Scoring a ketamine prescription online took me exactly five minutes and 24 seconds one dreary Tuesday evening in November, and I didn’t even leave home.
I logged onto Everyone’s M.D., a telehealth company that provides on-demand prescriptions for California residents. I clicked “Start Visit,” waited a few seconds, and began video chatting with a doctor, whom I told I had trouble sleeping. Five minutes and 24 seconds later, I had a prescription for ketamine nasal spray, with instructions to take 1 spray before bed.
After paying $225, a ketamine spray bottle arrived in the mail two weeks later, dispatched from a special type of pharmacy that distills its own medications. The bottle contains 15 milliliters total and administers a 0.1 milliliter spray. In total, that amounts to 150 sprays, or 75 doses of one in each nostril.
“Instill 1 spary [sic] into each nostril every 6-8 hours while awake,” instructions on the bottle said.
Ketamine, a dissociative psychedelic drug which was first used as an animal anesthetic before becoming a party drug—known as ‘Special k’—due to its euphoric effects, is approved by the U.S. Food and Drug Administration as an anesthetic.
But in recent years there’s been a surge of interest in using it for a different, off-label purpose: a cure for treatment-resistant depression.
For individuals who don’t see results from typical depression drugs, a high dosage of ketamine can provide fast, though transient, relief. The discoveries are part of a general societal push toward decriminalizing party drugs like psilocybin magic mushrooms and MDMA.
Couple that with Covid-era measures allowing doctors to remotely prescribe controlled substances like ketamine, Adderall and opioids, and you get an internet gold rush.
Dr. Don Davidson, the founder of Everyone’s M.D., said people will seek drugs out anyway, so providing them through a pharmacy is safer than buying them off the street where they could be laced with cheaper, deadlier drugs like fentanyl. One study found that though still rare, recreational ketamine usage in the U.S. is increasing.
“It’s really time America legalized all these drugs,” he said. “People are going to abuse them no matter what. At least this gives people a safe supply. People are gonna kill themselves with a bottle of Tylenol; they will kill themselves by jumping off a bridge. […] We’re working with young professionals so they don’t have to resort to street drugs.”
But others say it’s negligent to be prescribing ketamine online so freely.
“I really believe that if you want to heal trauma you need a therapist next to you,” psychedelics investor Christian Angermayer said on a recent “Business Trip” podcast. “The human side of psychedelics therapy is extremely important.”
Some go even further and say it could be the start of another addiction crisis.
“It’s horribly irresponsible and unethical for a doctor to do something like that over the phone,” said Anthony Coulson, a consultant who retired in 2010 after 28 years with the U.S. Drug Enforcement Administration. “They’re just as bad as the Mexican cartels. They’re just traffickers.”
Davidson, who has piercing blue-green eyes and a SoCal surfer vibe, is a former Division 1 tennis player and telemedicine pioneer. As one of the first doctors at Eaze, an online cannabis dispensary, he was staffed on its on-demand service, providing medical marijuana prescriptions to California residents before marijuana was legalized.
“I myself talked to over 100,000 Americans about cannabis via telemed visits,” he said. “I am America’s biggest cannabis doc in the history of the states, that’s for sure.”
For that, the California Medical Board revoked his license, after an investigator from the board posed as an Eaze customer and determined that he did not ask the appropriate evaluation questions before handing out a prescription for medical marijuana. Davidson does not prescribe medication on Everyone’s M.D.
Since then, Davidson has weathered the storm of entrepreneurship, from living in a Malibu mansion to living out of a fancy van. He now couch-surfs between friends’ apartments in “LA, Austin and Miami […] the usual suspects”.
With Everyone’s M.D., he’s set out to create a plant-based medicine empire. He currently offers ketamine and CBD, both of which he sees “growing into multibillion dollar revenue-generating drug classes.” He dreams of creating health and wellness parks where people can come for pet therapy, healthy food and mental health therapy.
He also believes that current drug policies have failed.
“The American people deserve to have an immediate and real conversation with our leaders about the failed drug war and the lack of education for our youth about how to use, if they choose to,” he said. “People want me to run for president: I have simple ideas like, 'Hey, let all drug criminals out into military service and education camps. Let America heal. Disband the DEA.’”
But those who are in the industry worry about uncontrolled usage leading to addiction problems.
Dina Burkitbayeva, CEO of Freedom Biosciences, a company working on new and improved types of psychedelic treatments, says that she’s worried because there is no national database tracking ketamine prescriptions that would detect systemic abuse.
“I have spoken to people that say, ‘I go to my psychiatrist, and they give me a ketamine spray. I see an online service as well, so here I am sitting at home self-administering [ketamine] every 45 minutes,’” she said.
Those who become addicted suffer from serious side effects, she said. According to the British Medical Journal, ketamine abuse may cause irreversible bladder damage.
The jury’s still out on how addictive ketamine is: While it’s certainly not as addictive as opioids are, and has been used successfully to treat heroin addiction, the DEA says ketamine has the “potential for abuse, which may lead to moderate or low physical dependence or high psychological dependence.”
This year, the DEA targeted Adderall telehealth providers, but so far hasn’t gone after ketamine providers.
Until several months ago, startups like Done and Cerebral were advertising Adderall prescriptions on TikTok, and it was very easy to get an online prescription, said Hadas Alterman, Director of Government Affairs for the American Psychedelic Practitioners Association. But the DEA started investigating the practice earlier this year, and at least one startup, Cerebral, said they would stop prescribing almost all controlled substances.
One San Francisco resident, who asked not to be named, said that he has used ketamine both in an in-person clinical setting and ordered it from a telehealth provider. In the clinical setting, a psychiatrist, nurse and therapist were present.
The SF man said it cost $1,200 for the first session and $400 for subsequent sessions. He was given an intravenous injection of a high dosage of ketamine and a therapist walked him through the hourlong experience while he was wearing a black eye mask and listening to music. In one session, he felt like he saw his life in a “deep and pure way” and garnered insights he’s held onto since.
For the telehealth prescription, he plans to use it in a party setting, but also try to mimic his experiences at the clinic.
“If you’re just given ketamine and you can do whatever you want, nobody knows how to do it right,” he said. “You have to be instructed to get the bang for the experience. But if you do it casually for fun, it’s still pretty safe.”
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