A new ketamine-assisted therapy clinic has opened in Waterloo region. Here's how it works
The opening of a new ketamine-assisted psychotherapy clinic in Waterloo sparks a conversation about uses
WARNING: This story mentions suicide and overdose.
Waterloo region is home to a new clinic that offers a psychedelic treatment method for those suffering from deep-seated mental health conditions.
Field Trip Health is a private clinic offering ketamine-assisted psychotherapy (KAP) as well as therapy using MDMA and psilocybin.
The company operates all over Canada, including B.C., Quebec and six locations in Ontario, including two new locations in Hamilton and Waterloo.
"It's not a magic bullet by any means," Ian Ruberry, CEO of Field Trip Health, said.
He said there's encouraging evidence that ketamine-assisted psychotherapy helps patients build "psychological resiliency."
Ketamine is a schedule 1 controlled drug labelled as an anesthetic. It's legally used by medical doctors and veterinarians. In the past decade, though, some people have discovered its medicinal and recreational benefits.
Ketamine-assisted psychotherapy involves taking a controlled dose of ketamine under the supervision of a professional, and then undergoing a talk therapy session.
It works in the brain by increasing what's called neuroplasticity and neurogenesis, which is the brain's ability to form new neural connections.
Field Trip Health promotes its use for stubborn cases of depression, anxiety, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder, chronic pain, addiction and eating disorders.
"The ketamine provides a biological response for depression, and then the therapy helps them develop more psychological resilience so that they're less likely to fall into depression moving forward," said Dr. Sheehan Chowdhury, Chief Psychiatrist at Field Trip Health.
KAP is a potential option when sufferers have tried at least two different medical treatments and show little to no improvement, known as treatment resistance, which Chowdhury said is more common than people think.
"Fifty per cent of people will fail one of the first antidepressants that they try, and then many others will fail a second one that they try," Chowdhury said. "So there's a lot of people with depression or severe mental health difficulties who are not getting better."
KAP isn't a new treatment in Ontario, but Waterloo region residents now have closer access, and that's what Ruberry said it's really all about.
"Every Canadian who could benefit from this treatment should have access to it," Ruberry said.
Field Trip Health opened its first clinic in Thunder Bay in 2019. Since then, they've expanded to locations in Toronto, Montreal, Vancouver, Ottawa, Thunder Bay and Sault Ste. Marie.
KAP is not currently covered by OHIP. Ruberry said a session is typically priced at $1,000, which includes the drug and two and a half hours with a therapist. He said the cost of the therapy can often be covered by many extended health care plans.
'Life changing' for some
Caitlin Foster said that KAP saved her life.
She did six sessions of it back in April at Field Trip Health's clinic in Sault Ste. Marie at one of the lowest points of her life.
After a string of traumatic life events, she said she fell into a depression and anxiety that she couldn't shake. She had tried multiple medications and gone to therapy, but was still at the point of sometimes physically throwing up from anxiety.
"I had gotten to the point of becoming very suicidal," Foster said.
That was until she heard of a friend who had used psilocybin to help his mental health. She worried about its lack of regulation, which sparked her to look for a more controlled way to experiment.
"It was life-changing because I didn't feel sick suddenly anymore with constant worry," Foster said. "I didn't feel like I couldn't breathe anymore, and I didn't feel that crushing weight in my chest."
Potential risk
Oct. 28 marks the one-year anniversary of actor Matthew Perry's death. He died from a ketamine overdose and allegedly received extra injections of the drug on the day he died.
Dr. Tyler Kaster, a psychiatrist at the Centre for Addiction and Mental Health (CAMH) and medical head of the Temerty Centre for Therapeutic Brain Intervention, said in an email that ketamine can have "psychoactive effects including dissociation, confusion, and in rare cases psychosis."
Dr. Kaster said there is also risk for dependency and misuse, with Matthew Perry being an "extreme example."
Health Canada notes on its website some of the short and long-term effects of ketamine, which could include sleepiness, hallucinations, numbness and blurred vision among other things.
Overdose can lead to sedation, slowed breathing, coma and death. Using it with other depressants, like alcohol or opioids, can increase the risk of overdose.
Dr. Chowdhury says controlling the drug treatment is key to avoiding addiction and overdoses.
"It's good that these regulations are in place so that it's done properly," said Chowdhury. "It helps reduce the risk of abuse and addiction."
Ruberry said that patients who undergo ketamine-assisted therapy are typically at low risk for addiction and are screened beforehand. They won't be offered treatment if they're considered high risk for abuse.
Dr. Chowdhury said time and setting matter most.
"Because it's done in a structured setting where the focus isn't on getting high, but rather on mental health issues, we find that our patients don't seem to have a craving for the substances," he said.
Professor Andy Hathaway researches drug policy and harm reduction in the sociology and anthropology department at the University of Guelph. He said that public conversation is always shifting around the use of psychedelics in medicine.
"I think it's the typical cultural war between those who see drugs as potentially beneficial and those who fall into the more conservative view that these drugs don't have any legitimate medical uses," said Hathaway.
He said that the solution to fear around drugs like ketamine could be a public health perspective, in which professionals have an interest in knowing the effects and do everything possible to educate and reduce harms which he said in the case of ketamine "can be quite substantial from chronic use."
"It does have some worrying effects… so that would be a reason perhaps to invest in more of a public health approach, which would also mean allowing for this use in a medical setting and not amping up the rhetoric that goes with that drugs are bad motif," he said.
Field Trip Health aims to promote the therapy by holding lunch-and-learn sessions at clinics, publishing papers and pushing for more research on the benefits of KAP.
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