Opinion Psychedelics

Ketamine: The Unused Answer to the Opioid Epidemic

ketamine opioid epidemic
Written by Sarah Friedman

The opioid epidemic is getting to a fever pitch, yet government bodies are not responding appropriately. While there is no direct cure for hundreds of thousands of addicted people, there is an answer, which should work for many. We’ve already established ketamine can work on different levels regarding addiction and pain, so why is ketamine not immediately being used as an answer to the opioid epidemic?

Ketamine might not be officially approved for it, but it could work as a solution to the growing opioid epidemic as it helps with addictive thought processes and can be used for pain control, without causing the addiction of opioids. Why is this ignored in the face of so many deaths? Welcome to a wholly independent publication focused on cannabis and psychedelics reporting. Play along by signing up for the The Cannadelics Weekly Newsletter, and get a daily dose of updates, along with putting yourself in first place for all product promotions, as they become available to the public.

What’s the deal with the opioid epidemic?

Just that the word ‘epidemic’ is widely used for this problem, should get our attention. An epidemic generally refers to the widespread proliferation of a disease, although we now use it to describe the out-of-control use of synthetic opium drugs. But it most certainly is an epidemic, and its not slowing down at all. The problem is so bad, that anything that can help reduce deaths should be used, which brings up the question of why ketamine is not being employed immediately as an alternative in this opioid epidemic.

The latest numbers come from a May 11th release by the CDC, in which preliminary data for 2021 show that the overdose death numbers in the US have skyrocketed up to 107,622 for that year. This is a 15% increase from 2020, when the number was just over 93,000. 2020 saw a 30% increase over 2019, which had about 73,000 deaths. These are total overdose death numbers, and apply to all drug overdoses. There were not over 100,000 opioid overdose deaths, but there were certainly enough to shock a person.

Exact numbers aren’t out for 2021 in terms of how many of the overdose deaths were caused by opioids, but of the ~93,000 that died in 2020, over 68,000 were opioid deaths, and that’s pretty extreme. While these numbers are not finalized, small changes wouldn’t do much to change the heaviness of the reality, because give or take a few thousand, there’s still a massive problem at hand.

opioid deaths

To give an idea of why this is, consider that in 2017, over 191 million opioid prescriptions were written, which means 58.7 prescriptions written for every 100 people. 45% of these were written by primary care physicians, who are not supposed to write opioid prescriptions in the first place; they should come from a specialist only. For 2017 the economic burden of these drugs on the entire country amounted to $78.5 billion between health care costs, emergency services, addiction treatment, lost productivity, and the criminal justice system.

Opioids belong to a class of drugs that are based on compounds from opium, a component of poppy plants. Opioids bind to receptors in the central nervous system, peripheral nervous system, and gastrointestinal tract, mainly of the μ, κ, and δ (mu, kappa, and delta) varieties. They are used mostly to treat acute pain, though they have other functions like cough suppression. Opioids are incredibly addictive, so regardless of why a person starts taking them, or if they want to continue, a powerful physical addiction can make it extremely hard to discontinue use.

A bit about ketamine

Before getting into why ketamine is an unused-answer to the opioid epidemic, let’s get into what ketamine is. Ketamine is a dissociative hallucinogen that was created by Parke-Davis in 1962 for use as an anesthetic in both humans and animals. Since that time it has remained a schedule III drug with no other official uses beyond anesthesia, according to the US government.

However, much more is known. Ketamine was used in studies on prisoners in the 1960’s, and at that time it was made clear that: ketamine is great at dealing with pain, that it doesn’t lower heart rate or breathing rate, that it has little-to-no direct death risk, and that it can affect psychological thought. This last point was noticed during these early studies, but its full abilities in this realm were not elucidated until after. However, it’s ability for pain control was so clear, that ketamine was subsequently used on the fields of Vietnam. Ketamine doesn’t cause physical addiction like opioids, meaning users can stop at will.

In terms of using ketamine to treat psychological issues, its so well understood, that it was recognized by the FDA. In 2019, the FDA approved ketamine’s half-brother esketamine for treatment-resistant depression, updating the legalization to cover suicidal thoughts in 2020. Esketamine is put out by Johnson & Johnson, the main big pharma company to pay out billions in the many and ongoing opioid lawsuits waged.

Ketamine might not be officially approved for other things, but its widely used thanks to a loophole. Since it is legal for medical use, ketamine is often prescribed off-label for both pain management, and for psychological issues, which is legal according to the FDA. As such, there is a large and growing gray ketamine clinic industry in which patients can access ketamine as medicine, by receiving a prescription in the clinic. This is preferable for those who do not want to take a standard antidepressant, which is a government requirement for using esketamine. Plus, ketamine cannot officially be prescribed for pain, but is used for pain treatment in these clinics.

ketamine clinic

Though ketamine is a pharma product (it certainly doesn’t exist in nature), it’s a pharma product that is made by any pharmaceutical company, big or small, or even in a person’s basement should they have the right training. This means ketamine isn’t a big money-maker for the big pharma companies that pump money into government representative pockets, and therefore, it doesn’t make extra money for the government either.

