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The ketamine boom: How the wealthy are getting their hands on the in-demand drug

A vial of ketamine
(Teresa Crawford / Associated Press)
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Good morning. It’s Thursday, May 30. Here’s what you need to know to start your day.

What is fueling the ketamine boom?

Mystery surrounded Matthew Perry’s death last year after the “Friends” actor was found dead on Oct. 28 in a hot tub at his Pacific Palisades home. Over a month later, the L.A. County Department of Medical Examiner determined Perry died from acute effects of ketamine.

Ketamine, a drug often used as an anesthetic, was found in Perry’s stomach and bloodstream. Although it is legal in certain forms, ketamine is used recreationally for its hallucinatory effects and off-label to treat mental health issues.

Matthew Perry speaks about his book
Matthew Perry speaks about his book during the 28th Annual Los Angeles Times Festival of Books at the University of Southern California on Saturday, April 22, 2023.
(Dania Maxwell / Los Angeles Times)
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The demand for the drug, especially by the rich and famous who are its newest users, is growing. Medical and law enforcement officials say the wealthy are financing the black market while more prescriptions and specialized clinics are emerging.

My colleagues Salvador Hernandez and Richard Winton reported on the ketamine boom. Here’s what they found.

Clinics and online services galore

According to medical professionals, clinics and online services that offer intravenous treatments and at-home prescriptions — such as nasal sprays and tablets — are fueling ketamine’s new boom.

These services aim to treat substance abuse and psychiatric stress disorders like depression and post-traumatic stress disorder. The sessions are not cheap. A patient can pay from $350 to more than $700 for a single intravenous session or thousands of dollars for packaged treatment sessions.

For instance, at Dr. David Mahjoubi’s Ketamine Healing Clinic of Los Angeles, patients can receive a one-hour ketamine infusion for $700, personally monitored by Mahjoubi. The clinic also offers memberships for six ($2,580) and 12 ($4,650) sessions.

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Ketamine infusions were unpopular among the general public in 2014, when Mahjoubi opened his clinic, the board-certified anesthesiologist told the Times. But five years ago, he said, that changed. Demand grew and Mahjoubi opened a second clinic in Orange County in 2022.

Mahjoubi, who is also the president of the American Board of Ketamine Physicians, said he’s worried that some companies are prioritizing profiting off growing demands for the drug, instead of focusing on patients’ health.

“Someone would just open [a clinic] up and stick an untrained nurse in there and have them give [the patient] whatever dose in whatever duration,” he told the Times. “It was quite distressing to see that being done incorrectly.”

Unsupervised use is growing, especially after the pandemic

Ketamine is offered off-label to treat mental health issues like depression. In October, the Food and Drug Administration issued a warning saying it hasn’t approved ketamine’s use for psychiatric disorders and that unmonitored treatments “may put patients at risk for serious adverse events.”

Medical experts also don’t exactly know what the risks of off-label ketamine use are.

“There is little data to support these uses,” said Dr. Caleb Alexander, an epidemiologist and professor at Johns Hopkins Bloomberg School of Public Health. “And it’s a really risky proposition to be using this drug willy-nilly to treat these sorts of conditions.”

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The growing use of ketamine, according to Alexander, was exacerbated when the DEA permitted doctors to prescribe controlled medications online in 2020 in response to the COVID-19 pandemic. The rule has since been extended, allowing companies to continue to sell ketamine through online consultations.

“There has been an explosion of ketamine usage with these kinds of online direct-to-consumer marketing practices,” Dr. David Goodman-Meza, an addiction-medicine and infectious-disease specialist at UCLA, told the Times. “If enough people use a drug, you are going to see a certain proportion that is going to start seeing adverse side effects.”

The drug could cause abuse, psychiatric events, increased blood pressure and slowed breathing, according to the FDA. But many suffering from mental health issues, like Lila Ash, have reported feeling lighter and more hopeful after using ketamine, when no other drug or treatment seemed to help.

Self-prescription and the black market

“People are hearing about the medicinal uses for it,” said Bill Bodner, former special agent in charge of the DEA’s Los Angeles field division. “[And] are sort of self-prescribing on the black market.”

Because ketamine has therapeutic usage and doctors still prescribe it, policing the black market which has fueled the demand for ketamine, he said, is extremely difficult. Going after a doctor “would be almost impossible,” he said, unless the prescription had issues, such as hiding the amount prescribed to a patient.

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Customs and Border Protection officers seized more than 8,000 pounds of ketamine being carried into the U.S. in the fiscal year 2023. The year prior, CBP officers seized 14,000 pounds and this year, they nabbed 2,500 pounds through April.

Though ketamine was only 0.4% of all 3,220 drug-related deaths in L.A. County for 2022, the most recent data available, medical experts, like Mahjoubi, are concerned its growing use could lead to such serious consequences if clinics and online services aren’t careful in following all medical protocols.

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And finally ... from our archives

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Police confronting strikers outside Republic Steel during what became known as the Memorial Day Massacre in Chicago.
(Chicago Daily News / Chicago History Museum / Getty Images)

On May 30, 1937, Chicago police shot and killed 10 unionists in what has become known as the Memorial Day Massacre.

In a column for the Times, Greg Mitchell wrote about the massacre and how not a single police officer or supervisor was punished for his part in the violence, a fact that often echoes today.

Have a great day, from the Essential California team

Defne Karabatur, fellow
Kevinisha Walker, multiplatform editor and Saturday reporter
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Karim Doumar, head of newsletters

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