Should Ketamine Clinics Stay Open During Pandemics?
By Dr. Samuel Ko
On March 10, 2020, the World Health Organization officially declared the global COVID-19 crisis a PANDEMIC. Governments are doing their best to help reduce the spread of this infection in the early stages. Some countries are quarantining their citizens and shutting down all non-essential businesses, while others are making strong suggestions to stay home.
Riverside County Public Health ordered all residents to limit gatherings of any size, outside of family members residing at home, and to wear a mask when leaving home. Furthermore, California Governor Gavin Newsom issued an Executive Order for all California residents to “shelter-in-place,” and to go out only for essential activities. Some examples of essential activities include buying groceries, seeking medical attention, taking your pet to a veterinarian, picking up medications, and exercising outdoors.
Are Ketamine Treatments Essential?
Undoubtedly, we believe that emergency departments, urgent care, and doctor’s offices should remain open. That being said, many hospitals and clinics are postponing elective non-urgent surgeries, as well as utilizing phone or video appointments to minimize the spread of the virus amongst patients during this time of social distancing.
Before this pandemic even began, depression had surpassed HIV, AIDS, malaria, diabetes, and war as the leading cause of disability. An estimated 17.3 million Americans have experienced a major depressive episode and some studies report up to 20-30% of teenagers experiencing depression before they reach adulthood, and statistics are showing that rates are increasing.
Of course, the major concern with depression is that it can lead to suicide. Close to 800,000 people die by suicide every year. According to the CDC, the national suicide rate has increased by 33% between 1999 and 2017. Suicide is now the leading cause of death for Americans from the age of 10 to 34 years, and, believe it or not, there are twice as many suicides in the U.S. as there are homicides.
Knowing these facts, it's essential for ketamine clinics to remain open because it may be the only effective treatment for some patients who suffer from treatment-resistant depression, PTSD, anxiety, and/or OCD. For other patients with chronic pain (like CRPS, fibromyalgia, trigeminal neuralgia, and other forms of neuropathic pain), their severe pain may only respond to ketamine treatments. Some patients cannot wait for adjustments to their traditional medications to alleviate their depression and anxiety to better function. Ketamine may be their best and only option. To say ketamine infusion treatments are non-essential would be detrimental for these patients.
Ketamine In the Times of COVID-19
The COVID-19 pandemic and the broad effects from it are likely exacerbating symptoms for those who already suffer from anxiety and depression. In these challenging times, those who already feel down likely may feel more hopeless, lonelier, and/or even have increased suicidal thoughts. As people become more concerned about shortages of toilet paper, water, and food this could spark increasing anxiety. Those with chronic pain may have increased worry and stress about the availability of treatments, medications, and ability to manage their pain.
Furthermore, we know that those who suffer from mental health have lower immune system function, which will be critical to fight off infections. Improving the mental health of an individual improves their stress levels, immune system, as well as their coping mechanisms.
Why Do We Question Whether A Ketamine Clinic Should Remain Open?
This discussion may have its roots in the stigma associated with mental health and chronic pain. As a society, we often view the non-visible pain to be less important simply because it’s hidden behind the brain and body of another person. We tell people to, “Just toughen up,” or “Think happy thoughts,” or “Stop being such a baby!”
It is tough enough to navigate life with a mood or pain disorder, but it is made even more challenging with the societal judgement about having a disease. Traditional medicine and insurance companies often place mental health below physical health in an archaic hierarchy.
Mental health is just as important as physical health, but because physical health is external and thus more visible, we sometimes pay much more attention to that. However, we know that having both a healthy mind and body is critical for whole person health. The World Health Organization (WHO) defines health as a “state of complete physical, mental, and social well being, and not merely the absence of disease or infirmity.” Thankfully more and more healthcare professionals are recognizing this, and we are making progress to change the way we view mental health.
With increasing levels of stress, anxiety, fear, and panic, our patients need ketamine clinics to be open, especially in these times. But it should be done in a safe and responsible way.
Recommendations For Ketamine Treatment Centers
How can we continue to provide ketamine treatments in a safe and responsible way in this time?
Have all staff members and patients wear masks.
Each patient has their infusion in a private room and a minimum of 6 feet distance from other patients.
Request that all patients reschedule their appointments if feeling ill or if they have been in contact with anyone diagnosed with COVID-19.
Ensure that staff members stay at home if they are feeling sick.
Schedule less patients so they are not bunched together in the waiting room.
Have family members, friends drop off and pick up the patient and wait in their cars versus in the waiting room (unless, the patient has difficulty walking independently).
Double down on cleaning the surfaces, door knobs, high touch areas in the clinic.
Be sure that all healthcare team members take care of their personal health (such as getting sleep, eating healthfully, practicing social distancing, etc.)
Final Thoughts
It’s scary to face an unknown, invisible virus that has the potential to spread rapidly. COVID-19 definitely has the media’s and public’s attention now, but we must not forget about our patients that are already known to have mental and physical challenges. Although, this infection has the potential to cause significant mortality and morbidity, let’s not forget the societal cost of depression, anxiety, PTSD, and suicide.
We instinctively pay attention to a limited amount of things in our brain, typically whatever is shouting the loudest, so let’s remember to include the quiet voice of mental health as well.
Remember that we are all in this together. We will definitely overcome this pandemic when we support each other in trying times. Spread the love. Be kind. Rest and take care of yourself. Watch less TV. Spend more time in nature. And know this too shall pass.