OPINION: Is Ketamine an Answer for Chronic Pain? Not Yet!

OPINION: Is Ketamine an Answer for Chronic Pain? Not Yet!

By Rosemary Lee

On the street it’s called Special K.
It’s a horse tranquilizer in veterinary medicine.
It’s a money maker for chronic pain.

Rosemary Lee

Rosemary Lee

I get it. Sometimes the pain gets too much and we’re at the end of our rope. We want to reach for something, anything that can promise relief from the pain. We just need to be careful that we are not reaching for something that can do more harm than good.

Ketamine infusion therapy is big business in the chronic pain world. A single infusion can cost $2000 a treatment and, believe me, the recommended course is definitely NOT  a single treatment.

Ketamine is used to produce a loss of conscienceness. It’s used as a general anesthetic but because of the hallucinations that it can cause it’s not the primary choice. It is used by compounding pharmacies as a cream with lidocaine and ketoprophan as a topical pain reliever.

This drug is no joke.

It increases your heart rate and blood pressure. It can cause hallucinations, dizziness, nausea, blurred vision, nightmares, memory problems and if used long term liver abnormalities. It induces a state of disassociative anesthesia.

Scary.

Years ago a study was done with 34 Fibromyalgia patients. They got a low dose Ketamine infusion followed by a dextromethorphan treatment. 19 responded to neither drug, 10 were favorable to both, 3 were helped by the ketamine but not the dextromathorphan  and 2 were helped by the dextromethorphan but not the ketamine. Link to study

There are sites offering Ketamine therapy. Everything about Ketamine states you should be monitored closely due to adverse effects but there are places giving you this therapy on an outpatient basis. Now they do tell you to stay with someone so if you have any ill effects they can get you to a doctor. Gee, that’s comforting. I may have someone watching me who hasn’t got a medical license and they are the ones to watch for adverse effects?  They also tell you that it may not work and this is a totally elective therapy.

It gets even better. There is a Ketamine Coma Therapy being offered in other countries. It is given in extremely high doses so that a coma is induced. This, obviously, is not approved by the FDA.

Back to the infusions……they tell you that if you want it YOU NEED TO SATISFY YOURSELF by the research YOU DO through search engines. In other words, we just give it to you and if there’s a problem you should have done better research. To me, that borders on negligence. We need qualified people that will tell us the realities of medicine and what it can do. We shouldn’t be the ones doing the search and then telling the doctor it’s ok.

It also tells you tough noogies because you may elect to proceed knowing it may have no benefit. They also tell you the greater number of infusions you have the greater the benefit.

At 2 grand a pop that sounds like double speak to me.

Just keep paying and pray it helps.

I’m not saying it may not help some people. It might.

Everything in me shouts NO.

Everything I read about this drug screams “dangerous in the wrong hands.”

It’s a street drug that packs a wallop.

It can kill you.

Please be very careful if you are going through with this therapy.

You need to be watched carefully.

Personally?

I wouldn’t do it.

I think it needs more study.

Rosemary Lee suffers from fibromyalgia and blogs on her experiences at http://rosemaryl.blogspot.com/. She is a frequent contributor to the National Pain Report.

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Authored by: Rosemary Lee

There are 36 comments for this article
  1. Al Winston at 5:37 am

    For centuries and even today, astrology is used. Utterly nonscientific and proven to be bogus, it is still in use and believed (e.g. Nancy Reagan). Medical science has the same situation in many cases, ketamine infusions included. CRPS, like all CNS conditions, is as much a curable condition as multiple sclerosis and ALS. Hence, all kinds of treatments will be proposed, much like incurable cancer conditions (remember peach pits and Steve McQueen?). The data on ketamine infusions is terrible, yet in desperation (both to try and help extreme cases and unfortunately in most cases to line their pockets) doctors offer ketamine infusions to CRPS patients. A lot. Repeatedly. It’s not a cure except in terms of getting $$ or in assuaging the conscience of a doc wanting to ‘try everything’ for a desperate patient in agony. I remember when IV infusions of lidocaine were done the same way (no help). And let’s not forget about how from the 1980’s to 2010 how much industry and patients pushed for chronic opioids to treat all kinds of chronic pain . . . that didn’t work out so well either. Ketamine is a good drug for acute pain. But for chronic pain, it’s no more effective than running a remifentanil infusion. No drug will ‘rewire’ the CNS, although as with all biologic systems, there will be the exceptional case . . . kind of like the one lottery winner who drives the many millions to buy tickets despite almost zero chance of winning (well, as likely as being struck by lighting daily for 2 weeks). A good example: stellate ganglion blocks were proposed for PTSD based on many, many case reports. The moment a proper randomized double blind study is done on sufficient numbers of patients, it’s found to be a placebo effect. Caveat emptor.

