Hundreds of clinics may be using false and misleading statements in online advertising campaigns by offering off-label and unapproved ketamine to treat a variety of mental health and pain conditions, according to researchers at the University of Colorado Anschutz Medical Campus and Johns Hopkins University.
The study was published in JAMA Network Open.
“These are expensive treatments for which patients generally must pay out of pocket, and the evidence base is often not robust for many of the advertised uses,” said Michael DiStefano, PhD, assistant professor in the Department of Clinical Pharmacy at the CU Skaggs School of Pharmacy and co-lead author of the study. “It is important that people considering these treatments are provided with an accurate and balanced statement of the possible risks and benefits.”
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In the paper, the researchers note that intravenous ketamine is not Food and Drug Administration (FDA) approved to treat any mental health condition but is sometimes used off-label for it. Oral formulations are unapproved drugs that are often advertised to produce a hallucinogenic experience at home.
For this cross-sectional study, the team identified online direct-to-consumer ketamine advertisers with at least one clinic in Maryland and a website by using six national ketamine databases. Researchers found 17 advertisers operating across 26 locations in Maryland that promoted infusions or ketamine assisted therapy for a wide range of conditions including depression, post-traumatic stress disorder (PTSD), anxiety and chronic pain. The advertising revealed numerous misleading representations regarding treatment and safety.
While the study focused on clinics in Maryland, DiStefano said their compilation of the six directories for ketamine treatment suggests that there are approximately 800 such clinics across the United States. He said there are also several companies that will send customers oral ketamine through the mail.
“Psychedelic or hallucinogenic substances are increasingly being considered as mental health treatments. For example, Colorado is at the vanguard of developing policies to govern the use of psilocybin in depression,” DiStefano said. “It is important to be transparent and accurate when explaining the potential risks and benefits of these treatments. While these treatments can provide hope and will be effective for some patients, there are real risks associated with ketamine use, especially over the long-term. There are high financial costs to consider as well.”
DiStefano said the researchers hope to do a national survey with an expanded analysis soon.