The use of Psychedelics in psychotherapy, particularly Ketamine-Assisted Psychotherapy (KAP), has gained increasing scientific and clinical attention in recent years.

Despite a growing body of research supporting their efficacy in treating mental health disorders such as depression, Post-Traumatic Stress Disorder (PTSD), and anxiety, significant stigma remains a barrier to widespread acceptance and access. This stigma is partly due to ketamine’s association with illegal drug use.

This article explores the origins of stigma surrounding KAP and psychedelics, its consequences, and potential ways to challenge and reduce these misconceptions.

When Did Ketamine Use Start?

The journey of ketamine began in 1962 when it was first synthesised by American chemist Calvin Stevens. Initially, ketamine found its place in veterinary medicine as an anaesthetic, but its use soon expanded to human medicine, particularly within surgical settings.

Unfortunately, during the 1970s and 1980s, ketamine gained notoriety as a recreational drug, often associated with the rave and party scenes. This period of recreational ketamine use contributed to a negative public perception, overshadowing its medical potential. The tide is now starting to turn in recent years as researchers have revisited ketamine’s therapeutic properties.

Public stigma is referring to a widespread societal discrimination that results in the marginalisation of individuals seeking psychedelic or ketamine-assisted therapy.

Many people fear being judged or labeled as “drug users” rather than as patients seeking legitimate mental health treatment. Self-stigma, on the other hand, occurs when individuals internalise these negative stereotypes, potentially discouraging them from seeking effective care. Research indicates that self-stigma can lead to decreased self-esteem, increased psychological distress, and a reliance on harmful coping mechanisms such as substance misuse (Corrigan & Watson, 2002; Pescosolido & Martin, 2015).

The risks associated with frequent recreational use among ketamine users, particularly urological symptoms like cystitis, further complicate the public perception of ketamine.

Stigma acts as a major barrier to mental health treatment. Studies have shown that individuals who perceive higher levels of stigma are less likely to seek formal mental health care, instead opting for self-medication or avoiding treatment altogether (Borenstein, 2020; Link & Phelan, 2013).

In the case of ketamine-assisted psychotherapy, stigma contributes to skepticism among both patients and healthcare providers, once media portrayals and misinformation often depict ketamine as a “party drug” rather than a legitimate therapeutic tool, the adoption of this potentially life-saving treatment for conditions like treatment-resistant depression and post-traumatic stress disorder (PTSD) is well correlated with stigma, therefore, slowing down research.

As a result, individuals seeking KAP may internalise these negative stereotypes, experiencing self-stigma, which can deter them from accessing treatment. The importance of monitoring ketamine usage to ensure personal safety, including appropriate dosage and side effects, is crucial in addressing these misconceptions and promoting safe therapeutic practices.

Clinical Efficacy Versus Public Perception of Ketamine Therapy

Despite the stigma, research has consistently demonstrated the clinical benefits of KAP.

Ketamine has shown rapid antidepressant effects, particularly for treatment-resistant depression and acute suicidal ideation (Berman et al., 2000; Zarate et al., 2006).

There is growing interest and advocacy for ketamine treatment, particularly for treatment resistant depression. Additionally, studies have highlighted its potential for reducing PTSD symptoms (Feder et al., 2021). However, public perception lags behind scientific advancements, often viewing KAP with skepticism and associating it with substance misuse rather than medical treatment.

Addressing Stigma: Education and Policy Reform

Challenging stigma requires a multi-faceted approach. Public education campaigns can play a critical role in reshaping narratives around ketamine and psychedelic-assisted therapy by emphasising their scientific basis and therapeutic potential.

National institutes like the National Institute for Health Research (NIHR) play an important role in funding research and setting clinical guidelines for ketamine use. Moreover, policy reforms, such as rescheduling psychedelics for medical use and integrating KAP into mainstream healthcare settings, can help normalise these treatments and reduce misconceptions.

Efforts in the UK, including clinical trials and policy discussions, signal a shifting perspective on psychedelics and ketamine as viable medical interventions.

The Key Takeaways

Although KAP and other psychedelic-assisted therapies show immense promise in mental health treatment, stigma remains a significant barrier. However, as treatment access expands, such as through Eulas, the perspective is beginning to change.

As these therapies become more accessible, the positive outcomes and real-world results will speak for themselves, helping to slowly dismantle the stigma surrounding them. By addressing misinformation, reforming policies, and encouraging open discussions, the therapeutic potential of ketamine and other psychedelics can be more widely recognised and accepted.

Over time, these changes in accessibility and acceptance will be essential in shifting societal attitudes and making these treatments more accessible to those in need.

References

• Borenstein, J. (2020). The Stigma of Mental Illness: Strategies to Overcome Structural Discrimination. Oxford University Press.
• Carhart-Harris, R. L., & Goodwin, G. M. (2017). The therapeutic potential of psychedelic drugs: Past, present, and future. Neuropsychopharmacology, 42(11), 2105–2113.
• Link, B. G., & Phelan, J. C. (2013). Labeling and stigma. In Handbook of the Sociology of Mental Health (pp. 525-541). Springer.
• Morgan, C. J. A., Muetzelfeldt, L., Curran, H. V. (2017). Consequences of chronic ketamine self-administration upon neurocognitive function and psychological wellbeing: A 1-year longitudinal study. Addiction, 105(1), 121-133.
• Nutt, D., Erritzoe, D., & Carhart-Harris, R. (2020). Psychedelic psychiatry’s brave new world. Cell, 181(1), 24-28.
• Pescosolido, B. A., & Martin, J. K. (2015). The stigma complex. Annual Review of Sociology, 41, 87-116.
• Stevens, J. (2019). Ketamine: A review of its history, pharmacology, and therapeutic use. Journal of Psychopharmacology, 33(12), 1370-1380.
• Zarate, C. A., et al. (2006). A randomized trial of an N-methyl-D-aspartate antagonist in treatment-resistant major depression. Archives of General Psychiatry, 63(8), 856-864.