  2. Dr. Diez at 12:00 am

    This article is so full of misinformation and scare mongering I wouldn’t even know where to start.

    Ketamine has only ever killed 2 people in recorded history, they were drug abusers not under doctors supervision.

    The LD50 (median lethal dose) is 50 to 100 times the normal anesthetic dose for humans. Doses for pain management are sub anesthetic so you’re taking less than someone that would be having surgery on it. Try taking even 10x a dose of an opiate and see what happens. Keetamine is safer than opiates.

    Ketamine is on the World List of Essential Medicines.

    Ketamine is often used in as a pediatric anesthetic because it is more safe than traditional anesthetics currently used.

  3. Carey at 6:49 pm

    My fiance has been fighting CRPS for 3 years and Ketamine has been the only method of pain management that has provided relief and a quality of life that does not leave her bed ridden. Is it for everyone, ABSOLUTELY NOT and we are always looking and searching for alternatives but Ketamine is what has worked for her so far. I pray for anyone who suffers from this horrific disease. Don’t give up hope.

  4. Katelyn Oleary at 11:00 am

    Dr. Aranda thank you for taking the time to respond and for giving real medical advice and sensibilities. Much appreciated.

    -Katelyn O’Leary

  5. Dr Margaret Aranda at 1:59 am

    To be clear, the NMDA receptor antagonist, ketamine is a PCP derivative, also known on the streets as: “K” or “Special K.” Other street names are Cat Valium, Purple, Super Acid, Special La Coke, Jet (Texas), and Vitamin K. Slang for experiences related to ketamine or effects of ketamine include “k-land”, “K-hole”, “baby food”, and “God”. It is actually used in shooting darts at stampeding elephants. So let’s stop pretending we are only giving it to nice little lions and tigers and bears. Or rats and mice. It’s given in zoo animals, people. Zoo animals.

    And while anesthesiology complication rates have decreased from 11.8% to 4.8%, there has been no change in the number of deaths attributed to anesthesia: 3 deaths per 10,000 cases.
    http://www.drugs.com/news/anesthesia-complications-drop-study-finds-53487.html

    Also, it costs pennies on the dollar. I’ll say it again. PENNIES. And it’s not usually given by itself, to decrease all the known, long LISTS of side effects, too long to list here, but found here: http://www.drugs.com/sfx/ketamine-side-effects.html . We’re not playing with water here. Hallucinations & paranoia can be so prevalent that we’re playing with the kind of stuff that makes people jump out of windows because they are convinced that they can actually fly. OK. Fact. Now we can go on.

    And just to clarify, ketamine is an analgesic, relieving pain. Propofol is an anesthetic, for losing consciousness and has NO pain-relieving properties whatsoever. NONE. ZERO. Fact.

    I trained at USC-anesthesiology, and am well familiar with the Anesthesiology-run Pain Clinics at the USC Norris hospital. I was former UCLA Assistant Professor also familiar with the “Anesthesiologist”-run (IS YOUR Anesthesiologist BOARD CERTIFIED?) Pain Clinic at the WLA Veteran’s Administration (The VAs are notorious for using NON-BOARD CERTIFIED Anesthesiologists as employees). What the doctors do “at the VA” may differ widely from the “standard of care” that the rest of the USA uses. Just so you know.

