely no benefit from them at all. Professor of psychiatry Ronald Duman has said that “The rapid therapeutic response of ketamine in treatment-resistant patients is the biggest breakthrough in depression research in a half century”. Scientists understand that one of the physical causes of depression is a weakening of the synapses (or connections) in the brain.
Duman and his colleagues have found that ketamine activates the release of a neurotransmitter called glutamate, and glutamate stimulates the growth of synapses. The Yale researchers have said that one dose of ketamine can, within a matter of hours, fix the synaptic damage associated with depression. It is a shame, however, that ketamine is not seriously being considered as a better alternative to anti-depressants such as Prozac. This is probably due to two reasons: the first being that ketamine is illegal; the second being that ketamine cannot be patented, and therefore profited from, by the pharmaceutical industry.