The Ketamine Mirage

Homepage of the Drug War Philosopher, Brian Quass

The Ketamine Mirage

and what it tells us about the Drug War

by Brian Ballard Quass, the Drug War Philosopher

May 14, 2022

Author's Follow-up: September 6, 2023

follow-up on essay by the Drug War Philosopher

I don't deny that Ketamine can help -- but this is a warning about long-term use. I absolutely hate to warn about problems with drugs, because that's all that Drug Warriors do, while totally ignoring the upsides, not with a goal of helping, of course, but in order to discredit the whole political category of substances called "drugs." But in this case, something weird is going on. Western promoters of ketamine say nothing about the downsides of long-term use about which Asian drug watchers are constantly chatting, namely, urinary problems. Even Drug Warriors in the west don't see the issue. They'll pan ketamine, perhaps, but in the same way that they'll pan any psychoactive drug: on Christian Science grounds as it were, without getting into specifics.

This again is all the fault of the Drug Warriors for their constant indifference to facts about drugs -- and it's now combining with capitalist boosterism to leave users in the dark.

So by all means, partake if it helps -- but be aware of the dangers of long-term use.

I have nothing to say on this topic about other drugs since the good and bad are constantly bandied about -- and especially the bad. But that does not seem to be the case with Ketamine, where only the good is being cited by folks with a vested financial interest in the therapy. The Drug Warrior would say, oh, this is a reason to outlaw Ketamine -- to which I say nonsense. It's a reason to be honest about all drugs -- including psychiatric meds -- and honest about their benefits as well as their downsides -- and not just their scientific benefits but their emotional and subjective benefits as well, about which the scientist cum scientist has no more expertise than anyone else, and often a lot less.

Americans can decide for themselves where any given drug will end up in a cost-benefit analysis, given the life goals of the user -- but this presupposes that they have honest info with which to make that judgment.

I thought I had done my homework. I checked out the first 10 pages of Google search results on "Ketamine" and "Depression" and saw nothing but cautious nods to the potential efficacy of the drug in fighting the blues. Might ketamine finally be one effective medicine that my government would actually allow me to use against my chronic depression? I called some of the companies already providing the drug and heard nothing but glowing accounts of the substance. I began checking out the location of these service providers and pondering budget schemes that would help me afford the high price tag for such treatment.

Just before I was ready to start making reservations for therapy, however, I ran across an unsolicited email from Hong Kong researchers warning of the rise of uropathy (urinary problems) in Ketamine users in Eastern Asia. The researchers claimed that ketamine use could result in the de-structuring of bladders, ureters, and kidneys.

This sounded highly suspicious to me at first, and for two reasons: 1) I had seen nothing but cautious praise for ketamine therapy in that Google Search I mentioned above -- and not so much as one single mention of potential urinary problems. Not one. 2) I knew that my own government had been lying to me about psychoactive drugs for well over half a century, demonizing coca and opium and psychedelics, when all three drugs have been used responsibly for millennia, not just by other cultures but by western luminaries as well. I knew that Benjamin Franklin enjoyed opium , that HG Wells swore by coca wine, that Plato's philosophy had been informed by the psychedelic rituals at Eleusis, and that the entire Vedic-Hindu religion had been inspired by the psychoactive plant medicine(s) known as Soma. If we unscientifically demonize drugs here in this "free and democratic country" of ours, why should I listen to a scare campaign coming from a seemingly less free and democratic country such as China (and/or a Special Administrative Region thereof)?

I didn't brush the topic under the rug, however. I did my due diligence, or so I thought. I called one of the main doctors providing highly publicized ketamine treatment in Florida and asked him directly: "Is there a risk of urinary problems resulting from ketamine use?" He gave me an unequivocal no. In fact, he had never heard of such a thing. Never.

Okay, I was depressed and I wanted to believe him -- and it seemed like I was being reasonable given those hope-giving search results I mentioned above. So I then shut down my search and began scheduling therapy.

Of course, had I really done due diligence and not listened solely to self-interested parties, I would have discovered there was much more to be worried about when it comes to ketamine than I wanted to believe. It turns out that it really matters what search terms you use on a Google search. If you search for "ketamine and depression," you will see only relatively positive stories about ketamine and depression. This makes sense from the point of view of algorithms. For if a story about ketamine is full of words associated with "urology," it is less likely to appear prominently under a search for the terms "ketamine and depression." What I found out, however, to my later horror, was that if you search Google for "ketamine and uropathy," you are swamped with results of stories flagging the dangers of ketamine use when it comes to the bladder, the ureter and the kidneys.

I will add in my defense that I was 64 at the time, and so my eventual decision to move forward with ketamine was also based on the fact that long-term negative effects were of slightly less concern for me than they might be for an 18-year-old.

And so I began what turned out to be five months of daily ketamine nasal spray therapy for depression.