    There are so many misbeliefs circulating these comments that it reads like a tabloid from a newspaper article. Caught in the middle? The poor, innocent patients who only want pain relief. But What is a Doctor Supposed to Do? You already know Our “Job Description.” Do No Harm.
    While YOU may be able to choose what risks/benefits YOU may want to take, you can not “make: ANY doctor give you a prescription or a procedure whose risks outweigh the benefits. So, it is the patient:physician relationship that determines what is to be done, not YOU, and not YOUR DOCTOR. Get it straight, and don’t come in with a bad attitude. I’m not risking my medical license for that kind of an attitude. We speak sensibly, and come to a common ground; if you have your heart set on something I cannot give you, then you go see another doctor. Because when it comes right down to it, I didn’t have to visit any of these links. I just had to find them to spoon-feed you so that you could be aware, empowered, and able to make a good decision. But in the end, it is MY medical license, not yours. So let’s be reasonable.

    *First of all, read the “package insert” on ketamine: http://druginserts.com/lib/rx/meds/ketamine-hydrochloride-1/

    *And the FDA Emergency Reactions:
    http://www.drugs.com/pro/ketamine-injection.html

    *There is a Ketamine Support Group (now why would that be necessary?):
    http://www.drugs.com/answers/support-group/ketamine/questions/

    COMMON Side Effects (1% to 10%): Respiratory rate increased, Nystagmus, diplopia, Nausea, vomiting, anorexia, Hypertonia, tonic clonic movements, Erythema, morbilliform rash, Hallucination, abnormal dreams, nightmare, confusion, agitation, abnormal behavior, and Anaphylactic reactions (that can lead to death within 3 min).

    I hope this stops some of the discussions in their shoes, for some statements had no substance. I also hope this educates all of you to have a better idea of what you are messing with. I didn’t include lots of other topics that go into a single administration of the drug: the other drugs that are also added, whether or not to use the ‘double strength’ concentration to save half the money, and just where IS the ANESTHESIOLOGIST (and are they Board Certified?) while this is being infused?

    Why did I sit here and take the time to do all of this? Because your experience does not matter. If you did this 10,000 times, you would have died and needed resuscitation 3 times. There are real risks that matter here. You can’t possibly, ever know all the pharmacology, physiology, pathophysiology, drug:drug interactions, and genetic metabolic variables that go into the physician’s decision-making, per patient. You are treated as an individual, each and every time.

    It is okay to have a healthy respect for this drug. If we as anesthesiologist have this respect for it, then I think you should have it too, even moreso than us. And I don’t think that you can possibly know or read or look on the internet to find one iota of the information that you need to determine whether or not this is right for you. My suggestion? It is the same as it is for any elective surgery or procedure. If it is “elective” and NOT an emergency, don’t do it. Then, you’ll have zero complications from an invasive drug that could wreak havoc and make you die.

    Get three opinions from Board-Certified Anesthesiologists with Advanced Specialty in Pain Management Fellowship, and then see how you feel after that. Consider other options, keeping this as a last option. My opinion. My experience, my best to DO NO HARM. I’m sticking to it.

    Thank you.

    Margaret Aranda, MD, Ph.D.

  6. Iris at 7:21 am

    How can you opine if you haven’t tried ketamine yourself?
    Fibro and CRPS are different diseases and what doesn’t work for one, can indeed have the potential to work for the other.
    I’ve had more than 2 dozen ketamine infusions for my raging CRPS and with no ill effects from the infusions. Moreover, I’ve never paid a dime. They were administered by a State-run Hospital, too.
    Diligent patients will always do their homework. We cannot always rely on docs to do what’s in our own best interest, but we do need them to share all of the facts and explain all of the risks and benefits within their level of expertise. Few will go beyond their level to learn more to help individual patients with this disease.
    Too bad so many medical providers are in this for the money. They take advantage of pain patients with limited/no access to quality care where infusions are covered by insurance at credible institutions.
    Ketamine can be helpful, but there are risks. It’s up to the patient to weight the risk/reward.
    Personally, I can always tell when it’s been 4-6 weeks since my last ketamine booster. It’s helping me tremendously.

