(Christine Caldwell is a psychedelics educator, advocate, and founder of the nonprofit End of Life Psychedelic Care, a nonprofit organization that offers educational programs for people interested in working in the end-of-life care field.)
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Grief, an emotion universal to human experience, has the power to shape and transform lives in profound ways. The loss of a loved one can send shockwaves through our emotional landscapes, leaving us in a state of despair and longing. While the traditional methods of therapy and support have proven effective in aiding the grieving process, there’s a potential alternative approach to consider, especially when other avenues have failed.
Ketamine, first approved by the FDA in 1970 as an anesthetic, has gained attention for its mental health and chronic pain applications. For more than 20 years, research and real-world applications have shown its therapeutic value in treating various psychological conditions, including depression, anxiety, Obsession Compulsive Disorder (OCD), suicidal ideation, and PTSD, among others. Ketamine therapy has also been found to successfully treat a range of chronic pain conditions, such as fibromyalgia, neuropathy, migraine headaches, Complex Regional Pain Syndrome (CRPS), and more.
The story of Patty H. is illustrative of the potential for ketamine therapy to treat both mental health and chronic pain. Patty was diagnosed with Stage 4 head and neck cancer about 5 years ago. She fell into a deep depression that was so debilitating she did not leave her home. Ketamine therapy, in the form of IV infusions administered in a clinic, immediately began to lift her mood and after several sessions, she experienced joy for the first time in years and found motivation to seek a job. Not only that, her approach to death and dying became a philosophical one where she learned to live life in the present moment. Fast forward another year and the great news is that she is cancer-free, but the not-so-good news is that she is suffering from neuropathy and trigeminal neuralgia caused by the radiation treatments. Ketamine therapy, now in the form of higher dose IV infusions and at-home lozenges, brought pain relief and an ability to retain her job. For her, as she will tell you, “Ketamine saved my life, the life that I so desperately missed after being diagnosed.” She’ll also tell you that “[Ketamine] brought me closer to my husband and together we have faced this terrible disease and become stronger for it.”
Ketamine’s potential to aid in the grieving process has also been explored, offering hope to those grappling with the heavy burden of loss. The grieving process is deeply personal, and no two individuals experience it in the same way. Grieving also occurs in the individual faced with dying, and in their loved ones, way before their passing. This diversity underscores the importance of a versatile approach to healing. Traditional therapeutic methods, such as talk therapy and support groups, play a crucial role in navigating grief. Yet, for some, these approaches might fall short in providing the relief and breakthrough needed to move forward. This is where ketamine therapy comes into play. Administered in controlled and supervised environments, ketamine therapy offers a chance for individuals to confront their grief from a different perspective, potentially unlocking emotions and insights that had remained dormant.
Amber Keinan, MSW, trained in ketamine-assisted therapy and a bereavement counselor, has witnessed the transformative effects of ketamine therapy firsthand. She states, “Grief can be an incredibly complex emotion, and it sometimes hides beneath layers of pain and numbness. Ketamine therapy has the potential to gently peel back these layers, allowing individuals to confront their grief in a way that might be inaccessible through traditional methods alone.”
One of the remarkable qualities of ketamine is its rapid onset of action. While traditional antidepressants can take weeks to show results, ketamine can often induce therapeutic effects within hours or days. This rapidity can be particularly advantageous for those trapped in a cycle of despair offering relief from the overwhelming weight of grief. Under the guidance of trained professionals, individuals can explore their emotions, memories, and thoughts in a safe and controlled environment. This process can lead to breakthroughs, insights, and a newfound sense of emotional release.
Critics of ketamine therapy for grief argue that it might be viewed as a shortcut or a way to avoid the natural grieving process. However, proponents of this approach emphasize that it’s not about circumventing the grieving process but rather providing a complementary avenue for healing. Grief doesn’t adhere to a linear timeline, and there’s no universally “right” way to grieve. For some, ketamine therapy can be the catalyst that facilitates a deeper connection with their emotions and a greater acceptance of their loss.
