Can I Get Ketamine Assistance Virtually? Things You Should Know
With the ongoing COVID-19 pandemic, those relying on ketamine assistance from a ketamine clinic may fear that they can not get treatment. Some clinics have closed to avoid transmission of the virus. Others have reduced their hours, making it more difficult to get an appointment.
As brutal as the effects of the pandemic have been, they have spurred some meaningful innovations in healthcare. Among the most promising has been the rapid increase of options in telemedicine. Medical institutions of all sorts have turned to virtual appointments to address non-emergency needs, from psychiatric care to regularly scheduled checkups.
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Perhaps most notably, the Department of Human and Health Services are relaxing regulations during the pandemic surrounding the Health Insurance Portability and Accountability Act (HIPAA). This has allowed healthcare providers to schedule appointments through a wide variety of video chat platforms, including FaceTime, Google Hangouts, Skype, and Zoom.
Previously, the legislation would mandate that such chats only be conducted through expensive proprietary programs that clinics would have to purchase. Some states are now allowing practitioners to see patients from other states via webcam as well. This would have been illegal in many cases prior to the adjustment of the regulations.
RELATED: Study Finds Ketamine Telehealth Is A Safe And Effective Treatment For Anxiety And Depression
Getting Ketamine Assistance Online
Some patients may be able to obtain prescriptions for ketamine lozenges or nasal sprays that can be used at home. These are options to few, either in isolation or as part of a regimen that also includes infusions. However, because these preparations are not as strong or as bioavailable as infusions, results may be less noticeable.
In the case of Mindbloom, a ketamine telehealth provider, patients take ketamine orally. Dr. Leonardo Vando, Mindbloom’s Medical Director and a board certified psychiatrist and addiction psychiatrist with over 15 years of experience, says:
Mindbloom’s at-home ketamine therapy uses sublingual tablets. Clients hold the tablet between their gum and cheeks to let it dissolve for seven minutes before spitting it out – this ensures peak oral bioavailability. We’ve found that many clients are much more comfortable with this oral administration than IV and intramuscular injections, which are the most common modalities for in-person ketamine therapy.
Notably, in the largest-ever study of ketamine-assisted therapy published in the October edition of the Journal of Affective Disorders, at-home ketamine therapy was shown to be even more effective than in-clinic ketamine therapy has been shown to be in similar studies. We attribute the increased efficacy of Mindbloom’s treatment programs to the comfort of the at-home environment, as well as the needle-free administration method and the combination of medicine with coaching, content, and community provided in our programs.
— Dr. Leonardo Vando, Medical Director of Mindbloom
However, patients pursuing ketamine-assisted psychotherapy (KAP) may possibly replicate in-clinic treatment via telemedicine. KAP typically involves the administration of ketamine followed by a session with a therapist. Telemedicine now allows patients to administer lozenges or sprays themselves and follow up with a therapy session once the effects kick in. Nurses or other monitors may watch the patient when the therapist is not on the call. An increasing number of clinics have begun to offer these services.
Also Read: Could ketamine therapy be a solution to PTSD?
Some may even allow patients to initiate treatment by webcam, including intake evaluations. Also due to the pandemic, the Drug Enforcement Agency (DEA) now allows providers to prescribe controlled substances over video without an in-person appointment.
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What Are Some Benefits Of Virtual Treatments?
With regulations relaxed on interstate medical care, patients can more easily find the best ketamine clinics to address their medical and financial needs. Further, most ketamine clinics are in large or medium-sized cities. That makes it difficult for those in remote areas — which makes treatment from homes more critical. Other people who have problems with mobility, or suffer from other issues, may find this option appealing as well.
Even patients who do live near ketamine clinics may find that video visits make therapy more accessible. Driving after ketamine assistance is typically prohibited, so patients must find alternatives. Instead of worrying about how to get home, patients can remain in place during video chats. This allows them to process the side effects of ketamine treatment safely.