  7. ed coghlan at 5:26 pm

    I am very pleased by the diverse reader commentary on this story, because it captures the essence of what the National Pain Report is about.
    There are people who disagree with Rosemary’s opinion and those who believe her skepticism is warranted.
    It is exactly we had in mind when we founded the National Pain Report–give information, provide opinion and give an opportunity for feedback.
    Thanks for your support.
    Ed Coghlan

  8. Susan at 11:33 am

    I was very excited when I heard that there may, after all this time, a treatment being developed that perhaps actually works for my Fibromyalgia and Chronic Pain Syndrome, Ketamine. I brought this subject up with my PCP at my last visit. He educated me to the dangers of Ketamine, many that he mentioned are exactly what Rosemary Lee mentioned. Again, I’m disappointed. I watched my hope evaporate again. I do use opiates, which has been the only treatment that even touches my pain. Of course, I’ve tried all the non medication treatments that have been suggested to me. Also all the non effective non narcotic medications such as Lyrica, etc. None of those designer drugs have helped me, and frankly I’ve never met anyone who has much good to say about that class of drugs, that also have side effects much greater than opiates. Strange as it is, I’ve been told that opiates, do not help my pain. That’s odd, as without them, I’m completely unable to function on any type of normal basis. I’m the one who “feels” the pain, how can someone else judge my pain level? The opiates also help with the IBS that accompanies my Fibromyalgia, and they also help with some of the other issues, not just the pain. I’m not on a high dosage, but only enough to “get by” and I’m never completely pain free, but as I said, I’m at least able to function. I’ve tried to stay hopeful that eventually some research will be successful, that a treatment will be developed, and I will have a chance at a normal life again. Thanks Rosemary for letting everyone know the dangers that accompany this treatment.

  9. Fran Luma at 9:18 am

    It’s not enough to hide behind “this was an opinion” when lives are at stake. Fact is, this article (and many others at National Pain Report) spreads fear on the basis of uneducated statements. That said, it’s fine to have op-Ed pieces, but please make sure they are researched and clear. Make sure they show the other side of the argument – in fact, make sure they have an argument. Perhaps ketamine wasn’t for your author, but it does work for many, and that should have been included at least as a publishing disclaimer. If a patient misses out on the much-deserved treatment they may have needed, I sure hope both your author and national pain report are willing to live with that. Listen to your comments, this was a miss – and you need to fix it.

  10. MJ at 6:53 am

    Ketamine can give some significant relief from neuropathic pain. It can be given orally ( off label), and at a low dose does not cause significant adverse effects. It works well for neuropathic pain at a low dose. It works well for acute flare ups of neuropathic pain.
    It is not a respiratory depressant. It is safer than opioids. We use it at our clinic for some appropriate patients.

  11. Erica at 3:59 pm

    @ Angie H.
    April 7, 2016 at 7:21 pm

    Sorry, but Walter Reed National Military Medical Center-Bethesda does do ketamine via their Pain Clinic I have been there and know others as well. Also not all military bases can do it for lack of trained knowledgeable doctors. However, San Antonio, Tx the VA and the military bases there do ketamine, even West LA VA and Las Vegas VA does ketamine @ the military’s Medical School, Uniformed Services University of the Health Sciences (USU), located on the same grounds as Walter Reed NMMC-Bethesda, Dr Charles Buckenmaier does teach anesthesiology as well as ketamine procedures for pain be it in the battle field or in the ER or for like CRPS as well. Ketamine was also being done at Evans Hospital at Fort Carson , Colorado Springs, Co for about 2-yrs until that Dr changed locations.

    I have had ketamine at several military bases, also I get it out in town at this time via the VA now.

    For me with ketamine has given me a quality of life back to enjoy things I would not otherwise be able to do. IT is not as hard on the body as many of the “pills” doctors try to give either.

  12. Katelyn O'Leary at 12:35 pm

    Rosemary – what “clinics” are you referring to? I go to Keck hospital of USC, one of the premier research hospitals in America and I’m treated by specialists who are trained in neuropathic chronic pain. These aren’t quacks looking to take advantage – they’re looking to heal and help. Even the nurses that attend to me during my infusions are specially trained (and they check on me every 15 min. They check and monitor all my vitals).

    Could you name these fraudulent clinics so people can know to avoid them?

  13. Rosemary Lee at 12:25 pm

    I’ve read the comments. I find them very interesting. What I’m against is “clinics” that take advantage of pain patients by opening up and offering the next best thing without oversight. Patients have been harmed by reckless clinics that do this. Ketamine infusions can help some and for those who benefit it’s well worth it. As I stated, do your research.