It’s crucial to acknowledge that ketamine therapy is not a one-size-fits-all solution. It’s not suitable for everyone, and its effects can vary from person to person. At very high and frequent recreational doses, ketamine can also be addictive. Dr Steven Reichbach, a Sarasota, Florida-based board certified anesthesiologist, provides ketamine therapy for existential and psychological distress, as well as for chronic pain. He emphasizes, “Ketamine is one of the safest medicines available and is on the World Health Organization’s list of Essential Medicines. Nonetheless, appropriate dosing and a safe setting, coupled with compassionate support, are all very critical for someone who is grieving.”
In the landscape of grief, where traditional methods provide solid ground, alternative approaches like ketamine therapy offer a potential path towards the light of healing. As Amber Keinan, the bereavement counselor, aptly puts it, “Grief knows no boundaries, and our approach to healing should reflect that. Ketamine therapy might just be the key that unlocks a path to solace for those who need it most.”
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Final Exit Network (FEN) is a network of dedicated professionals and caring, trained volunteers who support mentally competent adults as they navigate their end-of-life journey. Established in 2004, FEN seeks to educate qualified individuals in practical, peaceful ways to end their lives, offer a compassionate bedside presence and defend a person’s right to choose. For more information, go to www.finalexitnetwork.org.
Payments and donations are tax deductible to the full extent allowed by law. Final Exit Network is a 501(c)3 nonprofit organization.
https://www.tandfonline.com/doi/pdf/10.1080/02791072.2023.2228303?casa_token=7mRrP5AuQ7wAAAAA:A5AJkzr_WzrLm6PA1ydxJWBFNCXC-1b7Ts1IITYbyO09IhIdmo2IrZcbNN6PrvWT1g3l4O5hpyXa
You might get a kick out of this paper. Variability is high but improvement can be superb!
Low, F., & Earleywine, M. (2023). Psychedelic Experiences After Bereavement Improve Symptoms of Grief: The Influence of Emotional Breakthroughs and Challenging Experiences. Journal of Psychoactive Drugs, 1-8.
Thank you for sharing your paper! I will review it later.
Very well written.
As a Ketamine Therapist familiar with research and anecdotal evidence supporting its efficacy in the treatment for depression, PTSD, anxiety disorders, chronic pain and Traumatic Brain Injuries, I am pleased to see its application to palliative and End of Life care.
Ketamine can be effective throughout its dose range and using various routes of administration.
Having to go to a clinical setting to receive IV ketamine therapy may not be the best approach for many end of life patients. Intramuscular ketamine is every bit as effective as IV administration and can be done in the patient’s home.
Nasal spray has high bioavailability and rapid onset of action.
For terminal patients when other routes of administration are not possible, rectal and vaginal suppositories are an option.
Ketamine is a wonderful catalyst not only for the dying person, but for grieving family members as well.
Facilitating group sessions I have seen grieving family members receive reassurance from dead loved ones in the form of transcendent visions and direct communication. Regardless of the source of these experiences, the effects I have seen have been universally positive.
In my experience I have found preparation for deep ketamine experiences to be enhanced by preparation focusing on opening our hearts to whatever arises, practicing self compassion and compassion for others, and practicing Mindfulness, (non-judgmental awareness of the present moment).
While ketamine can be a life changing experience, and is quite safe through the dose ranges commonly used, it is not a universal panacea. No one should ever be pushed into accepting any therapy with which they are uncomfortable.
Folks who are hypervigilent, have a strong need for control, or previous negative experiences with psychedelics may not be good candidates. However, beginning with very low dose work at home to facilitate relaxation and pain control can be a good way to overcome negative expectations.
Thank you again for a well written introduction to end of life care through the use of ketamine therapy administered by experienced compassionate practitioners.
Thank you for taking the time to provide such in depth detail. Are you familiar with the Palliative Care Psychedelic Therapy google group? It was co-founded by Dr. Michael Fratkin, a palliative care physician in N. California. He works with palliative/hospice care patients in their homes using IM ketamine administration, so exactly what you are describing. If you would like to join the google group, please go to https://groups.google.com/g/PalCarePsychedelicTherapy and request to join.