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Ketamine was originally used as an anesthetic. It was especially useful on battlefields and with children because, unlike most anesthetics, it isn’t an airway depressant and, therefore, doesn’t pose the same kind of risks. However, doctors started noticing that severely depressed and suicidal patients who received ketamine for anesthetic purposes experienced dramatic improvements to their mental health.
Since then, ketamine clinics have opened across the country. Providers administer small doses of ketamine, much less than the dose necessary to put someone out for surgery, and often couple that treatment with therapy to help patients with depression or other mental health issues. Doing so has proven not only effective, but safe. Utah started tracking adverse events related to outpatient anesthesia in 2017. In that time not a single ketamine-related adverse event has been reported although tens of thousands of doses have been administered to patients.
The same cannot be said of other anesthetics. In fact, adverse events including deaths have been reported for patients undergoing dental procedures under anesthesia. In response to these events, lawmakers put in place patient protections in 2022 to require providers to remain in the room for the duration of a procedure anytime an anesthetic is administered.
While this protection makes sense in the context of more dangerous anesthetics, it is unnecessary for ketamine, especially when administered at low doses. In fact, because most insurance companies don’t cover ketamine treatments, providers typically administer ketamine to several patients at a time and then monitor them via video, through windows, by going from room to room, or by having a therapist in the room with each patient. These protocols ensure patients are safe and that they can afford treatment that would be prohibitively expensive if a doctor had to remain in the room with them during the entire course of treatment.
Senate Bill 197, sponsored by Senator Michael Kennedy, requires a provider to remain on-site and available, but not in the room with a patient when ketamine is administered for nonanesthetic indications. Doing so ensures that competent help is available if a complication arises but keeps ketamine affordable and accessible to patients.