  14. Sandy Auriene Sullivan at 10:30 am

    It doesn’t surprise me that the procedure isn’t well tolerated by those with Fibromyalgia. What we know is that FM doesn’t cause inflammation. Those illnesses that cause burning w/inflammation of the soft tissues benefit.

    I swear by ketamine compound creams w/lidocaine. Miracle cream. Ketamine needs more research. Chronic pain illnesses need more research.

    It’s never fair to beat up on someone over an opinion. I greatly respect the points of view shared here. Opinions are important and there are several studies on the benefits of ketamine for med-resistant depression. The other NPR/PBS did a piece on the study mentioned previously by me that was supposed to be a ‘blind’ trial but nearly failed as the researchers could tell who had what too easily! A quick search for it should bring it up. Think the study came out in 2011-2012
    Best of luck to everyone and all searching for relief. We cannot judge each other – we get enough of it out in the big bad world.

  15. Sage at 7:01 am

    The only reason I have a life worth living is ketamine infusions. While this may be just someone’s opinion it isn’t a very well educated one.

  16. PainInTheBack at 5:10 am

    Some patients have had a reduction in their chronic pain, some had MORE pain after having Ketamine infusions. While I’ve never had an infusion, a katamine nasal spray compound has been a Godsend at night, when the pain from my Arachnoiditis (secondary to a congenital spinal tumor that was removed in ’94) makes getting any “good” sleep nearly impossible. (My nightly frustration: lay down, spend 15-30 minutes tossing, turning, trying to find the “right” position that’s comfy enough for sleep. Sleep for MAYBE an hour. Wake up, start the process again. Rinse and Repeat. ALL NIGHT LONG) Now of course, you can’t have precscription pain meds and use marijuana, so my doctor will no longer prescribe my ketamine spray. Back to very little sleep, again!

  17. Christine Pohl at 9:33 pm

    You know that is scary. Yes, it could be it could help some but at what cost? To me I don’t think I would try it.

  18. Angie H. at 7:21 pm

    I am seeing alot of people getting angry with the way this article/blog was done. Right off the bat it states OPINION. That means her personal decision no one else’s, including the national pain report. We all have our own opinions and choices to make. What she stated that it was a street drug by the name Special K is true, I know alot of people that died from it. It is also used for horses, talk to a veterinarian and they will be more than happy to tell you all about it. Its also used for aesthetics.
    Want my problem with it. One of the pain clinics in Johns Hopkins University will recommend Ketamine infusions for several different chronic pain condition (I have CRPS). They do not do ketamine infusions at Johns Hopkins University Hospital. They will refer you to George Washington Hospital center. Even the main army hospital Walter Reed will not do them.
    If it is so safe tell me why those 2 well known hospitals do not do them?
    Yes it does help some. But remember there is no long term study done. They do not know what kind of damage can be done from long term infusions.
    What she was stating was this: do your research, weigh all the pros and cons before you make a decision, do not let anyone push you into doing something you are not ready for. She personally would not do the treatment. Me its on the back burner. I want alot more information and studies done first. Would also like to see more insurance companies paying for it. Because they all do not. Depending on where you are the price is 2,000 dollars.
    Dont always jump to conclusions and read all with a clear mind before responding. I read this 3 times including the comments. Every area just like every person is different and things are never the same from one to another.

  19. Geo Sims at 3:37 pm

    Thank you all for your comments.

    National Pain Report strives to share different points of view on topics – and there certainly are different points of view regarding ketamine.

    This article was categorized as both “Pain Medication” & “Opinion” on the site, as well as titled, “OPINION:…”

    This article was NOT published by any “Pain Foundation”, but solely by NationalPainReport.

