I think clinics provide at home ketamine therapy as I've come across many providers at different costs. Specialty clinics provide in person guided ketamine therapy. I talk to someone who worked at UCB's psychedelic treatment program and says guided therapy works best for positive changes. At home ketamine therapy can unguided supposedly can create negative connections in the brain. With my insurance, no guided ketamine therapy providers will see me even if I self pay. The story they give is that there is some legal complications with my insurance and self pay but I don't get it. I'm at the end of my rope with these providers. Aren't they there to help people? All they've done is make me more hopeless but may have to do at home ketamine therapy unguided by a professional, just guided by a friend. It's my choice but prefer a guided session for the first time at the least. My current medication prescriber can't provide me with ketamine therapy for some reason. I think treatment is financially motivated and they discriminate against poor people. Ketamine is a very cheap drug which has been around a long time but these clinics are making this revolutionary treatment unaccessible to so many. I'm bewildered by the lack of empathy these clinics provide for people who are just seeking help with their medical care. So sad that only the privileged people can get the proper help.

Thanks for the concern but every time I switch providers they want to change my medications to what they think I should or shouldn't be on. My major in college was pharmacology at UCSB so I know medications. My doctor of 15 years who gave me a nuclear brain scan showing the defects in brain functioning and correctly diagnosed my 3 neuroses with a prescription regimen for the rest of my life. I lost him to retirement/illness 26 years ago. Ever since, new doctors want to rip me off the medications which made me comfortable and were working. Where's the consistency in treatment? I've currently been seeing nurse practitioners who only fucked things up worse. I had a telihealth visit with a psychiatrist who said I needed to be hospitalized as an inpatient. God damn quake. All I need is to be put back on the medications which made me most stable and comfortable. I'm fed up with the for profit healthcare system and incompetent so called medical professionals. I know how drugs work on the molecular level and am better educated than most mental health prescribers and providers on myself and what I need. I'm sick of the medical community not listening to me. I just need a medication adjustment back to what worked. Why can't I get proper treatment and chose my drugs based on personal experiences and knowledge. I'm the expert on myself and what works and what doesn't. All I need to be treated legally is the right medical professional for me. Why is this concept so difficult to achieve? I don't get why there's so much mistreatment and variability by so called educated professionals. It's so frustrating and counterproductive, meanwhile my health is suffering.

I'm not worried about addiction. Ketamine isn't physically addictive.I just stopped taking narcotics I was physically dependent on for almost 25 years. It kept me numb from depression but without them my depression is showing through. I saw my practitioner today but she isn't capable of prescribing Spravato but I found a medical practice that delivers ketamine in troches, little gel squares for oral administration. They start you on micro doses of oral ketamine of 10-15mg then adjust your dose over time. The practice is called Joyous and costs $129/month for your ketamine and visits everyday by phone or zoom to report your experience and follow your progress and adjust your dose. Then follow you weekly for 8-10 months or more. If I can't find a clinic I'll try Joyous.

And community inpatient mental facilities can't supervise the first dose of esketamine as a hospital on an outpatient basis since it's an emergency to arrest my depression. Can't an ED support your first use of esketamine and if you have no ill side effects leave you to be medicated at home? Not everybody has negative side effects and if there was such a problem, why isn't it reserved for inpatient treatment only? If there were so many problems with this medication, why is it listed as a CIII and not CII controlled substance? It all seems a bit hypocritical and reserved for only people who can afford it. That's not right since one of my 11 daily medications costs over $50,000/year, many times more than being seen for ketamine therapy, especially Spravato. It should be at the discretion of the medical professional whether to prescribe Spravato to a patient and what supervision is needed, if any. The clinic I seek care from is across the street from the main fire station in town and half a mile from the nearest ED if an emergency arises which I'm not convinced can occur.