There are four unique methods of administration for ketamine during psychedelic therapy: intravenous infusion (IV), intramuscular injection (IM), lozenges, and intranasal spray. Here’s how each method of administration works and why IV is an efficacious choice.
Intravenous Infusion
Intravenous infusion is the most common method for administering ketamine. A catheter (a soft, hollow, flexible tube) is inserted into the patient’s vein by an experienced medical professional, and a small amount of ketamine is delivered directly into the bloodstream.
With an IV, ketamine is absorbed into the bloodstream in a gentle, gradual way, leading to a soft entry and exit to a journey. Additionally, a person has a peak experience throughout their infusion with strong psychedelic and therapeutic effects. The IV can be stopped at any point if needed.
Intramuscular Injection
Ketamine intramuscular injections are administered into the thick muscles of your arm. They are fast-acting and efficacious—in fact, many people have a quicker start to their psychedelic journey—but the absorption of the medication from the muscle may not be as consistent throughout the journey as with intravenous administration.
While Nushama’s protocol for individuals is mostly administered with IV, Nushama also uses IM for its group cohorts or members with sensitive veins.
Lozenges
Ketamine can be administered orally by taking a lozenge. The ketamine lozenge is placed under their tongue, allowing it to dissolve for 10-15 minutes. Lozenges are an inexpensive alternative to infusions as they don’t require specialized equipment or a physician trained in anesthesiology. With a doctor’s permission, participants may even administer the treatment themselves.
The downside of lozenges is that the rate ketamine gets delivered to someone’s bloodstream, and therefore the brain, is usually slow and variable. The positive effects of ketamine therapy may be less, and for some patients, lozenges alone may not provide long-lasting relief. Lozenges may also supplement IV infusions, prolonging their effects and increasing the time between “booster” sessions.
Nasal Spray
Nasal sprays are another alternative to ketamine infusions. Like lozenges, nasal sprays are generally less expensive and may be self-administered with a doctor’s permission.
Nasal sprays are less common because they can be very imprecise. The condition of the patient’s nose and the accuracy of their aim affects both dosage and rate of absorption.
The Ketamine Advocacy Network uses the metaphor of baking a cake. It’s not enough to have the right ingredients—you also need to control the amount of each ingredient and the length of cooking time. Nasal sprays and lozenges don’t give your doctor the same control as infusions.
Why IV?
IV holds the distinction of being the most effective, safe, and well-researched method. Let’s take a look at why.
Environment
Ketamine IV is administered in a safe and serene environment. Here are some examples:
- The administration is done by an experienced medical professional who monitors the experience every step of the way. This includes monitoring a person’s vitals for safety and assurance.
- The dosage can be adjusted after injection throughout the journey. If a person is at all uncomfortable with the effects, the journey can be stopped within minutes.
- Treatment often takes place in a setting designed for preparation, journey work, and integration. Like Nushama, some ketamine-assisted therapy resources offer curated playlists to foster a therapeutic experience.
Other ketamine-administration organizations offer nasal sprays and lozenges that can be taken from the convenience of a person’s home, and therefore, they do not provide a serene environment. The home setting for these routes of administration presents a plausible concern for addiction. Additionally, if a person has a unique reaction to the ketamine, a medical professional is not present to help.
An IV infusion’s tranquil, highly supervised environment creates the right setting for a mystical journey. Any dissociative effects dissipate upon completion within a few minutes or a few hours depending on how a person metabolizes ketamine.
Directness and Efficiency
IV infusion will ensure that patients receive the maximum benefits of ketamine treatment. When ketamine is administered directly into the bloodstream, it delivers the full dose throughout the length of the journey treatment.
Oral lozenges work slowly and with less efficiency. As much as 84% of the ketamine metabolizes into other chemicals and never reaches the brain. Nasal inhalation can be even more imprecise, as discussed above.
IM injections are comparably fast-acting to IV. However, they cannot as easily take advantage of certain ketamine admixtures that IV infusions use. These admixtures are used to mitigate conditions like nausea and increased blood pressure.
The Healing Process
IV ketamine infusions may provide immediate relief from symptoms like suicidal ideation, but for long-term relief, healing is a process. Patients with ongoing psychological diagnoses should expect to take part in an official protocol of ketamine-assisted therapy. At Nushama, members receive 6 infusions over the course of 3-6 weeks with additional boosters as needed. Ketamine-assisted therapy can be used to treat depression, anxiety, PTSD, OCD, eating disorders, addictions, and other ailments of the spirit. Psychedelic therapy works best with the proper preparation and integration, gleaning key insights to integrate into daily lives for long-term sustained relief and personal growth.