    We also recognize that people have been helped by ketamine – you can find the 1st story of another author’s ongoing experience with ketamine, published a few days ago, here: A Pain Patient’s Experience with Ketamine

    Another (more positive and informative) ketamine article was posted the day prior, and can be found here: This Could Be Big: Intravenous Ketamine for Fibromyalgia

  20. Suzanne at 3:06 pm

    I feel exactly the same as this writer, Rosemary! I’ve been told by my best Dr’s NOT to do it, Not to get Ketamine infusions. I suffer from PTSD & several pain illnesses, including systemic CRPS. I’ve been warned about the heart issues that could hurt me because of my own heart problems. Also about the hallucinations that can show up out of nowhere several months or more, later! This is upsetting that they allow these infusions to be done on an outpatient basis and for so much money! These same Dr’s who won’t prescribe a “pill” for pain nowadays because pain Med’s have become “taboo”, will give these costly infusions! They’ll give these pain patients “horse tranquilizers” at $2,000.00 per treatment x’s many many treatments…..YET…A prescription for pain pills/opioids may only cost a co-pay of 10$ with insurance and that’s no good any longer bcz it’s “too dangerous & we are all going to become like Heroin addicts” (I don’t think this way!! This is what we’ve been reading!!”)….it’s all about making money on these procedures and infusions. It’s not really about what’s safest and best for the patients anymore! I’d much rather take my chances with a pill that helps my pain, than have all of these horrible infusions & surgeries they propose now days! I know of one person who was sitting getting a Ketamine infusion. She was talking with another Ketamine infusion patient when suddenly she fell asleep. She awoke to that woman having coded and then that patient passed away right in front of her. She had just been talking with that other patient!! Another young girl that I know personally, went to Mexico to have the “K” coma done! Her parents had to pay cash and they put her in a coma to “reset her brain chemistry”! It did put her into remission for awhile but side effects are many! For me, my opinion … I’d rather take a pill and get my liver checked via blood tests every 2 -3 months! So far after 12 years, still my Liver is OK!

  21. Jean Price at 3:01 pm

    This article is pretty one sided for an educational piece! And from the responses, obviously people have been helped by it! I’m not sure of the goal of the article or the goal of the Pain Foundation for publishing it here! It seems like this would be good information for those who use it “from the streets”….you didn’t get us confused with them, did you?! Some others have….just wondering!

  22. K. at 1:03 pm

    To everyone: when an article says “OPINION” by its title, then it is an opinion, just as your comments are. With medication of any kind, we all know that it works for some and not for others, and side effects can range from horrible to none. Opinion articles have been around forever…they can be helpful. But you have to read and take it as the author’s opinion. Factual articles are different.

  23. Sandy Auriene Sullivan at 11:32 am

    Seeing comments from CRPS patients who have done this makes me think there is something to it that could be of benefit.

    CRPS patients have some of the highest suicide risks and the desire to try anything even high risk beats dying because many CRPS patients do take their own lives. Goes back to the med resistant patients with severe prolonged depression – a moderate dose helped ease them into normalcy. Ketamine also has anti inflammation properties which may be why some benefit more than others.

    The therapy discussed here seems high risk. Should be used with caution and talk to your specialist before doing it and your primary care doc if they’re different.

  24. Dawn Gonzalez at 10:16 am

    Really sad to discourage people from something that may work. Yeah so it didn’t help “fibromyalgia” in one tiny and poorly set up study. Those of us with intractable burning nerve pain have benefitted greatly. I get it outpatient, insurance covers it, they don’t give you enough to cause all of the crazy issues they mention, it does NOT depress respiration and is so safe it’s what they use in emergency medicine and on the battlefield, and often in pediatrics. NPR has really gone downhill recently.. With Arachnoiditis and CRPS any benefit and relief is a godsend for our difficult to treat pain. Myself and others swear by ketamine.. Infusions nasal sprays tablets lozenges pills and creams. Should it be used for fibromyalgia? Probably NOT! But our pain is NOT even comparable to fibro. We are on a whole different level, where the pain can be dangerous. This is damaging and inflammatory reporting that may sway a lot of people from finding something that returns some life and dignity. I get my infusion once a month and it lasts the entire time. One hour infusion once a month for me if beyond worth the relief I get and the function I have returned. It helps prevent tolerant to pain meds as well, and keeps the levels you require lower. That’s a plus dealing with the opioid pain crisis we are in as well. It’s all about weighing risks and benefits and deciding what is right for you and your situation PERSONALLY. The more options available to us, the better.

  25. Sandy Auriene Sullivan at 9:57 am

    Not sure about Ketamine for chronic pain but it has shown a great deal of promise for those with med resistant depression in fact it worked so well the ‘blind’ trials almost failed. You see some get placebo and some would get ketamine.
    Within 15min it was obvious which depressed patient received the drug. They felt *NORMAL* and didn’t get a ‘high’ but they expressed a desire to do things like shop, cook, clean – mom stuff.