The good news: ketamine did give me blessed relief from the strength-sapping defeatist "mind talk" which is the nemesis of the overthinking depressed, a blessed temporary escape from full-on consciousness. (By the way, this is one benefit of so-called "drug use" of which the Drug Warrior, in their psychological naivete, never takes account: namely, the "blessed temporary escape from full-on consciousness.") Besides being good in and of itself, the mere anticipation of these "mental escapes" was itself a godsend, giving me the motivation to carry on when "sober" under what might otherwise seem to be overwhelming sadness.

The bad news: Eastern Asia was right. After five months of use, I began noticing very subtle indications of potential urinary trouble.

Of course, I ceased use at once, fearful that I had not done so in time.

I don't entirely regret my experience, however, given my age and the extent of my depression. The experience also gave me more insight into how psychoactive medicine and disassociation can ease the mind. But make no mistake: if the price I pay turns out to be high, medically speaking, then America's Drug War is to blame, thanks to which we schedule and/or greenlight drugs not based on scientific facts and reports of actual usage, but rather based on political and capitalistic considerations alone.

MORAL OF THE STORY: The Drug Warrior would love to parley my misadventure into a morality tale against "drug use" in general, but the real villain of this piece is the Drug War itself, which has never taught us to understand drugs but rather to fear them. Far from trying to educate us, they lie to us, telling us that medicines that created entire religions actually "fry the brain ¹" -- this after drilling it into our heads as children that "drugs" are the one "boogieman" that we must fear for our entire life. According to the Drug Warrior, the monster under our bed is imaginary, but the boogieman of drugs is an eternal presence before which we must tremble for a lifetime.

Thus the Drug Warrior is the Great Chicken Little of modern society. We all discount his pronouncements because we know that it lies, exaggerates and tells half-truths. The problem is however that the Chicken Little (like the broken clock) is right on rare occasions -- even when he himself does not realize it -- and in those cases folks like myself are going to turn a deaf ear to what may turn out to be very valid anti-Drug Warnings, indeed.

So, I'll tell you what. Let's fix this so that it never happens to anyone again, either with ketamine or any other "godsend" that gets promoted based on capitalist motivations rather than scientific ones. Here's how.

In the post-Drug War world that I envision, where we have re-legalized Mother Nature and mind drugs in general (where we have rejected, in short, the government's right to tell us how we can think and feel...) we would replace the Drug Enforcement Agency with the Drug Education Agency -- and that agency would be full of pharmacologically savvy and empathic individuals with a deep knowledge of the sociocultural history of substance use around the world -- including every drug from sugar to heroin ², from coffee to coca, from Monster Energy drinks to opium , from Big Pharma anti-depressants to psychedelics and MDMA . They would be completely independent, free (and duty-bound) to bring out every objective bad side -- and every subjective good side -- to every possible form of psychoactive substance use.

This new - and demilitarized - DEA -would have an online FAQs page, where users and potential users could ask any question they want about any psychoactive substance in the world - and would get honest answers, based on the subjective and objective reports of actual users of the substances in question, both in modern times and the past. I'm talking about the kind of unbounded honesty that neither Drug Warriors nor self-interested capitalists can even imagine: a FAQs page that would actually warn you that modern anti-depressants lead to lifelong dependency, that intermittent opium sessions can increase creativity under proper circumstances, that the coca leaf can sharpen your mental focus without yet ruining your life, as the Drug Warrior would insist must happen when using such an "evil drug."

Complete honesty. That's the answer to the Drug War. Facts not fear.

In such a world, the depressed would not have to wonder whom to believe when considering new potential treatments like ketamine: they could 'ask the 'Drug Education Agency' experts', who, unfettered by either financial interests or the ideology of substance demonization, would clearly tell us the truth about the dangers and benefits of any and all psychoactive substances on planet earth, natural or human made.

I'm talking about the kind of unbounded honesty that neither Drug Warriors nor self-interested capitalists can even imagine: a FAQs page that would actually warn you that modern anti-depressants lead to lifelong dependency -- that would actually admit that intermittent opium ³ sessions can increase creativity under proper circumstances -- that would tell you how you can use the coca leaf like HG Wells and Jules Verne to sharpen your mental focus without yet ruining your life, as the Drug Warrior would insist must happen when using such an "evil drug."

May 17, 2022

You shoot, you score, Brian. I mean, only imagine: The DEA has been demonizing and criminalizing a host of godsend plant medicine for your entire life, all of which could be used safely with education and guidance. And now that you're 64, they finally decide to grudgingly allow the therapeutic use of one single psychoactive drug that they've been demonizing for years. And which one do they choose? The most harmful one they can find. Yet another proof that the DEA and the Drug War are not in business to protect Americans. Their goals are, 1, to give monopolies to Big Pharma and psychiatry for creating and selling psychoactive substances respectively, and 2) to shield the liquor business from competition, and 3) to provide work -- and plenty of it -- for local law enforcement and corrections officials when it comes to cracking heads, chiefly those of minorities and the poor.

