988Lifeline.org<\/a>.<\/p>\nResources in the Teton area include Mental Health and Recovery Services of Jackson Hole\u2019s 24-line at 307-733-2046, which people can dial if they or someone they love is in crisis. St. John\u2019s Health\u2019s Mental Health Resource Line can be reached at 307-203-7880 and thew Mental Health Coalition of Teton Valley can be reached at 208-354-6198.<\/p>\n
Barnes called a suicide hotline and later reached out to Wolff, who had helped her treat depression years ago. The psychiatric nurse practitioner suggested Spravato.<\/p>\n
Barnes was insecure during the first few ketamine sessions, unsure of what to feel. During the first session, she remembers feeling out of control \u2014 not in a way that made her feel as though she was in danger, but rather unable to connect her thoughts with her body.<\/p>\n
\u201cWhen I spoke to Sue, I just said \u2018I don\u2019t know about this. I can\u2019t see how this is going to help,\u2019\u201d Barnes said after the first session. \u201cBut thankfully, we hung in there and did multiple sessions.\u201d<\/p>\n
Covered by a weighted blanket as thunderstorm sounds played in the background, Barnes continued ketamine treatment. She took note of the colors and shapes she saw, how her body felt and jotted her experience in a special journal as the effects of the drug wore off.<\/p>\n
She credits the treatment with helping her understand that she had value and could contribute to the world.<\/p>\n
\u201cIt changed the way I feel about my place in the world,\u201d Barnes said. \u201cI still have days when I\u2019m kind of depressed and I\u2019m down, but I want to be here. I want to thrive and be alive.\u201d<\/p>\n
Ketamine treatments \u2014 journeys, as providers call them \u2014 can be slightly different from patient to patient and provider to provider in Jackson Hole.<\/p>\n
Spravato, the medicine Wolff administers, is the only ketamine drug approved by the Food and Drug Administration to treat depression. As far as she knows, she is the only provider in Jackson Hole who offers it. Providers elsewhere in the valley can, and do, prescribe ketamine off-label to address mental health.<\/p>\n
Some Jackson Hole providers can only make room for a few patients. At least one clinic has all the clients it can handle. Recently, one provider has pulled back from offering the drug.<\/p>\n
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Dr. Bruce Hayse is one of a handful of providers in Teton County that will provide ketamine treatments.<\/p>\n
REED MATTISON \/ NEWS&GUIDE FILE<\/p>\n
The Jackson Hole Ketamine Clinic has treated around 300 patients since opening in 2020, 100 of whom are currently treated on a regular basis, according to nurse anesthetist Aimee Racette. She runs the clinic, which delivers ketamine through an intravenous infusion that feeds ketamine directly to a patient\u2019s bloodstream.<\/p>\n
Racette\u2019s clinic is busy. She is currently not accepting new patients.<\/p>\n
Physician Bruce Hayse and Hannah Meier, a psychiatric nurse practitioner, have turned to injectable ketamine shots.<\/p>\n
\u201cKetamine, I think, is one of the really most beneficial things I do in terms of talking about improving people\u2019s lives,\u201d Hayse said.<\/p>\n
Despite the promise, Gerard Sanacora, a professor of psychiatry at the Yale University School of Medicine who has studied ketamine for over a quarter century, cautioned against thinking of ketamine as a miracle cure. Instead, he said it should be used in conjunction with other mental health support, a guide that Jackson Hole providers agreed with.<\/p>\n
\u201cKetamine, by itself, is probably not the treatment. Ketamine is part of a treatment plan,\u201d Sanacora said. \u201cIf your level of depression is severe enough where you\u2019re requiring ketamine treatments, you really should be having follow up with a mental health care provider.\u201d<\/p>\n
Health insurance companies generally cover Spravato, but off-label uses often fall to the patient. <\/p>\n
Local providers say they\u2019ve tried to ameliorate those costs, though the off-label treatments still cost hundreds of dollars per session.<\/p>\n
The extent to which Jackson Hole\u2019s wealth might influence its residents\u2019 access to ketamine is unclear. Racette, for her part, said that most of her patients were workers and not affluent. Wolff said insurance can bring costs to around $10 for patients.<\/p>\n
\u201cThe folks I\u2019m helping and working with are the average person in Jackson, who are not overly wealthy,\u201d Wolff said. \u201cBut they\u2019re also going through insurance.\u201d<\/p>\n
