KAP article GWC

What is Ketamine?

Ketamine is a dissociative anesthetic often used in medical settings due to its excellent safety profile. First approved by the US Food & Drug Administration (FDA) in 1970, its effects include sedation and reduced sensation of pain. It is seen as a safe alternative to existing anesthetics because it suppresses neither respiration nor heart rate.

Early in the 21st century, it was discovered that ketamine was remarkably effective as an antidepressant when given in smaller doses. It has also been shown as effective in reducing anxiety, decreasing suicidal feelings, in the treatment of addiction disorders, and to improve PTSD symptoms by allowing you to revisit past traumas more safely and confidently. In other words, ketamine helps with the processing of difficult emotions in order to heal from these experiences. Although ketamine works on different parts of the brain than classic psychedelics like psilocybin, the experiences on ketamine can be very similar.

What is Ketamine Assisted Psychotherapy?

Ketamine assisted psychotherapy (KAP) is an intense type of therapy that can get to core feelings and help to rewire emotional memories. Ketamine helps to bypass defenses, lower anxiety and provide access to deep feelings. Our defenses and anxiety can act as protective mechanisms in times of stress or trauma, yet when they are activated automatically, (and often below our awareness) they can keep us stuck in unhealthy patterns.

Ketamine triggers neuroplasticity (a state where you brain can more easily learn, change and adapt) almost immediately. This state allows the brain to form new neural connections and to disconnect from old patterns or ways of thinking that contribute to mental health symptoms. This temporary window of neuroplasticity is an excellent time for establishing new habits, thought patterns and perceptions, and this is why KAP at the Golden Wellness Center includes integration work after each medicine session.

One advantage of ketamine over traditional antidepressant medications is how fast it works. A 2020 review from the National Institute of Health suggests it may provide benefit within 2 hours of dosing, with the effects being sustained for up to two weeks following a single dose. This is in contrast to antidepressants which take several weeks to start working and up to 4 weeks to reach therapeutic levels.

Is Ketamine Safe?

Ketamine has been studied as an anesthetic for over 50 years. The World Health Organization has it on their list of essential medications and reports “Ketamine [is] one of the most essential medications due to its therapeutic effects and wide margin of safety.” It is used in emergency medicine and minor surgical procedures for pain relief, and more recently as an “off-label” use for the treatment of depression. Ketamine is well understood, and there is a strong amount of research supporting its use. In addition, this medicine has a relatively short half life which refers to the amount of time it takes for ½ of the substance to be excreted from your body. Ketamine metabolizes quickly with a half-life of around 2.5 hours, and after approximately 10 hours the majority has left your body. In contrast, caffeine has a half-life of 5 hours.

Ketamine is very well tolerated for the majority of people, and has a fast onset and manageable total duration. It is metabolized and moves through the body quickly—all of which are considered advantages and help with the limited side affects and safety of this medicine.

Are there any side effects with Ketamine?

Less than 10% of people report some nausea with ketamine. This is one of the reasons we request that you fast for at least 4 hours beforehand. Ginger chews or tablets can also help, as can anti-nausea mediation taken before your session.

Other temporary side effects reported in approximately 10% of people include headache, elevated heart rate, drowsiness, light-headedness, dizziness and increased blood pressure.

What does ketamine feel like?

It is important to remember that each persons experience is different, and highly dependent on one’s mindset as well as the setting of their experience. Preparation sessions offered at the Golden Wellness Center are part of this process and help to ensuring the maximum benefit is available for this type of treatment.

During the medicine session most people report feeling a sense of calm, feelings of awe or joy, tingling sensations, slightly elevated heart rate, altered sense of time and space, reduced awareness of the physical body, a sense of sacredness, a deeply felt positive mood and ineffability.

Why do ketamine assisted therapy in groups?

In addition to a significantly lower cost, an advantage of participating in ketamine therapy in a group setting is the opportunity to connect and a chance to support one another in a meaningful way. The use of psychedelic plants and fungi in group or community settings has been practiced by indigenous cultures for millennia. Once FDA approved, the future use of psychedelic medicines like MDMA or psilocybin is likely to include group therapy.

All Golden Wellness Center group participants are required to respect confidentiality and no one is asked to discuss or share more than they are comfortable with. The majority of the medicine sessions are spent with each person wearing headphones and eye masks and are mostly experienced as an internal journey. The collective energy of several people working towards healing together is an experience that many describe as one of the most significant parts of their treatment with ketamine. It provides an opportunity for connection with others and many people in therapy report this is something they desire more of in their lives. Group preparation and integration sessions are generally held in the early evening and group medicine sessions are often held Friday mid-morning. Group size is limited to 6-8 participants.

Does ketamine therapy work for couples?