According to Mindbloom’s Medical Director, Dr. Leonardo Vando, “By offering ketamine therapy through telehealth, we’re meeting people where they are. People who don’t live near an in-person clinic, or are unable to go to a clinic for any reason can still take advantage of ketamine therapy facilitated through telehealth. At-home ketamine therapy is also significantly less expensive than in-clinic treatments, which can sometimes cost over $1,000 for a single treatment session. The comfort of the at-home setting, as well as the needle-free administration method, can also make at-home ketamine therapy a lower-stress option for many people. At-home ketamine therapy is also significantly less disruptive to people’s lives. It takes a lot of time to go to a clinic, and wait to recover before going home. At-home ketamine therapy takes significantly less time out of a client’s day.”
Virtual KAP sessions may be more affordable, too. There is lower overhead for the clinic: more efficient use of time, fewer maintenance and cleaning costs. These savings also positively impact the consumer. One provider even offers group sessions, further reducing the cost. Remember to always coordinate with medical professionals, as self-medicating psychedelics brings risks.
Communication With Clinics Remain Strong
Some clinics now offer a guide for meditations as part of at-home ketamine assistance. It is possible that virtual reality (VR) assistance may soon become available at home. Some clinics already offer it onsite. VR channels the sometimes disorienting side effects of ketamine by walking the user through a virtual landscape. Of course, that development will be contingent on the patient having their own VR equipment, which is costly and likely not often accessible.
Most programs encourage the patient to journal their experiences after a session has ended. This can help the patient more fully integrate their experiences and chronicle their progress over time. Some clinics also require patients to record how medications make them feel, which is useful in adjusting dosages.
Potential Risks Of Ketamine Therapy
Since ketamine has a high potential for abuse, in-clinic administration has been the standard. Only licensed professionals can monitor dosing. Further, patients can only receive a limited number of infusions, lozenges, or nasally administered doses in a given amount of time.
During the pandemic, immune-compromised and elderly patients should benefit from at-home dosing. Risks of exposure to COVID are limited. Treatment is provided in the comfort of a household. It cuts out steps in the process of going to a clinic.
However, patients with a history of substance abuse or addiction problems will want to have a serious conversation with their prescribing physician about whether or not taking ketamine at home is right for them.
Reputable telehealth clinics will take certain steps to mitigate any potential risks. Mindbloom’s Medical Director, Dr. Leonardo Vando, says, “Any risks of at-home ketamine therapy are mitigated by Mindbloom’s clinical practice guidelines, which govern all aspects of treatment and were developed by leading experts in psychiatry and ketamine therapy. Mindbloom’s psychiatric clinicians conduct thorough medical and psychiatric evaluations of all prospective clients to ensure they don’t have any pre-existing conditions that might make treatment inappropriate. And our protocols require limited, incremental dosing to ensure that the medicine is well-tolerated and taken appropriately. We provide a blood pressure and heart rate monitor that clients use before treatment, and clients must always have a peer treatment monitor present. The peer treatment monitor is a trusted adult who will remain home throughout the duration of the treatment, and check on the client intermittently during treatment. You can learn more about the safety of at-home ketamine therapy on Mindbloom’s website.”
While ketamine lozenges and nasal sprays have proven to be largely safe, it is worth emphasizing that medical staff will not be immediately available should problems arise. Those who self-administer at home without a web link to staff who can monitor them should try to arrange for a companion to keep an eye on them. If the patient lives alone, he or she should be sure to keep a phone within reach and place clearly marked emergency contact information nearby should paramedics be needed.
Michigan Psychedelic Therapy Clinic Spotlight:
Michigan Progressive Health – Royal Oak, Michigan
Wayne Health at Wayne State University – Detroit, Michigan
Ketamine Clinic of Michigan – Flint, Michigan
LifeInfusions – Kalamazoo, Michigan
Thrive Center for Health – Grand Rapids, Michigan
Michigan Progressive Health – Ann Arbor, Michigan
Cratus Medical Vitality Institute – West Bloomfield, Michigan