You're advocating buying a black market substance online and then snorting it as the safer option?
Only issue I see with intranasal is that bioavailability is only 33%
Though, ketamine is pretty damn safe, and it's rarely adulterated on the black market. In powder form, it forms crystals so it's hard to fake.
A priori, you can always say that something regulated is more safe than something not. But if you're a savvy consumer, you can significantly mitigate or eliminate that risk.
What is harder to fake it vial ketamine. There is a significant cost to that.
I'm suggesting that if you can't afford a Ketamine clinic: a) Ketamine is generally unadulterated on the black market b) if it is adulterated you can often tell c) unless a professional is administering it, you probably want to snort it and finally d) snorting Ketamine should have roughly the same effects (anti-depressant or otherwise) as injecting it.
Also egcg seems to completely block it's damaging effects https://www.sciencedirect.com/science/article/pii/S187952261...
Insufflation is only "just as effective" if your goal is to get an intense psychedelic high.
If your goal is a strong antidepressant effect, insufflation is extremely less effective than IV-drip-over-40min. This isn't just my opinion, it's the consensus opinion of ketamine docs across the world.
Insufflation helps you for a few minutes to a few days, IV drip method works for 3-6 weeks.
What about IM? What about rectal administration? How about sublingual? Are there any papers suggesting that IV is somehow quantitatively different from the aforementioned methods?
My personal experience is that IM, IV, and snorted all made me feel better for maybe a period of 2 weeks. I wasn't necessarily doing a "clinical" dose, whatever that means (maybe 25-75mg of IM or IV and 100-250mg snorted), but the anti-depressant effects all seemed comparable.
A drug crossing the blood-brain barrier is a drug crossing the blood-brain barrier. There should be no difference in administration if we are talking about weeks to months later.
Optimizing the dose & duration to get your mind into that state, and for the right amount of time, makes a huge difference in how long the effects last. This is why I prefer using an actual doctor with ketamine depression treatment experience, because they have experience figuring out the right dose & duration for you.
The time that the effect lasts is variable. A patient may need an infusion every week. That's $26,000 a year in some cases.
I actually had a doctor tell me that the infusions last 6 months.
My previous doctor runs a monthly group meeting where patients get together to discuss their experiences. The vast majority of attendees had positive experiences. So even if you don't trust the doctor, you can trust the living proof of positive outcomes. Sure, you could say that the group self-selects for positive outcomes, but no one claims this treatment is 100% effective, either.
Yes, ketamine docs want you to see a psychiatrist because they don't want to deal with you. It's about the money and having as little responsibility as possible.
A support group to discuss experiences? That sounds like it would encourage a placebo effect.
What makes you think both my doctors don't have clinical experience? (I never stated, you never asked. As it turns out, they both do.) You've turned this conversation into a pissing match about whose doctor is best, which is too petty for me, so this will be my last post in response to you.
> Many of the practitioners aren't even psychiatrists
> ketamine docs want you to see a psychiatrist because they don't want to deal with you
So a ketamine doc that isn't a psychiatrist is bad, in your opinion. And also any ketamine doc who realizes that the situation he's treating requires psychiatry for optimum outcome, recognizes they lack said experience, and makes you go to someone with that experience, is also bad? I'm sorry, but your posts reek more of an anecdotal agenda rather than... science. So, I'm done.
"ketamine doc who realizes that the situation he's treating requires psychiatry for optimum outcome, recognizes they lack said experience, and makes you go to someone with that experience, is also bad?"
The "ketamine doc" you're advocating people should see to treat their persistent psychological conditions such as PTSD or Depression, has no experience or background in treating any psychiatric/psychological conditions at all (and they get credit for recognizing that!).
Given the above, what service does the "ketamine doc" provide other than selling the ketamine? Like, what difference does it make that they are a doc? The access to an IV drip? The ability to google dosage? I can do renal function work ups with my family physician.
I'm genuinely confused on what value they add beyond a street dealer (assuming identical substance quality, home tests do exist).
Which is to say, a doctor is generally understood to be something beyond a prescription pad and should actually be involved in the treatment he's supposedly providing. Also, I feel like this "treatment" model is highly likely to incentivize profit-maximizing-pill-pushing clinics rather than compassionate therapists.
(1) Safely starting an IV on you
(2) Monitor your heart rate, O2, bp levels during the infusion - sometimes people have problems during infusions, I've never had one, but I feel safer having these treatments knowing my vitals are being monitored
(3) Training to know how to solve emergency health issues you may have during the treatment. I personally value this on-the-spot emergency medical knowledge very highly, but if you don't then I can understand why you might question the value. I am completely and utterly helpless during an infusion, if anything bad happens to me, I will be utterly unable to help myself, even a tiny bit.
(3) Access to pure/safe ketamine
I've never known, or heard of, a psychiatrist that will do all this. They very well may exist but not in my area.
tl;dr - don't need to worry about urinary tract issues unless you're using the drug (1) recreationally; (2) irresponsibly
So you feel like you need to piss regularly, but only a few drips come out. The damage can get so severe bladder gets removed.
At the lesser end of the damage is agonising stomach cramps, no idea what the cause of this is.
source: spent too long in the uk freeparty rave scene when ketamine was legal and people assumed it was completely safe due to lack of come down. Too many people ended up with severe ketamine addictions and many have to know piss through a bag
Also, it's much much cheaper on the black market than ketamine. We're talking around 1000 (recreational) doses for $20. Compared to say 10 (recreational) doses of ketamine for maybe $50?
What is it like to still be living in 2014? MXE hasn't been manufactured in any significant quantity since China banned it years ago. The stockpiles that remained have been stretched out at high prices and have significantly degraded over the years, people are reporting needing 2-3x the previous dose.
MXE does have the same bladder issues, but is taken as a smaller dose so it takes longer to happen.
PS: Chronic Ketamine use destroys your urinary tract (I know people that wet the bed every night from too much of the stuff). Also, it might cause brain damage, but no one is really sure.