The recently published Harvard Gazette Article entitled Rapid Relief for the Severely Depressed? There’s a Catch highlights the important work that colleagues at MGB are undertaking to promote the safe, monitored, and ethically financed provision of ketamine and the briefly mentioned esketamine (the FDA-approved, insurance covered intranasal spray). Having recently been a part of the broader MGB team at MGH’s sister-hospital, Brigham and Women’s Hospital, it was wonderful to read my friends’ and colleagues’ thoughtful reflections on this life-saving treatment. Their words and the piece, in general, thoughtfully explore the complexities surrounding ketamine therapy for treatment-resistant depression, highlighting both its potential benefits and the concerns associated with its use. As someone deeply involved in this field, I found myself nodding in agreement with many of the points raised. The article encapsulates much of what we at Lumin stand for and strive to provide and the values espoused in the article serve as the foundational principles on which Lumin stands.
Embracing Safe and Medically Supervised Ketamine/Esketamine Therapy
The article underscores the importance of administering ketamine and esketamine in a medically supervised setting, integrated within a comprehensive psychiatric treatment plan. This resonates profoundly with our philosophy at Lumin: we believe that ketamine and its FDA-approved derivative, esketamine (Spravato), hold significant promise for individuals grappling with treatment-resistant depression. However, this promise is best realized when treatments are conducted safely, ethically, and under the guidance of qualified medical professionals. The treatment must also be provided in the context of a person’s broader continuum of care: this incorporates liaising with a person’s outpatient providers and, should a person benefit from higher levels of care such as intensive outpatient programs, partial hospital programs, and inpatient/residential programs, taking the time to be part of that conversation, as well. In this way, the provision of ketamine and esketamine is not a treatment isolated from all of the things a person engages in to diminish suffering. Instead, it is woven into and engaged with a person’s broader treatment approach. It is crucial to highlight the need for onsite medical supervision, strict protocols, and coordination with patients’ care teams.
Addressing Concerns About Accessibility and Oversight in Ketamine Treatment
The article raises valid concerns about the proliferation of private ketamine clinics operating with minimal oversight, often at prohibitive costs. In the early days of Lumin Health, Gene Dolgin, Co-Founder CEO of Lumin, and I had spoken about our particular care delivery model. Both of us agreed that medical safety was a priority and direct supervision was our value. In this way, we can be more engaged with a person’s treatment and broader treatment team. We can also address emergencies with skilled medical personnel in the (rare) circumstance that they come up. As the article notes, ketamine is not without its hazards, but these risks can be dramatically mitigated with proper oversight.
Accessibility is also a primary concern. Lumin has leaned heavily into understanding the complexities of insurance-based esketamine care as an alternative to more expensive ketamine (which we also provide at rates lower than those quoted in the article!). We are one of the largest esketamine-providing medical centers in the country, having achieved that feat in just two years time. Esketamine is a logistically complicated medicine to provide (not to mention receive) but the upshot is that it is accessible to nearly all those who have insurance.
Ketamine and esketamine both come with the legacy of its reputation as a substance of abuse. Part of developing a narrative around its safe, medical application is to provide these life changing medications in a safe and medical environment. The environment should certainly be warm with the priority of set and setting close to heart, but keeping this medication within its intended frame - a medical treatment for a medical illness - must also be prioritized as a high value. To help with monitoring, our clinic is staffed with a team of highly qualified professionals, including board-certified Psychiatrists, Psychiatric Nurse Practitioners (PMHNPs and APRNs), Physician Assistants (PAs) Registered Nurses (RNs), Medical Assistants (MAs), and Licensed Mental Health Clinicians (LMHCs). We ensure that every treatment is administered in a controlled, medically supervised environment, aligning with the best practices advocated in the article.
Shared Vision for the Future of Mental Health Care
The Harvard Gazette article encapsulates a vision for mental health care that prioritizes patient safety, accessibility, and collaborative practice. It is great to see this message spread throughout the broader treatment community as this vision is our mission at Lumin. We are dedicated to advancing the responsible use of medical psychedelics, such as esketamine, to provide relief for those who have not found success with traditional treatments.
Final Thoughts: Walking the Path Together
Depression can be an isolating and overwhelming experience. Yet, there is hope. By embracing safe, medically supervised treatments and fostering a collaborative approach, we can make significant strides in alleviating suffering.
At Lumin, we are committed to walking this path with you—not just as providers but as partners in your journey toward healing. We share the concerns and values highlighted in the Harvard Gazette article and are dedicated to upholding the highest standards of care. We are excited to continue to make ketamine and esketamine available and accessible to those who could benefit from it.
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