    The other major breakthru for ketamine in depression is it’s ability to treat depression FAST. No longer is it 2-8 weeks ‘maybe’ and that takes a lot of time for every person who doesn’t respond or their depression eased all on it’s own. Currently we have no emergency depression med for the highest risk patients and it wouldn’t remove the need for 24-72hr holds for observation though it could in the near future.

    Where it will help us CPPs? Is the depression that comes with the overwhelming fatigue and pain. Pain taps the same brain chemicals that are required for normal healthy emotions. So many are on SSRIs/SSNRIs with a lot of side effects and low benefit to the overall state of well being. If Ketamine can fill that role? If it can lift people out of a severe, prolonged depressive state in 15 minutes [6+ weeks with or without suicidal idealization]

    Fight for it to get broader use. Like pain medication doesn’t make a CPP ‘high’ ketamine doesn’t make someone in a true depressive state high either. It shows promise.

  26. Lauri Nickel at 9:29 am

    I do NOT appreciate the scare tactics in this article! Shouting that it’s a street drug, shouting that it’s a horse tranquilizer (both of which are true), without telling the other side of it. That’s it’s often used in pediatric anesthesia and on soliders in the battlefield, because unlike opioids, it does not suppress respiratory function. Where is THAT information in your article?

    I haven’t tried ketamine infusion yet but plan to this summer, once I’m sure my insurance company will treat it at least as an out-of-network procedure. The Center that will do mine charges $750 per treatment, not $2000.

    My intake appointment was very detailed and comprehensive. I was evaluated not only by the medical personnel, but by a psychologist as well, in addition to taking a 200+ question psych survey.

    I know several people who have had great success with the treatment, as well as others who did not achieve the pain relief they hoped for. Each individual’s body is exactly that, individual.

    Of course it’s dangerous in the wrong hands! So is tylenol. So is alcohol.

    With your scare tactics, are you also on the anti-opioid bandwagon as well?

  27. Katelyn OLeary at 8:52 am

    Rosemary,

    I understand where you’re coming from. Ketamine infusions are no joke, they are costly, and there’s no guarantee.

    But just hear me out for a minute.

    Imagine your friends ask you out to dinner. You put on your favorite pair of jeans and you walk out your bedroom door ready for a fun night with friends. You sit at your kitchen table, patiently waiting for your roommates to be ready. Then the pain starts. The jeans push too hard on your leg and hip. The burning from your hip to your foot starts with a rage. I get to my feet and I barely make it to the bathroom in time before I’m throwing up so hard I nearly smash my head on the toilet. I rip the pants off of me as if they are on fire, when really the the fire is in my leg and nothing will quench the flames inside.

    Sometimes, just having toilet paper brush my leg causes severe pain.

    I’m 28 years old. I have a lot of life left in me. And I’m willing to fight. And I’m willing to try ketamine, which I have now for several weeks, if it means quenching the fire to a low burn: so I can go back to my life.

    I hope your pain is tolerable. I really do. For patients like me – we don’t have a lot of options. We just have to keep hoping and trying. And I’m willing to.

  28. Julian C Phillips at 8:47 am

    I have tried Ketamine infusion but unfortunately it had zero effect on me however, it is so important to remember that we are all so different.

  29. D.E. MacDonald at 7:51 am

    Thank you Nick for sharing your experience with us. Living like this is not really living. I’m terrified someone will want to operate on me (I’ve had 26 surgeries in the past 5 years) and I’m afraid one day they won’t be able to knock me out.)