Hayse believed there was \u201cprobably\u201d a connection between wealth and people seeking ketamine treatment, but added that he didn\u2019t see a socioeconomic stratification on the day to day.<\/p>\n
\u201cAt least in my practice, I wouldn\u2019t say there\u2019s wealthy people doing it,\u201d Hayse said. \u201cI guess they are wealthy by American standards, not wealthy by Jackson standards.\u201d<\/p>\n
Outside experts believed that generally, ketamine prescriptions go up in wealthier places.<\/p>\n
\u201cThese treatments tend to be provided much more, especially off-label, to people with greater affluence,\u201d Sanacora said.<\/p>\n
After over 25 years, Sanacora praised ketamine\u2019s potential. Still, he pushed for keeping an eye on its use.<\/p>\n
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When Wolff treats patients with ketamine at her office in Jackson, she will covert her sofa into a bed, draw the blinds, play nature sounds and dims the lights. Patients can also use a blindfold and weighted blanket when undergoing treatment.<\/p>\n
KATHRYN ZIESIG \/ NEWS&GUIDE<\/p>\n
\u201cI really do think it\u2019s an amazing treatment. I\u2019ve witnessed with my eyes, my own eyes, how it can be life-saving and really turn people\u2019s lives around,\u201d Sanacora said. \u201cYou really want to make sure that people are getting this treatment who could really benefit from it, but you also want to make sure that it\u2019s not being overused.\u201d<\/p>\n
If you walk into a hospital, you should be able to find ketamine. That\u2019s because the drug has been approved by the FDA as an anesthetic since the 1970s.<\/p>\n
Over two decades ago, scientists \u2014 including Sanacora \u2014 realized that the drug might also be able to help treat depression. Though injectable and IV ketamine are not FDA approved to treat psychiatric conditions, providers can prescribe ketamine off-label to people who they feel might benefit from it.<\/p>\n
That allows Hayse, Meier and Racette to treat patients with injections and IV ketamine. Hayse first started the injectable treatment after seeing a client \u2014 who didn\u2019t respond to antidepressants, medicine or counseling \u2014 go to California and benefit from ketamine treatment there. He trained and learned about the drug, saying ketamine has since made a difference in his patients\u2019 lives.<\/p>\n
Lisa Smith-Batchen said she \u201ccouldn\u2019t find a way out of the darkness\u201d before starting ketamine treatment with Hayse. She credits the sessions, the last of which she had over two years ago, with saving her life.<\/p>\n
\u201cI tell the guy he saved my life,\u201d Smith-Batchen said. \u201cHe says it wasn\u2019t him who saved my life, I saved my own.\u201d<\/p>\n
Hayse said he initially restricted injectable ketamine treatment to patients with severe depression who had not responded to other treatments. He\u2019s now expanded it to patients with anxiety, chronic pain and more.<\/p>\n
Sanacora, the Yale expert, said the best and strongest efficacy data exists for intranasal Spravato for treatment-resistant depression. The further that providers stray from that, the less reliable the data, he added.<\/p>\n
\u201cOnce you start going to one formulation or another formulation, once you start going to different dosing frequencies, once you start including other indications, other disorders, you\u2019re just getting further away from where we have highly reliable data,\u201d Sanacora said. \u201cNot to say these other treatments don\u2019t work, not to say they\u2019re not safe, we just don\u2019t really have good data.\u201d<\/p>\n
Ketamine hasn\u2019t just shifted patient perspectives. Providers, too, have changed the way they think about the drug.<\/p>\n
Wolff, the provider who treated Barnes, was initially skeptical of ketamine.<\/p>\n
\u201cI am a believer now in ketamine, post skepticism,\u201d Wolff said. \u201cBut I also know that I don\u2019t want someone to be reliant on that.\u201d<\/p>\n
Meier said therapy was \u201cnon-negotiable\u201d for clients who she treats with ketamine. She likened ketamine to fertilizer. Though fertilizer could help a garden thrive, the garden would still need to be worked on every day.<\/p>\n
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Drew Ramsey, M.D. is a psychiatrist, author, farmer and founder of Spruce Mental Health. He is stepping away from ketamine treatments.<\/p>\n
KATHRYN ZIESIG \/ NEWS&GUIDE<\/p>\n
