Former N.S. Mountie with PTSD calls for ketamine therapy to be offered to active members

A retired Mountie from Nova Scotia is crediting an unconventional, but increasingly mainstream, drug treatment with providing him relief from his PTSD symptoms for the first time in years.

Byron Maclean recently completed six months of treatment at a clinic that specializes in ketamine — an anesthetic used in veterinary surgeries, a club drug favoured by recreational users for its hallucinogenic effects, and one that the former police officer wants offered to his peers still on the job in Nova Scotia.

"These treatments that I'm talking about, at this very moment ... are not available to officers that are currently serving, so that is kind of an unfortunate thing," said Maclean in a recent interview.

Ketamine is a fast-acting, mind-altering painkiller that can cause people to feel as though they are in a dream-like state and less inhibited. However, over the past several years, research has suggested ketamine can reduce the severity of PTSD symptoms, as well as suicidal thoughts and feelings of anxiety.

Selling, possessing and producing ketamine is illegal in Canada unless authorized for an approved purpose.

While retired members of the RCMP are able to seek ketamine treatment and have it covered through Veterans Affairs Canada, those still serving are not generally allowed to partake in this kind of therapy — something Maclean said needs to change.

"If this treatment would have been available to me before I medically retired, the RCMP would have got another five more years out of me," he said.

RCMP Sgt. Caroline Duval told CBC News in an email that active members are not permitted to use ketamine, stating: "The RCMP drug formulary management committee determined that there was no relevant evidence regarding the clinical effectiveness of intravenous ketamine for the treatment of post-traumatic stress disorder or treatment-resistant depression."

Duval said should an active member require the use of ketamine they would be placed on off-duty sick leave.

"This medication is considered to be 'not evidence-based' and therefore not eligible for reimbursement as per RCMP health-care benefits policy," Duval wrote.

Exceptions can be made on a case-by-case basis, she said.

Dr. Claire O'Donovan, a psychiatrist with Nova Scotia Health's mood disorders clinic in Halifax, said ketamine has shown promising results, but there's been little research done on the long-term effects of the treatment.

Additionally, she said ketamine is not used as a first option; rather, it is suggested when other treatment methods have failed. The treatment, which is not covered under the province's public drug plans, is also costly, she said. Treatment can cost a patient hundreds to thousands of dollars, depending on how many sessions are required and whether the dosing is combined with therapy.

"The resources are enormous to get it through like a health authority. That's sort of our big cost," said O'Donovan. "The money has — and the resources have — to come from somewhere."

Maclean said he hopes to see ketamine offered to active RCMP officers so that they're able to deal with trauma when it's happening to avoid getting to a breaking point.

"Once you are getting to a point that you have to medically release out, you are actually very far along. I like to argue that you're actually in a very dangerous place," he said.

"What we need to get wrapped around our heads is it's [ketamine treatment] preventative.... The six ketamine sessions that I've done, I done more work in those six months than I did in five years."

Maclean sought help at Field Trip Health, a ketamine treatment clinic in Fredericton that he said focuses on a therapeutic experience versus a clinical one in a hospital setting. 

On its website, the company says it offers "an immersive ketamine-assisted psychotherapy program" that "supports your emotional health and personal growth."

Nova Scotia has four locations where ketamine treatment is offered: two private clinics and two hospital locations. While the hospital locations offer on-site therapy, the private clinics do not. And none of them offer ketamine in pill form, which is Maclean's preferred delivery method.

"It didn't meet my standards of what I wanted to get from it. I wanted a holistic, pure therapeutic approach," said Maclean.

"I'm not a fan of it being injected into me … that was the other thing that weighed on me. I'm not interested in having an IV put into me to administer the drugs."

Field Trip Health, which launched in 2019 in Toronto, opened its Fredericton location last year. Clinics are also in operation in Vancouver, eight cities in the U.S., and Amsterdam. The company hopes to expand further, including potentially opening a location in Nova Scotia, though there are no firm plans in place.

David Muise, the clinic manager in Fredericton, said the facility has had 10 people successfully go through its treatment program. There are roughly 50 people enrolled.

Field Trip bundles therapy, consultations, and the drug itself into one treatment plan costing around $6,000, rather than patients receiving the ketamine and being sent home.

Muise said the company is pushing to have the treatment fully covered by drug plans.

"It's not covered under medicare, and it's not covered under private insurance or employee benefits," he said.

"That is one thing we're working on to help and push insurance companies along because, you know, there's a lot of people suffering out there who just can't afford this right now."