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Liz Kost had “never experimented” with ketamine, an anaesthetic with a reputation for being a party drug. But she decided to give it a try when she was offered it by her employer. “It was awesome,” she says.
The experience was not for fun, but for therapeutic reasons. Dr Bronner’s, the California-based organic toiletries company, where Kost is a marketing operations manager, provides fully paid-for ketamine therapy as part of its employee benefit package.
The offer coincides with a “dramatic growth in interest in ketamine-assisted psychotherapy over the past few years,” says Jeffrey Zabinski, assistant professor of psychiatry at Columbia University Medical Center.
Ketamine has been approved by the US Food and Drug Administration for use as an anaesthetic since the 1970s. But more recently, specialist clinics have begun touting it as a mental health treatment. While it has not been widely approved by the FDA, it is legal for doctors, psychiatrists or in some states nurse practitioners to prescribe the drug “off label” for these new purposes.
The perk arrived at a “desperate time” for Kost. “I had a pretty traumatic time as a child. I’d suppressed my emotions but when Covid hit . . . that uncertainty unearthed my traumas.” She had anxiety attacks and couldn’t sleep. “I was stuck in a trauma loop.”
Kost initially sought more conventional psychotherapy, but after watching her company’s founder Mike Bronner talk about the new benefit, she decided to give it a go. “He’d been open about depression in the past and [spoke about] how ketamine had helped.”
Patients usually have three to six sessions through a specialist clinic, sometimes after being referred by another medical professional. Kost had six over a couple of weeks, with a booster session later. After a consultation with Flow Integrative, a ketamine therapy provider, the service was overseen by Enthea, a health insurance administrator that offers employers psychedelic treatment for staff.
It comes as more companies look to help employees with mental health, offering access to therapy, or apps. Saïd Business School professor Sally Maitlis says employers’ interest in ketamine is at best motivated by “real concern” for depressed employees. But she warned it could also be part of a “scattergun approach”, that avoids tackling complex root causes of mental ill health.
Kost first took the ketamine in lozenge form at home, supervised by a trusted adult and virtually-connected therapist. “I was terrified, I’d never done anything like this. Ketamine immobilises you. When you come from trauma you’re not excited to be immobilised,” Kost says. The home setting wasn’t helpful. “All I could do was think about the laundry.”
Next, she had it intravenously in a clinic. “You sit in a big comfy armchair, they give you a weighted blanket, they hook you up to the IV, and play music. You spend an hour thinking about your life and people you love.” The practitioners were “kind and caring . . . If it was more of a cold clinical setting I might not have done it.”
Ketamine, she says, helped her overcome her tendency to ruminate. “I call it a massage for the soul. It helps kick you out of your trauma,” she says. “[I thought] wow, the universe is a larger place than I imagined. It puts you in a positive mood and mindset.” Having access to therapy, to process thoughts and feelings, was essential, she believes.
Allan Young, director of the Centre for Affective Disorders at King’s College London, says there is good evidence ketamine helps treatment-resistant depression. Among his patients suffering from it, up to half improved after taking a nasal spray derivative of ketamine, which is approved for use in many countries.
Sherry Rais, Enthea chief executive, says new uses of ketamine are “widely considered normal, safe, and effective” — an example of “off-label” prescribing already common in cases such as the drug propranolol, approved for heart conditions but often prescribed for anxiety.
However ketamine comes with risks. The FDA warns of “sedation, dissociation, psychiatric events or worsening of psychiatric disorders”. Abuse has been linked to bladder and heart problems. Last year, actor Matthew Perry, who had received ketamine-assisted therapy in the past, accidentally died from “acute effects of ketamine”, according to the Los Angeles coroner. This, Young says, means ketamine must “be part of a well formulated care package” following a “thorough assessment” by professionals.
Yet while much about long-term effects is still unknown, Zbinksi says commercial clinics offering the drug for an array of condition are springing up faster than new research. “Some places seem to have minimal screening requirements — as if they’re willing to treat almost anyone who has the ability to pay.”
Ketamine seems unlikely to go mainstream as an employee perk. Kost suspects most companies are too cautious for it to become “a big business trend”. But she remains an evangelist. “It’s definitely worth it . . . I don’t want people to think we’re sitting around taking a bunch of party drugs.”
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