\u201cMy feeling with ketamine is \u2018let\u2019s give you this compost dump, this fertilizer dump into your brain,\u2019\u201d Meier said. \u201cBut if you\u2019re not going to get in there and work it \u2014 that being going to therapy, doing sleep hygiene, drinking water, us working on your social connectedness \u2014 it can only take you so far.\u201d<\/p>\n
At least one local provider is setting their sights away from ketamine. Though psychiatrist Drew Ramsey offered about 100 \u201cjourneys\u201d over a year and a half around 2022, he has only done two ketamine sessions this year.<\/p>\n
\u201cI\u2019ve pulled away from it significantly,\u201d Ramsey said.<\/p>\n
Ketamine could be life-saving if dosed appropriately and into the right patient, Ramsey said. But he listed multiple concerns with ketamine treatment, including questions about overprescription and its efficacy. He also worried about research<\/a> that suggests ketamine could be neurotoxic at high doses.<\/p>\n\u201cI haven\u2019t had a problem getting patients better without ketamine,\u201d Ramsey said. \u201cI think one of the concerns is that people are mistaking psychedelic medicine for good mental health clinical work. Psychedelic medicine is a procedure, but it\u2019s not necessarily good mental health work.\u201d<\/p>\n
Ramsey praised Wolff for jumping through hoops to provide FDA-approved Spravato. He wondered, though, whether a town as small as Jackson needs such a breadth of providers.<\/p>\n
\u201cI think that Jackson is like a lot of towns where there\u2019s a lot of access,\u201d Ramsey said. \u201cThere are a lot of different players in the ketamine space here, way more than there should be given the population.\u201d<\/p>\n
In general, Sanacora worries about potential overuse or misuse. He wondered if providers may be causing damage to patients or society in a way experts are not yet aware of. The concerns are on the heels of the opioid epidemic, he said. Ketamine has the potential for abuse, he added, calling for making sure the drug was used responsibly.<\/p>\n
\u201cThese are real risks. It doesn\u2019t mean we should stop in any way, or we should be dramatically limiting availability,\u201d Sanacora said. \u201cI\u2019m not saying that, but we really do need to stay aware that these risks do exist and not minimize them.\u201d<\/p>\n
Even as a patient, Barnes said that she does not see ketamine as an end all be all.<\/p>\n
\u201cI think that it works beautifully in conjunction with the other treatments: antidepressants, therapy,\u201d Barnes said. \u201cIt\u2019s like a recipe. You\u2019re using all these different ingredients to create the end result.\u201d<\/p>\n
Barnes had her last treatment a few weeks ago. Moving forward, she feels that she is \u201cokay\u201d and that she doesn\u2019t need ketamine. The door remains open for maintenance treatments if needed, she added.<\/p>\n
\u201cI would hesitate to recommend to anyone going in to receive ketamine treatments thinking that that was going to be the magic bullet,\u201d Barnes said. \u201cIt\u2019s not. It\u2019s not. But it certainly is powerful.\u201d<\/p>\n
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Patients can choose to wear a blindfold while receiving the Spravato treatment.<\/p>\n
KATHRYN ZIESIG \/ NEWS&GUIDE<\/p>\n","protected":false},"excerpt":{"rendered":"When Sue Wolff is ready to start the journey, she draws the blinds to her windows overlooking Highway…\n","protected":false},"author":2,"featured_media":264922,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[35],"tags":[64,63,73941,1730,155001,137,5266,15367,60013,16144,137457,1679,28510,514,515,40627],"class_list":{"0":"post-264921","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-mental-health","8":"tag-au","9":"tag-australia","10":"tag-clinical-medicine","11":"tag-drugs","12":"tag-esketamine","13":"tag-health","14":"tag-health-care","15":"tag-health-sciences","16":"tag-ketamine","17":"tag-medical-specialties","18":"tag-medical-treatments","19":"tag-medicine","20":"tag-mental-disorders","21":"tag-mental-health","22":"tag-mentalhealth","23":"tag-pharmacology"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/264921","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/comments?post=264921"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/264921\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media\/264922"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media?parent=264921"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/categories?post=264921"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/tags?post=264921"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
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