Depression almost did me in—until I found a miracle cure. It’s mostly illegal.

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Kuya Wellness sits in an Austin, Texas, office park, close enough to the airport that folks stop by before or after a flight from New York or to Bali to float in the sensory-deprivation tank or dip in the cold plunge. The waiting room is outfitted with inviting green sofas, lush plants, and a tea and tonic bar. Signs read “Where Science Meets Soul” and “Do Less.” The space feels like the sort that might offer a $68 supplement or $38 tincture, and it does.

At least on the bottom floor, Kuya seems like a spa, with lockers and low-lit hallways that herd visitors from cold plunges to two saunas, one for socializing and the other for quieter, introspective time. It’s all sort of “wellness center meets the Wing.” But it’s Kuya’s upstairs that I’m here to see—the floor where visitors undergo ketamine therapy, the treatment with a Schedule 3 controlled substance that, two years ago, saved my life.

For $2,400, visitors are granted Kuya’s two-month “ketamine membership,” which includes unlimited sauna sessions, cold plunges, sensory-deprivation floating time (before therapy only), and, of course, ketamine.

Even as the death of actor Matthew Perry has heightened public awareness of and anxiety around the drug, ketamine has also become a full-on “wellness” trend. Places like Kuya now dot the country. Nushama Psychedelic Wellness Clinic in New York looks like a new-age coffee shop and provides ketamine therapy and events in zero-gravity chairs and “Moon Pods” named after psychedelic leaders. The Holistic Ketamine Institute in Los Angeles offers ketamine therapy alongside healing via sound baths and “vibrational frequencies.” And at StrIVeMD, with multiple locations in Texas and Illinois, you can get a ketamine infusion from the same clinic where you receive your Botox.

In all, there are now between 500 and 750 ketamine clinics throughout the country and counting. You can probably Google one near you right now. The industry is expected to reach $6.9 billion in revenue by 2030.

When you know what ketamine can really do, it can be hard to see this and not wince. The line between health care and more ephemeral wellness has never been fuzzier, and these clinics are on the blurry front lines. Ketamine therapy is a game-changing treatment. It’s also questionable, to say the least, that accessing it should be as uncomplicated and easy as booking a 30-minute massage. What’s happened in my life since I first began ketamine treatment, and what I saw in these spas, suggests a country that’s not quite ready to decide what to do with a drug that people are turning to in ever-increasing numbers.

I received my first therapeutic dose of ketamine on the morning of my 30th birthday. As I lay on a leather recliner in a random office park off the highway, a nurse practitioner injected my left shoulder with 70 milligrams of the drug, then covered the puncture with a blue Band-Aid dotted with rainbows and narwhals. A twilight state blanketed me, then a big, black void. I had the thought I might be dying. But at that moment, I also thought, That’s OK.

After I sobered up two hours later, I floated through the rest of the day, my feelings encased in a protective layer of chemical-induced bubble wrap. Everything indeed felt very OK—a neutral state I’d found it hard to maintain over a yearslong period of depression. The relief the drug gave me that day felt like a revelation.

It’s been a circuitous path to get to the point that this therapy exists at all. Ketamine was first synthesized in 1962 as a fast-acting anesthetic for surgery. Derived from PCP, or “angel dust,” the drug proved especially useful throughout the Vietnam War for its ability to quickly anesthetize pain without slowing breathing. It wasn’t until the turn of the 21st century that scientists began recognizing ketamine’s antidepressive effect; a landmark 2006 study by the National Institute of Mental Health found that one dose of ketamine, administered by IV, could lessen depressive symptoms in patients who weren’t responding to traditional treatments. More studies followed, and the drug’s therapeutic properties were consistent enough that a thriving ecosystem of ketamine providers popped up across the country.

The line between health care and more ephemeral wellness has never been fuzzier, and these clinics are on the blurry front lines.

Though one ketamine derivative, esketamine, is approved by the Food and Drug Administration for treatment-resistant depression, ketamine hasn’t been specifically cleared for psychiatric use. Instead, the drug is often used off label by psychiatrists to treat a range of mental health issues including depression, anxiety, post-traumatic stress disorder, and obsessive-compulsive disorder, as well as chronic pain and addiction. In 2020, a change in Drug Enforcement Administration policy made it possible to receive ketamine at home. Around that time, you might have started seeing ads for services like Joyous or Mindbloom pop up on your Instagram. Those providers mail ketamine for people to take at home, orally, with a telehealth operator guiding each session.

At the same time, ketamine is also one of America’s most popular party drugs, cheaper than cocaine and a warm-feeling dissociative in the same way that makes it therapeutically useful. Ketamine seems to be everywhere, and perhaps because it makes people feel better or perhaps because it provides insightful “trips,” providers are adopting the language and aesthetics of wellness in their offering of the drug.

