Episode 41: What Does It All Ketamine? with Dr. Erica Zelfand

Ketamine is one of the most versatile drugs on Earth, an amazing anesthetic that can relieve pain without the same risk of respiratory failure as opioids (nothing against them, of course.) Overwhelming evidence also suggests ketamine can rapidly reverse suicidal thoughts, making it a potent treatment for PTSD and treatment-resistant depression. 

Last year, a specialized blend of ketamine called esketamine was approved by the FDA to treat depression, the first new major depression drug in more than 30 years, but its use has proven controversial. Meanwhile, dozens of clinics are popping up across North America, offering off-label use of ketamine to treat a wide range of issues. 

Yet, somehow ketamine is most often conflated with recreational use because it can give an ecstatic, lucid, out-of-body trip known as a dissociative hallucination. According to several surveys, including one published in the journal Consciousness and Cognition, ketamine has the highest semantic similarity to a near-death experience. What is it about this intriguing drug that makes it so popular, both clinically and elsewhere?

Our guest is Dr. Erica Zelfand, an integrative and functional medicine physician, who has written about how to get the most of ketamine therapy.

You can follow Dr. Erica Zelfand on Facebook and learn more at https://ericazelfand.com/

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Producers: Christopher Moraff, Troy Farah, Zachary Siegel
Co-producer: Garrett Farah
Music: Glass Boy / Pictures of the Floating World
Image: louise stockton / edit: Troy Farah
Two clarifications we want to make: In the intro, we say that “no other drug will make you feel like you died and left your body.” We mean *compared to ketamine.* So there’s no room for confusion, we obviously weren’t implying ketamine is the only drug that is like a near-death experience, ketamine is simply the closest, and this semantic similarity is based on a number of surveys, which are not necessarily fully reliable as they are self-reported.

Second, around the 44:00 mark, we used Compass Pathways as an example of a company that is doing psychedelic research, but didn’t mean to also imply that they are opening ketamine clinics. Many psychedelic research companies, including Mind Medicine Inc, Mindbloom, and Field Trip Health, are going this route, but so far Compass is focused solely on psilocybin. We care deeply about accuracy at Narcotica, so this is just for clarity’s sake.

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