Top U.S. doctors have issued a chilling warning over the rise of mail-order ketamine therapy after clinics started posting the drug as an injectable.
Tens of thousands of Americans are flocking to the sedative as a growing body of research shows it can be used to treat depression.
But experts have sounded the alarm over firms who post the drug to vulnerable customers following cursory online checks.
Doctors say unsupervised administration of the tranquilizer, despite being legal, is ‘a recipe for disaster’.
Now, the American Society of Physicians, Psychotherapists, and Practitioners (ASKP3), the largest think tank for ketamine practitioners, has warned against firms that have started to post the drug as an injectable.
This photo, posted to social media site Reddit, claims to show a mail-order ketamine therapy kit sent to a customer that includes syringes, alcohol swabs and a vial of ketamine
The tragic death of Matthew Perry, who overdosed on ketamine, has put the drug’s booming popularity in the spotlight
Previously, clinics largely offered mail-order prescriptions in the form of lozenges and nasal sprays.
ASKP3, however, said it had become aware of at least one telehealth company ‘offering liquid injectable ketamine with syringes intended for subcutaneous delivery in unsupervised, at-home settings on an ongoing basis’.
The society said in a statement that this practice can be ‘harmful to patients, and poses substantial risk for misuse, abuse and diversion’.
It comes after DailyMail.com revealed the ease with which customers can now access the sedative, which is sometimes abused as a street drug, after a reporter signed up to an online supply within minutes.
Following a tick-box online survey and short virtual consultation, our correspondent was offered a plan that cost $129 a month and included a package of ketamine lozenges.
Another online clinic, Mindbloom, offers mail-order ketamine therapy for up to $359 a month.
Its website says its ‘Bloombox’ package includes ‘essentials’ such as ‘an eye mask, journal, and blood pressure monitor’.
It does not explicitly state what form the drug arrives in, but an icon suggests it is a lozenge.
However, the firm that has come to the attention of AKSP after reports on social media suggested it was offering ketamine as an injectable.
Jules Evans, an expert on psychedelic therapy at Queen Mary, University of London, shared a post from The Mindbloom Community, a private Facebook group, which said the firm was piloting ‘Mindboom Injectables’.
The post, which appears to be from Mindbloom itself, said customers could now self-administer ketamine into their abdomen using a tiny needle in ‘the comfort’ of their homes.
It added that this should be done with a ‘peer treatment monitor present’.
Posts on Reddit by people claiming to be Mindbloom customers said they had been offered the injectables if they had failed to reach a ‘dissociative state’ from the lozenges they had been sent.
The Mindbloom Community, a private Facebook group, says the firm is piloting ‘Mindboom Injectables’ for its customers
Mail-order clinics, including Mindbloom, which offers at-home ketamine therapy for up to $359 a month, have been accused of putting patient safety at risk by medical experts
Evidence suggests that ketamine is on the rise both recreationally and medicinally
One user posted a picture of what they said was a Mindbloom mail-order kit that came with syringes, alcohol swabs and a vial of ketamine.
The injectables are said to cost an extra $139.
ASKP3 said in its statement that ‘sending syringes and liquid ketamine to patients for home use is substantially outside of community standards and is highly risky at both the individual and community level’.
It said such injections can cause a ‘painful’ sterile abscess that can last for weeks and even require surgical intervention.
DailyMail.com has contacted Mindbloom for comment.
The tragic death of Matthew Perry, who overdosed on ketamine, has put the drug’s booming popularity in the spotlight.
Evidence suggests it is on the rise both recreationally and medicinally, as more Americans look to alternative forms of therapy.
In October, the Food and Drug Administration (FDA) voiced concerns over the trend.
It warned that the drug, which is approved as an anesthetic, is not approved for the treatment of psychiatric disorders.
‘FDA is aware that compounded ketamine products have been marketed for a wide variety of psychiatric stress disorders (e.g. depression, anxiety, post-traumatic stress disorder … and obsessive-compulsive disorder); however, FDA has not determined that ketamine is safe and effective for such uses,’ the statement read.
Use of ketamine for those treatments without monitoring ‘may put patients at risk for serious adverse events,’ the agency added.
Mindbloom’s website claims that 89 percent of its clients report improvement for anxiety and depression.
But the figure comes from a study where more than half of participants didn’t report any follow-up data.
Perry was known to have been using ketamine therapy. His last known infusion was a week and a half before his death. The medical examiner noted the ketamine found in his bloodstream could not have been from that session as it typically disappears from the system in a matter of hours
The research, titled ‘At-home, sublingual ketamine telehealth is a safe and effective treatment for moderate to severe anxiety and depression’, has been met with public criticism by Dr Sanacora.
In a written response, the professor and his Yale colleague Dr Samuel Wilkinson said they objected to the title of the paper ‘for several reasons’, adding that ‘the authors’ conclusions go well beyond the data’.
They continued: ‘Potential worrisome scenarios with at-home ketamine administration include drug diversion, abuse, and dysphoric reactions which could leave patients in a fearful and paranoid state without appropriate monitoring that could lead to harm of self or others.’
Dr Sanacora’s letter was made public in August 2022, but Mindbloom still proudly trumpets the paper as ‘the largest ketamine therapy study to date’ on its website.
Mindbloom’s Chief Strategy Officer, Mike Petegorsky, previously told DailyMail.com that online clinics make ketamine therapy ‘accessible and affordable for people in need’.
‘I’ve seen the concerns about at-home ketamine therapy, but I haven’t seen data to support them,’ he added.