Ketamine as the yet-unused treatment for opioid epidemic

Another benefit of ketamine in an opioid epidemic like this, is that it helps to control compulsive thoughts, which are a part of any addiction. For example, an eating disorder study found that after ketamine treatment, the majority of patients reduced or eliminated their compulsive thoughts, and that this persisted well after the ketamine administration. While it’s not 100% understood how, its thought that the following mechanism was in action:

“Memory is a neocortical neuronal network, excitation of which involves the hippocampus, with recall occurring by re-excitement of the same specific network. Excitement of the hippocampus by glutamate-NMDA receptors, leading to long-term potentiation (LTP), can be blocked by ketamine.”

To clarify the point, ketamine has the ability to allow someone to exit their normal thought cycle, and create a new one. The same has been found with other psychedelics, including MDMA. In ongoing trials by the organization MAPS into PTSD, over half of the treatment resistant cases treated with MDMA, no longer qualified as PTSD a year after treatment. Ketamine makes a better candidate for opioid replacement, as it can also satisfy the pain issue, which got so many people addicted in the first place.

This means a hallucinogenic drug exists with essentially no real death toll, that can take care of the pain issue that led to the opioid crisis, and that can help with the circular thinking of addiction that keeps many people on them. Yet its not immediately being used to treat this problem. Why? Is it because it’s not a money-maker for big pharma or the US government?

Funny how the only approved version of ketamine is made by the same pharmaceutical company that helped get everyone addicted to opioids in the first place. Back in the 1980’s Johnson & Johnson was selling Tylenol with codeine (Tylenol 3), and doing very well with it. But it needed a better supply of raw materials. The company bought a farm in Tanzania to produce the raw materials, becoming the top provider for opioid raw materials by 2015. This is one reason that J&J is paying out billions of dollars in settlements right now, including to virtually the entire Native American population, and the whole state of Idaho.

opioid lawsuit

Where did this issue come from?

When 2019 information was released, it made clear how people were dying, and from what. That year, of approximately 73,000 drug overdose deaths, less than 15,000 were heroin overdoses, and a massive 48,000 were from synthetic opioids like oxycodone and fentanyl.

The thing about synthetic opioids, is that they’re the ones made by pharmaceutical companies and prescribed by doctors. In comparison, heroin causes problems, but nothing that can’t be kept in check. This is evident by over 100 years of heroin use, starting with legal sales in 1898 by the company Bayer. In 1996 Purdue came out with Oxycontin – a time-release version of oxycodone, surrounded by tons of lies, and it propelled to a top-prescribed medication. This happened even though immediate issues came up regarding the time the pills last, and the mass ability for addiction due to their strength.

Technically, opioids are in generic form, like ketamine, meaning anyone can make them. A 2019 report showed that between 2006-2012, of the over 76 billion opioid pills that made it to market, three companies were responsible for manufacturing 88%: SpecGx, a subsidiary of Mallinckrodt; ­Actavis Pharma; and Par Pharmaceutical, a subsidiary of Endo Pharmaceuticals. The creator of this epidemic, Purdue, which consistently lied about its product Oxycontin, was fourth.

In 2006 8.4 billion pills were put on the market, in 2012, that number went up to 12.6 billion, and that was 10 years ago, when the death rate wasn’t nearly as high. This is a 100% pharmaceutically made, and government promoted epidemic. And we know the government is complicit because it takes money from the companies, allows the situation to keep going, and has tried ruthlessly to cover the information I am talking about now (particularly through the DEA and the Justice Department). In fact, if the government wasn’t complicit, it probably would have released way more information, and the reason I’m giving numbers from years ago, is because the government, along with the big pharma companies involved, have made that information extremely hard to get to.

What we can glean, is that the four companies that are paying out the most, probably caused the biggest issues. These include Johnson & Johnson, AmerisourceBergen, Cardinal Health, and McKesson. The latter three are drug wholesale companies. Together, these four companies are set to pay $21 billion from global lawsuits, out of a $26 billion total. Purdue obviously shoulders blame as well, but managed to get out of paying such high amounts.

So even though a practically-no-death-toll drug like quaaludes was banished because of its lied-about threat (when in reality it was a black market that the government wasn’t profiting from), opioids are still allowed while killing people by the tens of thousands. The government just made it clear it wants fewer prescribing guidelines in the face of all this controversy, which makes them easier to get.

opioid epidemic

There is already medical research on the issue of ketamine vs opioids, but it hasn’t been publicized in the press, and the government certainly isn’t talking about it. Its existence is important though, as that means this idea should become more relevant in the future. Interested readers can check this review which showed ketamine as a safe and effective alternative to opioid treatment, through the analyzation of 76 related papers. And this study of 870 adult patients who showed up in emergency rooms with severe pain, which demonstrated that ketamine is a comparable treatment to opioids for acute pain.

Conclusion

It’s not shocking that the government doesn’t want to correct the problem; because the government seems to like the problem. It might claim its trying to find solutions, but in order to believe this, you’d have to forget that the government must approve medications, regulate their use, and has the power to take them off the market. If the US didn’t want this opioid issue, it would already be substituting ketamine for opioids, banning them like it did with quaaludes, and trying to get as many people as possible, to find a different option than the one killing them.

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About the author

Sarah Friedman

I look stuff up and and write stuff down, in order to make sense of the world around. And I travel a lot too.