  30. D.E. MacDonald at 7:38 am

    I am here. I take 30 mg of Morphine every 8 hours and take Percocet for breakthrough pain 10/325. I take 3-4 a day. I have extensive pain in my back from neck to just above my rear end. sometimes I just sit and cry. I’ve recently been given muscle relaxers that make me really, really weird! I’ve actually ordered things online in my sleep! But I can’t tell you any point in time that I was free of pain. I hate taking all this pain medication. I would try anything fun or relief and a reduction if pain. Now my doctor says I can’t have xanax anymore with the morphine and it makes me just want to take everything I have to finally get complete and final relief. Sign me up I’ll try it

  31. Katie L at 6:59 am

    I use this in small doses, very small doses .15 of a ml daily and .2 at bedtime and the relief it has given me with my burning pain is indescribable. I don’t hallucinate, become fatigued, nothing, it simply works on certain receptors that others don’t. It is apart of my pain protocol for crps and has been a God send to me and others using the same protocol. Was I terrified when I heard I would be taking it? Yes! Did I learn I can’t take the recommended amount, yes. Which by the way is only .25 of 1 ml. The problem here lies within patients who use meds for other than therapeutical reasons, I don’t mess with my medications, I don’t take more than I need and I don’t take them to do anything other than relieve a little of my pain so I can be a mom. These infusions are saving people’s lives and some of us have it apart of our daily routine. It is not a spinal stimulator or eSi that can potentially harm us more. It is a medication that when used properly can reduce ones pain to a livable level. It might not be for you but for some of us it is the missing piece to our pain control. Id rather see am article on epidural steroid injections and how the medicine used has a black box warning saying not for use than one that is something that can help people.

  32. Ray at 6:16 am

    Hi, I respect your prospective on Ketamine. I’ve had lose dose infusion and I never lost consciousness! My doctor monitored me every ten minutes. Yes it was weird, but I was able to respond. Two things happened, I got significant relief for days and it was FREE! Dr Balog, Portland, OR

  33. HAZZY at 5:46 am

    I READ ABOUT KETAMINE IN ANOTHER ARTICLE, THIS STUFF IS JUST LIKE PROFOFIL, THE SAME STUFF OD’ED MICHAEL JACKSON DIED FROM. I WILL TAKE MY REGULAR PAIN MEDS AS IM SUPPOSED TO DO AND NOT ABUSE IT. DR’S CAN PICK OUT AN ADDICT AND IM NOT ONE!!! BUT NOW I HAVE TO GO TO PAIN MANAGEMENT AND IT DOSEN’T HELP. IT COST A DR 317.00 FOR LICENSE TO PRESCRIBE PAIN MEDS. ALL YOU HEAR IS THE DOCTORS POOR MOUTHING !!!! I WILL TRADE PAY CHECKS AND SEE IF THEY CAN SURVIVE. SO, TAKE KETAMINE AND NEVER WAKE UP !!!!

  34. Em Raven at 5:46 am

    If you have heart problems, autonomic dysfunction, or are medically frail, don’t do it. Half a week of feeling slightly less bad maybe isnt worth it. You could go into a crisis where your bp drops and/or a dangerous heart rythm happens and die. (Much more can also happen but thats it in a nutshell) There’s a reason that literature says all vitals should be monitored closely for the duration and awhile after. These reactions can happen in people without heart issues as well. MANY people with fibro can have dysautinomia or POTS and just have it brushed off by doctors and not diagnosed. I’m not saying people who have had benefit or are otherwise healthy should avoid it… But if they are pressing this over some thing else that works for you (even if it’s elective doctors will still push… look what happened with steroid injections) don’t let them make you. Also if you have reacted to lidocaine with bp or heart issues (which is also very common) this is a good indicator you might want to avoid it. Im directing this at the dysautonomia/heart problem community just fyi though others should be careful as well.

  35. Nick at 3:30 am

    Wow, this post disturbsmeto no end. I have had the ketamine therapy and yes it was expensive. I had three weeks of no pain the best three weeks in ten years, I felt normal. Had it not been for this therapy I would not have found out I have neuropic sarcoidosis which is causing my CRPS. I am now being treated for the neuropic sarcoidosis in the hopes when that is under control I can have ketamine treatment again and possibly go into remission for good. To each is own but my experience with this treatment I had seven infusionsover 14 days starting at 250 mg day ending at650 mg day. I was monitored by nurse, heart monitor, and blood pressure machine, and a blood oxygen sensor. The total cost was under 10,000.00 but three weeks of bliss was quite worth it. Please don’t badmouth treatments that you have only read about, I know7 people who have had the treatments and all were positive results. We are warriors fighting daily sometimes willing to do almost anything to help ease the pain. As stated in the post it may not help everyone but it has helped thousands…….

    GodBless