Imagine that! This drug, ketamine, with its nasty urological baggage, is now available for depression therapy at the same time when materialist science and the FDA are still wringing their collective hands about the possibility of allowing depressed folks like myself to use MDMA , one of the safest drugs in the world. They say, "Oh, it's still too early for you to use it, Brian!" I say, "Begging your pardon, but as far as I'm concerned it's 60 years too late!"

This endless delay of psychoactive drug approval is based on and justified by a flawed assumption: namely, that safety is the number-one concern when it comes to the decriminalization of psychoactive drugs. Certainly safety is one concern. But the idea that such drugs can be deep-sixed for safety concerns alone is problematic, to put it mildly. People use psychoactive drugs in order to make their life meaningful, and for many of us, self-actualization trumps safety. In other words, we would gladly live 30 years in a drug-aided self-actualized manner than 50 years in a drug-free world of listlessness and boredom. What we need are the facts to decide whether use of a given substance passes a cost-benefit analysis for us personally, given our priorities in life. The FDA has no standing in making that sort of determination, and therefore should limit its role to advising potential users of the objective risks and benefits of use based on actual case stories, past and present -- something that they have failed to do so blatantly when it comes to ketamine.

Moreover, to the extent that the drugs in question are products of Mother Nature, the safeness of a given substance is a moot point. The government has no right (under the natural law upon which Jefferson founded America) to debar us from what Locke called "the use of the land and all that lies therein." So if scientists believe that botanical substance A is dangerous for us, they should feel free to tell us about it -- but not to withhold it from us.

May 19, 2022

I have perhaps given short shrift (in fact no shrift at all!) to the possibility that the above-described ketamine use, despite the mentioned side effects, may still have beneficial long-term effects for me by dint of the chemical changes that it effected during my five months of use. That, after all, is the way that the substance's use for depression is generally justified these days, not on the psychological effects which have primarily interested me but rather on the mood-elevating neurochemical effects that ketamine is thought by researchers to bring about. And indeed I do seem to have more personal initiative post-ketamine use, although that, of course, could just be a happy coincidence brought about by unrelated factors.

I'll be glad to give ketamine the benefit of the doubt for now -- always prefaced by the big asterisk flagging potential urinary side effects in any but quite short-term use (months, not years).

I should add, however, that I have a good excuse for having downplayed the reductionist case for ketamine use in depression therapy. It was, after all, a reductionist mindset that brought about the great psychiatric pill mill,
thereby turning America into a nation of Stepford Wives in which one in four American women are dependent on Big Pharma antidepressants ⁴ for life. The idea was that scientifically, through reductionist chemistry, one could find a one-size-fits-all cure for depression. Yet, over half a century later, America remains the most depressed country in the world. Meanwhile these "silver bullet" drugs that were originally meant to cure depression in the short term have turned out to be highly dependence-causing and, in fact, are often harder to kick than heroin. And was there some form of giant recall? Did newspapers halt the presses! Did politicians scream bloody murder Au contraire. Instead of apologizing for thus addicting the entire country to faulty meds, psychiatrists turned around and told their "patients" that they had a medical duty to take these dependence-causing drugs every day for the rest of their lives! (They no doubt learned a thing or two from the dairy industry, which denied their product caused stomach aches and blamed the problem on the drinkers themselves, who they told us were intolerant of dairy's wonderfully safe product.)

Americans console themselves for this unprecedented pharmacological dystopia by embracing the myth that SSRIs fix a chemical imbalance in the brain. Yet that's simply not true. As Richard Whitaker writes in "Anatomy of an Epidemic":

The medicine clearly doesn't fix a chemical imbalance in the brain. Instead, it does precisely the opposite.... Fluoxetine (Prozac)... gums up the normal removal of serotonin from the synapse, and that triggers a cascade of changes, and several weeks later the serotonergic pathway is operating in a decidedly abnormal fashion.

So, if reductionist researchers are right about the long-term mood-lifting benefits of short-term ketamine use, that's great. But we must not lose sight of the fact that the reductionist approach already has a body count. Moreover, the reductionist mindset of the NIMH and FDA makes those agencies antagonistic to the needs of the depressed? Why? Because it gives them an almost laughable indifference to human motivations and common-sense psychology. How else do we explain the fact that MDMA and nitrous oxide remain out of reach of the depressed to this day despite the fact that any sad sack will tell you that either drug would be a godsend for them? Yet the reductionist researcher keeps saying, in the teeth of over half a century worth of evidence of safe and efficacious use for creating transcendence and mood improvement: "Wait! We must prove that this drug actually 'works' with a capital W?" Well, I think I speak for all of the depressed when I say I'd be happy to have it simply work.

