Ketamine therapy clinics have been popping up across Chicago as research redefines the uses of the sedative.

Judy Seals, a nurse practitioner with years of experience, learned about the transformative powers of ketamine — known as “Special K” to the typical recreational user — at a Halloween party in 2017. Seals learned that the substance was being used to treat mental illnesses in licensed clinics.

“I actually did not know much about ketamine,” Seals said. “In cardiology, we just don’t use it very much … Once I learned that it was being used for a mental illness and had lots of success with that, I was definitely very intrigued by it.”

After learning about the benefits of ketamine therapy, Seals felt compelled to bring her medical expertise to the practice. She left her 17 years of experience in cardiology to work at Field Trip Health in River North, where patients are administered the drug in a clinical setting to help treat mental health issues.

“I’m actually still caring for hearts, but in a different way,” Seals said.

From Taboo to Treatment  

A few years ago, ketamine had two known identities – a drug mainly used in the veterinary and medical field as an anesthetic, or an illegal party drug that provided a euphoric and slightly hallucinogenic effect. However, studies have shown that it can greatly reduce, if not eliminate, debilitating mental illnesses like generalized anxiety disorder, major depressive disorder, PTSD, social anxiety and many more.

If you’ve noticed ketamine clinics popping up around the city, it’s because the previously unorthodox treatment is now mainstream. According to Seals, ketamine is especially helpful to those with long histories of mental illness and psychiatric treatment.

The use of hallucinogenic or euphoric substances to treat mental illnesses is by no means a new concept. Indigenous civilizations around the globe have extensive histories of implementing psychoactive plants and other natural substances as medicine.

For decades, hallucinogen enthusiasts have been trying to get psilocybin, better known as “shrooms” or “magic mushrooms,” regulated by the FDA. The first state to successfully legalize psilocybin was Oregon, which allowed the psychedelic for therapeutic use.

Although ketamine is synthetic, it still produces a high that is similar to naturally occurring psychedelics. According to the DEA, ketamine is referred to as a “dissociative anesthetic,” as it “makes patients feel detached from their pain and environment.” This is different from other commercially produced and abused painkillers like fentanyl, morphine or hydrocodone, which obstruct the brain’s ability to feel and process pain.

A study reported in the British Journal of Psychiatry Open shows overwhelmingly positive data to support the idea that ketamine infusions administered by IV greatly relieved depression. There was a mass reduction of unipolar depression, or major depression, that took effect within 1-24 hours and lasted 1-2 weeks. Bipolar depression relief occurred within 4 hours of the IV administration and lasted up to 7 days. The study also noted that ketamine should be administered in clinical settings so that heart rate and blood pressure can be monitored.

Possible side effects of ketamine infusion may cause high blood pressure, nausea and vomiting, perceptual disturbances, visual hallucinations and out-of-body experiences.

While doses of ketamine given for mental health treatment are much lower compared to usual doses of anesthesia, it’s worth noting that similar to opioids, ketamine has addictive properties. People who have a history of substance abuse are advised to consult with a doctor before considering ketamine therapy.

The Trip 

Abdullah Saeed shares his experience during an intravenous (IV) ketamine-infusion therapy session for Vice Tonic. According to his experience, it feels as if you were watching your life as a movie. You’re the main character being swayed from left to right from all the events that are happening. You’re in the audience and judge every aspect of it without any emotional reaction.

“The realization that I’m having on (ketamine) is that emotion does not have physicality in the world,” said Saheed during the peak of his infusion, which he received to treat PTSD. “There is a distinct difference between what is tangible and what is intangible.”

Needless to say, that’s one possible outcome.

With scientific evidence to back up the claims, major clinics have been opening offices all over the country to provide ketamine assisted psychotherapy. Seals works as the clinic manager at Field Trip Health, which takes a multi-component approach to the ketamine therapy process. On their website, they break it down as “preparation, psychedelic exploration, and integration therapy.”

Psilocybin and lysergic acid diethylamide (LSD), have many testimonials of greatly lessening the symptoms of major depression, anxiety or PTSD, but where ketamine has a leg up on these drugs is that it is already legal for medical use. Ketamine has been used in high doses as an anesthetic to reduce pain during major medical procedures for decades, but as doctors would later find, in smaller doses, ketamine succeeds in doing what a lot of antidepressant and anxiety medications have failed to do.