Its mental-health applications exist on a fuzzy spectrum between traditional medicine (clinically proven, scientifically backed) and nontraditional medicine (psychedelic, prescribed off label, not typically covered by insurance), so the places offering ketamine treatment tend to exist in this gray space as well.

There is currently no regulatory body governing what kinds of health care professionals can open a ketamine clinic or what services they can offer. Ketamine providers operate out of clinics ranging from psychiatric offices to med spas and yoga retreats. You can get an IV drip of the drug alongside an infusion of vitamins purported to impart antiaging, glowing, or immunity-boosting effects. You can order your ketamine session—duration and dosages customized—off a menu like a massage. Or you can get an injection of ketamine, then lounge in a sound bed and drink an adaptogenic tea.

“Over the past decade that it has been increasingly offered in freestanding clinics and other sort of less traditional clinical settings, other epidemiologists and clinicians and I have watched those trends with alarm,” said Caleb Alexander, a professor of epidemiology and medicine at the Johns Hopkins Bloomberg School of Public Health. “People have to go into it eyes wide open and well informed about the risks and benefits of the product.”

I know from experience that people have very different ideas about what that should look like.

My own ketamine treatment took place in a typical therapist’s office, albeit one with trippy art. Portraits of mushrooms and abstract doodles adorned the walls, and the clinic gave away free smiley face stickers and shirts that read “Thank You, Ketamine.” The amenities included weighted blankets and blindfolds, iPads with preloaded playlists, and a random assortment of snacks that appeared as if the staff had emptied out the leftovers from their pantries: bags of nuts, Veggie Straws, cheese crackers, barbecue chips.

Before each treatment at my clinic, a nurse practitioner would take my blood pressure—something you have to monitor on ketamine—then weigh me to help determine the size of that day’s dose. Then a provider would come in and ask me a few questions about my mood. How had I been sleeping? Badly. Eating? Not super healthy. Was I feeling depressed? Well, yeah. The nurse was different each time, so there was no relationship between my attendant and me; mostly, they read from the notes of the colleague I had spoken with before.

I received no posttreatment care. After each session, the nurse would come in, tell me that my time was up, and allow me to sit for a few minutes while waiting for my ride to arrive. When I later told my current psychiatrist about this setup, she seemed appalled. She couldn’t believe that no one had helped me process the experience afterward, a procedure known in ketamine lingo as “integrating.”

Still, almost immediately after I entered that first void, the treatment helped relieve the suicidal ideation I’d been having. Studies show that this happens for most patients within 24 hours of muscular or intravenous injection. This was a breakthrough I had feared might never come. I thought more people should know about, and have access to, this lifesaving drug—that more people might benefit like I had. In my social circles, I began to evangelize about ketamine’s potential to ease suffering from depression and anxiety.

But eventually, I became disillusioned with my care. It became harder to get a hold of the office. The price for treatment ratcheted up. My initial sessions cost just $20. Eventually, that leaped to $175, then $200, and, finally, $300, still on the cheap end for the industry but becoming unrealistic for me. The clinic would randomly charge my card and blame filing issues. It all began to feel like a sketchy cash grab.

On r/TherapeuticKetamine, a subreddit that became a source of support during my treatment, I learned that many patients seeking relief had had similar experiences. One young woman received treatment with Spravato, the ketamine derivative approved by the FDA, in a room with another person. When she began to cry, the other person left, which caused a wave of shame. Like me, after those sessions, the woman was sent on her way without time to process. Another Redditor received treatment while a person in the adjoining room was getting Botox—twice, at two different clinics.

These experiences colored how I encountered the expanse of ketamine clinics offering “wellness” services as I began to look around for alternative care. I saw the IV bags and the mushroom coffee, and I saw ketamine sessions offered in the same facility as yoga classes. I felt icky about it. It seemed to me that this attitude toward treatment—“vibes” and “well-being” and “holistic health”—lent a sort of snake-oil sheen to the very real medical miracle I had observed. With the fog of depression lifted, I finally had the clarity to question the economics—the Veggie Straws vs. the vitamin infusions—of the treatment that had saved my life.

On Kuya’s deep-green sofas, two buff men spoke softly to each other in a tone that implied a conversation deeper than small talk. A woman worked on a laptop at a nearby table, while a third man ordered a drink from the bar and made friendly conversation with a staffer.

I blame the hushed tones and zen vibe for the hug I gave Kuya President Megan Butler as she stuck out her hand to shake mine—it just felt like an intimate sort of place. I had paused treatment in May 2025 because of a remission of symptoms, as well as cost considerations. But I wanted to see what a full-service Kuya ketamine process might look like, complete with the wellness amenities I had judged superfluous.

According to Butler, Kuya’s process begins with an assessment by the medical team, led by a physician’s assistant, who goes over the client’s physical and mental health history and any medications they’re currently on to determine if ketamine would be a good fit.

“It’s not like you show up one day and say, ‘Hey, I’m interested,’ ” Butler told me. “We take it very seriously. We really want to make sure this is right for patients.”