Ketamine assisted therapy can be an effective tool for healing and deepening relationships and improving communication between two people. Along with therapy, two people journey together using ketamine. This treatment is available for couples, family members or friends who are interested in creating a deeper connection and understanding, working to transform old patterns, reduce defensiveness, repair and heal from hurts and increase openness.

How often should ketamine be taken?

6-8 sessions with Ketamine are recommended in order to maximize the neuroplastic effects of each session—which can last up to two weeks. Our evidence-based treatment protocol is designed to help you reach your desired outcomes by pairing multiple sessions together. Research and clinic results have indicated that this extends the effectiveness of treatment, leading to longer-lasting relief. The increase in mental flexibility, openness and general mood brought on by a single session can be built upon by adding on multiple sessions through the course of treatment. This process is called stacking, and is believed to be the best way to encourage more long lasting effects and overcome ketamines overall short duration. While benefits can be achieved with 1 or 2 sessions, it is our experience that 6-8 sessions can give the best overall picture of the potential for this type of therapy.

How much does it cost?

The Golden Wellness Center protocol includes two initial evaluations to get started with Ketamine Assisted Psychotherapy. The first meeting will occur with a specially trained psychedelic assisted therapist who will then make a referral to a medical professional with specialized training in KAP. We work with Journey Clinical for ketamine prescriptions. These initial appointments are the same regardless if you choose to participate in individual or group KAP. If the initial evaluations support continued work with ketamine then the client will receive a prescription for ketamine that is enough for two dosing sessions and will also schedule the preparation session. Therefore the first round of treatment includes two initial evaluations (medical and psychological), one preparation session, the medicine dosing session and one integration session. After that, each round of medicine includes a dosing session followed by an integration session. At least one integration is required before having another session with ketamine. After the second round of ketamine sessions, and if the client decides to continue with treatment, a follow up is scheduled with the medical provider which includes a dosage adjustment (if needed) and a prescription for 6 sessions worth of ketamine.

BREAKDOWN OF FEES

 INDIVIDUAL      GROUP          COUPLE
Initial KAP Evaluation –     $200$200         $300
Initial Medical Evaluation –     $250$250    $250 each
Ketamine prescription (2 doses)      $85$85      $85 each
Preparation Session –     $200$100          $300
2 hour KAP Treatment Session –     $450$200          $500
Integration Session –     $200$100          $300
Medical follow-up (after 2 treatment sessions)     $150$150     $150 each
Ketamine prescription (6 doses)     $145$1455     $145 each

Is Ketamine therapy covered by insurance?

While the value of ketamine in medicine is well-established, many insurance companies remain hesitant to provide mental health treatment reimbursements, and seldom take a consistent stance on ketamine coverage, meaning decisions can vary on a case-by-case basis. As a result of these inconsistencies, many ketamine therapy providers have elected to take cash-only payments and not work with insurance.

The Golden Wellness Centers seeks to address the issue head-on by working with your insurance company and providing the support you need throughout this process. We will attempt to bill your insurance for reimbursable expenses, although most plans are unlikely to cover more than 40% of the cost. If your insurance plan is not part of our group of in-network carriers, or doesn’t provide direct reimbursement we can provide you with a super-bill and help guide you with steps you can take to attempt to receive some reimbursement.

In cases where ketamine therapy is not covered through insurance, other aspects of the bill may be reimbursed. The price tag on ketamine therapy also includes medical evaluation, monitoring, therapy preparation and integration sessions all of which are often covered by insurance. In many cases patients do not pay the full cost of treatment, even if insurance does not cover the full ketamine therapy itself.

We recognize that, despite our commitment to keep our pricing as low as possible, it can still be a financial stretch for many to afford ketamine therapy. In addition to working with insurance companies, we also accept the Advanced Care Card which may be used to finance payments for Ketamine Assisted Psychotherapy at a low or in some cases 0% interest rate.

  1. Instructions to apply for the Advanced Care Card:  Go to https://advancecarecard.com/ and select “For Patients.” Select “Apply Now.”
  2. After the application is submitted, approval takes approximately 60 seconds.
  3.  If approved, a Citi credit card with the pre-approved amount is mailed to you
    within 5-7 business days.
  4. You can then use the card for services at our clinic. Since it functions as a regular
    credit card, the clinic simply receives the full amount that we charge for.

https://www.scientificamerican.com/article/getting-the-inside-dope-on-ketamine-rsquo-s-mysterious-ability-to-rapidly-relieve-depression/

https://pubmed.ncbi.nlm.nih.gov/20673547/. Rapid resolution of suicidal ideation after a single infusion of an N-methyl-D-aspartate antagonist in patients with treatment-resistant major depressive disorder

https://jamanetwork.com/journals/jama/article-abstract/2662752 Ketamine Minus the Trip: New Hope for Treatment-Resistant Depression
https://www.npr.org/sections/health-shots/2012/10/04/162299564/ketamine-re lieves-depression-by-restoring-brain-connections

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