On a risk/harm scale, it's comparable to alcohol or cigarettes[1].
[1]: https://en.wikipedia.org/wiki/Drug_harmfulness#/media/File:D...
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When you get ketamine from the internet, you're getting a mystery powder that is, at best, a potent form of an addictive drug in quantities that are not metered and are ripe for abuse. At worst, you're getting some form of fentanyl because internet drug dealers are inept.
> a potent form of an addictive drug
It's literally the same chemical; you didn't use those adjectives when you described it earlier.
> quantities that are not metered
Readily fixed for < $20: https://www.amazon.com/dp/B07D1NNGM6/
https://erowid.org/chemicals/ketamine/ketamine_dose.shtml#or...
> At worst, you're getting some form of fentanyl because internet drug dealers are inept.
That's not a ketamine problem; it's a prohibition problem.
My friend had one like this. It was barely accurate enough for all the funny RCs we had.
I would talk the same way about treating ADHD with Desoxyn prescribed by a doctor versus buying a pile of methamphetamine online to self-medicate with.
> Readily fixed for < $20: https://www.amazon.com/dp/B07D1NNGM6/
If you're going to make bad choices, volumetric dosing is one of the less bad choices.
> That's not a ketamine problem; it's a prohibition problem.
It's a regulation problem. The supplement market is full of bunk or outright fake products. It took the FDA to reel actual medicine in.
At least near me, there are "ketamine centers" that already to ketamine clinics - $500 per session, and insurance doesn't cover it. Ends up being around $3000. I haven't done it, so I can't comment on its effectiveness.
It's pretty lame that the cost difference is so large. I guess the barrier is a psychiatrist's willingness to prescribe. Maybe all of this research will open up psychiatrists to prescribe take-home ketamine more readily?
It's been a long time since I lived in Canada, but one of the "small problems" was that prescription medicine wasn't covered. You need private health insurance, or you need to be covered by one of many confusing provincial health care plans. Generally, you can find a way, but at least 15 years ago (when I left) it could be pretty dicey. I remember several of my friends having difficulty affording their insulin when I was in university -- too rich to qualify for aide, too poor to be able to pay for their life saving drugs without hardship. My dad (who still lives there) tells me things have improved, but he still pays more for prescription drugs than I do (living in Japan) I think.
The UK's NHS seems to be a better system to compare to ;-) I lived there for 2 years and was really surprised at what the NHS covers. Interestingly they will even pay for emergency treatment for non-residents who happen to be in the country!
The caveat is all of the stuff that the NHS won't cover. The service is largely free at the point of use, but there has always been some element of rationing which has drastically increased in recent years due to Conservative government cuts.
Mental health gets the short end of the stick in this respect - it represents 23% of the disease burden but only 13% of NHS spending. Most patients with a mental health condition will never see a psychiatrist and receive no more than six half-hour sessions of psychotherapy. If esketamine does prove to be effective, the NHS is exceedingly unlikely to offer it to more than a handful of patients until the patent expires.
https://www.nuffieldtrust.org.uk/resource/rationing-in-the-n...
[1] https://www.nhs.uk/using-the-nhs/nhs-services/visiting-or-mo...
In the specific case of ketamine for depression, some people do seem to have successfully gotten insurance companies to pay for it.[2] Even without FDA approval, this would probably get easier over time, as more studies show effectiveness.
[1] https://www.aafp.org/afp/2003/0801/p498.html [2] https://www.ketaminewellnesscenters.com/getting-insurance-to...
is just a system that forces healthy people to pay for unhealthy people.
In this last case, you might pay more for certain markers (smoking, uncontrolled high blood pressure, and other wellness marks), but not if you have asthma or migraines, for example. Part of your premium is literally paying for folks that are sick. Paying for other people's pregnancies and children and stuff like that.
[1] https://en.wikipedia.org/wiki/List_of_countries_by_total_hea...
Let's say my doctor says to me "you're depressed, I'm prescribing esketamine, go to this clinic and pay them $3000". Well, I do my research and learn that really this stuff has the same antidepressants effect as ketamine. And the same number of doses of ket on the darknet markets are going to cost me a heck of a lot less.
Sure, there's the question of legality. But if I can't afford esketamine but can afford dodgy internet ket, and I'm desperate for something, anything, to help with this nagging constant psychic pain weighing down my life...
Suddenly I appreciate my Canadian single payer health care system a lot more, even with the small problems it has.