What? Prove that laughing gas ⁵ might work for the depressed? Prove that MDMA ⁶ , a drug which brought universal harmony to the British dance floor, will work for the depressed? The proof is extant, Mr. and Mrs. Reductionist, and your delays are merely torturing the depressed by unnecessarily disbarring them from the use of godsend medicine. So please, pull your bi-focaled eyes away from the microscope lens and take a look at the millions of folks whose lives you are unnecessarily ruining with your obsession for "REAL" cures. What? Real cures like the Big Pharma ⁷ ⁸ one that supposedly would cure depression, but instead ended up creating the greatest chemical dependency in world history???)

The Links Police

cop car image courtesy ReiRever via tenor.com

Do you know why I stopped you? That's right, I wanted to give you some essay links to eke out your understanding of the issues raised above by that Brian Quass chappie. On the subject of materialism ⁹ and the Drug War, you could do worse than read the following: . Oh, and here's a good one: I think that latter essay may have even gotten Brian banned from the Reddit Psychiatry group -- though I've long since lost track of who banished Brian from what.

Author's Follow-up: July 21, 2022

I hear many tech pundits praising Google for having made Web searching "objective." Of course, this is nonsense because all search algorithms are based on subjective (and economically self-interested) judgments by the coders as to what constitutes a valuable link for a given search. Google search fails almost completely when it comes to searches for ketamine and depression since the results almost entirely fail to point out any health concerns -- unless you specifically look for those concerns. Likewise, if you look for ketamine-related health concerns, you get the idea that no one's using the substance for treating depression. In other words, Google algorithms behave according to the rule: "What you see is what you wanna see -- not necessarily what you need to see."

Matthew Perry and the Drug War Ghouls

Notes for essay entitled The Ketamine Mirage: and what it tells us about the Drug War:

1: Meds fry the brain, not drugs DWP (up)
2: Hall, Wayne, and Megan Weier. 2016. “Lee Robins’ Studies of Heroin Use among US Vietnam Veterans.” Addiction 112 (1): 176–80. https://doi.org/10.1111/add.13584. (up)
3: The Truth About Opium by William H. Brereton DWP (up)
4: Antidepressants and the War on Drugs DWP (up)
5: Forbes Magazine's Laughable Article about Nitrous Oxide DWP (up)
6: How the Drug War killed Leah Betts DWP (up)
7: Seife, Charles. 2012. “Is Drug Research Trustworthy?” Scientific American 307 (6): 56–63. https://doi.org/10.1038/scientificamerican1212-56. (up)
8: LaMattina, John. n.d. “Why Is Biopharma Paying 75% of the FDA’s Drug Division Budget?” Forbes. https://www.forbes.com/sites/johnlamattina/2022/09/22/why-is-biopharma-paying-75-of-the-fdas-drug-division-budget/. (up)
9: How materialists lend a veneer of science to the lies of the drug warriors DWP (up)

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Ten Tweets

against the hateful war on US

Drug prohibition is a caustic lye that destroys every democratic freedom that it comes in contact with.

Kids should be taught in grade school that prohibition is wrong.

This is why we would rather have a depressed person commit suicide than to use "drugs" -- because drugs, after all, are not dealing with the "real" problem. The patient may SAY that drugs make them feel good, but we need microscopes to find out if they REALLY feel good.

The drug war controls the very way that we are allowed to see the world. The Drug War is thus a meta-injustice, not just a handful of bad legal statutes.

Drug Warriors will publicize all sorts of drug use -- but they will never publicize sane and positive drug use. Drug Warrior dogma holds that such use is impossible -- and, indeed, the drug war does all it can to turn that prejudice into a self-fulfilling prophecy.

"Like Christians burning mosques and temples to spread the word of Jesus, modem drugabuseologists burn crops to spread the use of alcohol." -- Ceremonial Chemistry, p. 48

The massive use of plea deals lets prosecutors threaten drug suspects into giving up their rights to a fair trial.

It is evil to give the depressed drugs to help them die while barring them from using drugs that could make them wish to live.

If we let "science" decide about drugs, i.e. base freedom on health concerns, then tea can be as easily outlawed as beer. The fact that horses are not illegal shows that prohibition is not about health. It's about the power to outlaw certain "ways of being in the world."

Freud's real discovery was that drugs like cocaine could make psychiatry UNNECESSARY for the vast majority of people. The medical establishment hated the idea -- so they judged the drug based on its worst possible use!

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(up)

The Ketamine Mirage

and what it tells us about the Drug War

Author's Follow-up: September 6, 2023

The Links Police

Author's Follow-up: July 21, 2022

Ten Tweets

against the hateful war on US

Break the ice with a sledgehammer: place this book on your coffee table.

Diary of a Drug Fiend