In the years since ketamine’s popularity has exploded, and in particular since the 2020 change that allowed startups to send the drug directly to consumers, more people—of all mental health backgrounds—have become interested in the drug. Much like how someone who wants to lose 10 pounds might now turn to a GLP-1 like Ozempic, ketamine could start to be seen as a quick fix for everyday anxiety or angst.

“Part of the problem is that the rules governing marketing and promotion of prescription drugs were designed in an era when it was the drug manufacturers doing the promoting,” said Alexander, the epidemiology and public health professor. “We now live in a world where wellness clinics and telehealth companies and online health platforms are not only offering these products but also marketing and promoting them.”

This conflict can lead some providers to leave out critical information for patients. “These clinics are buying wholesale and selling retail, and consumers are left not only holding the bill but also undertaking potentially enormous risks,” he said, pointing to the few, but still possible, cases of trouble breathing or psychotic episodes caused by ketamine.

The marketing of the drug can also trivialize its treatment power. A colleague “was driving to work, and they heard an ad on the radio where the advertisement was for ketamine as a pick-me-up, the perfect example of what it should not be,” said Sandhya Prashad, a psychiatrist and president of the American Society of Ketamine for Physicians, Psychotherapists, and Practitioners. The organization is one of the only groups that provide guidance for both patients and providers on what to look for in clinics and how to provide ketamine therapy ethically. Among the patient-facing advice: Avoid clinics that offer other services, like Botox, as it is “completely unrelated to ketamine or other treatments tied to mood and pain disorders.”

Prashad says calm settings can actually be beneficial to the healing process. “There is some evidence to suggest that people might actually be more likely to respond to treatment if they are in a more nurturing setting,” Prashad said. “Having less anxiety during treatment seems to translate.” But, she said, “it’s not a spa. It is very much a medical practice.”

ASKP3 vets clinics according to this distinction, before adding them to its patient-facing directory. “If we see that they’re kind of more of a med spa, not really focused on the mental health kind of side, then we don’t accept them as a member,” Prashad said.

For Alexander, wellness-type offerings can be a complement to traditional medicine, but he questions whether those seeking ketamine in such a format are wanting mental health care or the more ephemeral “wellness.” “My concern is that ketamine is not the best solution to whatever is driving people to these sorts of clinics,” he said. “It’s one thing if you want to do yoga with hot stones for an hour, you know, and then have a smoothie. But this is a world away from that. This is a really, potentially deadly serious drug.”

Back at Kuya, which isn’t currently a member of ASKP3, Butler and I arrived at the ketamine treatment rooms, which were unsurprisingly cozy: one contained low purple lighting, the other featured forest-themed wallpaper, and both offered a pallet of pillows for sitting and lounging. These settings help patients “feel really grounded,” Butler said. Both rooms also accommodate a facilitator, who remains with the patient for the entirety of the session.

It is this element of Kuya’s therapy—and not the post-ketamine sound bed and saunas, though lovely—that makes me feel most resentful about my own treatment experience.

Because almost any ketamine patient will tell you that healing isn’t linear, even with the assistance of a Schedule 3 drug. For numb, depressive patients, it can wake up feeling again, including pain. Ketamine is quite safe physically when taken in a controlled setting, but psychologically it can be rocky. Some patients need, or want, more handholding than others. I certainly did. Patients with trauma, for example, may need to work directly with a licensed therapist while undergoing treatment.

“What you have available in your area may not necessarily be the thing that’s the best fit for you, but there’s no one to help you navigate that,” Prashad said. Or what you may have in your area may not be accessible in other ways. ASKP3 quotes an average cost of between $3,000 and $5,000.

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Prashad told me that the whole messy spectrum comes down, ironically, to the prevalence of the drug. Because ketamine is generic, without a privately owned patent, pharmacy companies have no incentive to put it through the financially intensive studies needed to bring it up for approval at the FDA. And because the drug isn’t FDA-approved, insurance usually won’t cover it. Thus, many patients must pay out of pocket. And patients who can afford to go out of pocket are probably more likely to want the level of service that comes with an adaptogenic latte.

Money was part of what forced me to seek out treatment alternatives. Looking around for new options, I wanted just the basics at an affordable price. I wanted ketamine therapy to feel like the medical service it is. But I also would have appreciated a pillowy couch or sound bed to come down on, or even the encouragement to slow down posttreatment.

In Kuya that afternoon, as I walked through the well-appointed rooms with their sound beds and cozy comedown corners, I again felt aggrieved that my experience hadn’t included such amenities. But in that center, I also learned what integrated care could—and maybe should—look like. Blessedly, my symptoms disappeared after two years of ongoing treatment. I’m not currently depressed, but I don’t doubt that the black dog will be back to visit me one day. And when it does, I want integrated, affordable, accessible health care—in whatever clinic, with whatever vibe, provides it.