“Ketamine doesn’t cure the mental illness and I wouldn’t even say that it makes it more tolerable,” Seals said. “… [I]t’s really more than just making it tolerable. It’s life changing, and we’ve heard that a lot from our patients.”

According to Seals, patients are coming to Field Trip Health after they’ve exhausted all their resources. Seals says that many patients arrive suffering with severe symptoms but leave the program with minimal to mild symptoms.

Tracie Mathewes is a fitness instructor and business owner from Charleston, South Carolina. She loves to dance and partake in self care. Matthews started taking prescription ketamine and oxytocin nasal spray in 2021 and now experiences less anxiety.

“Ketamine detaches me away from that obvious stress in my life, day-to-day, and allows me to relax,” she said. “I’m much more creative, I’m a better trainer. I think outside of the box more and it just feels like I’m focusing on the good things and not the bad things.”

Field Trip Health 

Field Trip administers the ketamine therapy through an injection rather than an infusion using intravenous ketamine.

“You’re getting an injection in your arm, kind of like the flu shot,” Seals said.

The process of administering ketamine can be daunting, but Field Trip Health has an intensive process that helps the patient get accustomed to the treatment. The journey starts with a consultation with a psychiatric nurse practitioner or psychiatrist.

If the candidate is determined to be a good fit, the patient will then go through the necessary steps to get medical clearance before their psychotherapy intake with a therapist. During this intake, it gives the patient and the therapist the opportunity to build a rapport and develop a therapeutic relationship while also going over the goals for the treatment. Due to COVID restrictions, the one-hour intake appointment is virtual at this time.

The next step is the preparation session which goes over what to expect on the day of the treatment such as logistics and intentions to further build rapport. This also helps the therapist access the patient’s readiness for change. Goals are individualized and depending on the program, the preparation session can take anywhere from 30 minutes to an hour.

The first in-person visit is the ketamine administration session. The patient can expect to be in the clinic for about two and a half hours. The patient will check in with their therapist 15 to 20 minutes before the treatment. When the patient is ready, the ketamine will be administered by injection and the journey can last anywhere from thirty minutes to an hour.

“Ketamine can make some patients feel great and a lot of experiences and journeys are very pleasant,” said Seals. “But sometimes there are some challenging journeys that occur where repressed memories and challenges that patients suffer with can resurface.”

The patient will be kept under observation throughout the entire session such as monitoring the body’s vital signs. Depending on what program the patient is doing, there may be a therapist in the room with them. The therapist will use talk therapy after administering the ketamine to help provide lasting effects to the patients. If a therapist is not in the room, staff will continue to watch the patient through cameras installed in the room.

“You’ll have a therapist that’s there with you for your journey, and to help you process and make sense of what you’ve experienced during your journey,” Seals said. “Knowing that there’s going to be someone there to talk to afterwards really helps to relieve a lot of patient’s anxiety.”

When the patient returns back from their journey, a therapist will meet with them for about 20-30 minutes to briefly unpack what they experienced. For every two ketamine sessions, a one-hour integration therapy session will follow, typically on the following day.

“There’s a saying that ketamine doesn’t always give you what you want, but it gives you what you need,” Seals said.

With locations currently in Toronto, New York, Chicago, Atlanta, Houston, San Diego, and more, companies like Field Trip Health are multiplying by the minute. However, with prices ranging from $350 to $2,000 per treatment at varying clinics, is this something that will become more affordable to the masses?

“I hope insurance will cover it because it is such a big breakthrough in the treatment of depression, especially for those who are treatment resistant,” said Seals.

Seals believes that the stigma surrounding the use of drugs has a lot to do with ketamine not being covered by insurance. Ketamine was commercialized in the late 1960s and was approved for anesthesia in the 1970s – just around the same time when the war on drugs was happening. The research that was being done on psychedelics had stopped due to changes in laws, which Seals says really hurt the growth of ketamine.

There are two different forms of ketamine that can provide relief for mental illness. Injections and intravenous ketamine, otherwise known as racemic ketamine, and Spravato, a nasal spray. are considered off-label forms of the drug. These forms of ketamine have slightly different molecular structures, but both treat adults with depression, PTSD, and other mental illnesses.

As of now, most insurance companies will not cover the cost of ketamine treatments. But if ketamine therapy sounds like something you may want to try to improve your mental health, you can try out the many available clinics that have been appearing all over the city.

Header image by Aylene Lopez.