FAQs

Before Your Visit

What is ketamine?

Ketamine was originally developed as an anesthetic and has been used for medical procedures like surgery since 1970. Known for its safety and breadth of uses, the World Health Organization has placed ketamine on its list of “Essential Medicines.” It has also been found to be useful in the treatment of depression, anxiety, PTSD, and other mental health concerns and has been used for these purposes for several decades.

Interest in the use of ketamine in mental health has been blooming in recent years as research is culminating, and psychedelic medicine has been re-emerging and gaining acceptance in the medical community. With the recent rise in depression across wide populations, this is a welcome innovation. 

What is psychedelic ketamine therapy?

Ketamine is the first legal clinician-prescribed psychedelic (or “mind-revealing”) treatment for depression, anxiety, chronic pain, PTSD, OCD, substance use disorders, and other mental health-related conditions. It works faster than traditional antidepressants and is potentially more long-lasting, proving itself an effective alternative. Researchers believe it can even protect against relapse with depression. Ketamine has the ability to reverse the damage that the chronic stress of mental illness causes to connections in the brain. Many are claiming that the discovery of ketamine’s rapid antidepressant effects may be the most significant psychiatric development in recent decades, one that is even transforming what we thought we knew about the neurobiology of depression.

The research on ketamine is still growing, so even though it’s been used for over 20 years, it’s still considered an “off-label” use to prescribe ketamine for such conditions such as depression and anxiety. Off-label just means using the drugs to treat conditions the FDA has not approved. The recent growth in the number of clinics offering ketamine in recent years speaks to the dire need for more comprehensive options in mental health care.

Also see our blog, “Why ketamine?” 

What is ketamine microdosing?

Microdosing ketamine entails taking very low doses daily or semi-weekly. This is a great solution that allows for someone to elicit some of the benefits if they can’t or don’t want to take psychedelic doses of ketamine. We offer microdosing as an option, as it has been shown to offer a wide range of potential benefits. These benefits include improved mood, increased focus and concentration, reduced anxiety and stress, and enhanced creativity and self-awareness. Additionally, microdosing ketamine has been shown to be an effective treatment for depression, PTSD, panic attacks, and chronic pain. This method of dosing delivers an amount of ketamine that is below the threshold for psychoactive effects. We utilize microdosing as a support on the path to healing, providing relief and support while a patient is addressing other root causes in their mental health picture. It pairs perfectly with our holistic mental health support, or that of a functional and holistic medical approach. We typically prescribe microdose ketamine for a limited time period, anywhere from 6 -13 months depending on someone’s need.

How does ketamine work?

The exact mechanism of how ketamine works in depression, anxiety, and chronic pain is not fully understood. What we do know is that ketamine works on the NMDA receptor to block the glutamate neurotransmitter. Studies have shown that ketamine improves the health of the neurons (brain cells) by increasing the connection between the neurons and improving the brain’s ability to adapt (aka neuroplasticity).

Ketamine also changes the way the central nervous system processes pain, so it can be like hitting the reset button on your computer in order to restore normal pain processing.

Research has also shown the potential for ketamine to increase resilience and recovery from stressful traumatic events (supporting its use in PTSD) which can trigger or cause depression and anxiety disorders.

Furthermore, ketamine decreases activity in the Default Mode Network (DMN) of the brain, which is often more active in those with depression, anxiety, and chronic pain.

What are the benefits of ketamine?

Pairing ketamine with the structure, support, and knowledge of an expert in treatments with ketamine (and the integration of the insights it provides) turns a psychedelic trip into a therapeutic and healing experience. Intentional healing with ketamine has a very different impact from taking it recreationally. This is true for all psychedelics.

When looking at ketamine as a treatment for mental health disorders such as depression, psychological trauma, and anxiety, the effects on the brain can best be understood in three processes:

  1. Changes in neurochemistry: beneficial changes to the balance of naturally occurring chemicals in the brain;
  2. Increased neuroplasticity: the brain’s ability to regenerate and adapt which is increased by the therapeutic use of ketamine;
  3. Insights gained: influential changes in thought patterns developed by the combination of ketamine with therapy and intention setting can lead to behavioral change and more 

Beyond healing mental illness, these transformations in consciousness help people experience more meaning and purpose in their lives and become more compassionate contributors and members in their communities. With larger doses, users report that those anti-depressive effects can last for days, weeks, or even a month.

At lower doses, ketamine can disrupt negative feelings and thought loops, and help the brain create new, healthier patterns and perceptions.

How do I know if I’m a candidate for this treatment?

We offer a free introductory call to determine the safety and viability of this treatment for you. This is for those looking for a new approach to mental health for anxiety, depression, PTSD, trauma, grief, and substance use.

Who is ketamine therapy NOT for?

Ketamine is not recommended for those with certain health conditions and situations such as:

  • unstable cardiovascular conditions such as uncontrolled hypertension, multifocal PVCs, or malignant arrhythmias
  • glaucoma
  • uncontrolled hyperthyroidism
  • active mania or a history of psychotic illness or breaks (ex. schizophrenia)
  • while pregnant, nursing, or trying to become pregnant. Clients with active mania or a history of psychotic illnesses (like schizophrenia) 
  • current or recent history of suicidality requires working closely with a therapist or psychologist in tandem with our ketamine treatments
  • active alcohol, opiate, or ketamine abuse

As holistic doctors, we have a vast toolbox of support for mental health conditions when ketamine is contraindicated. 

We conduct a thorough screening with every patient (including a physical exam) before prescribing ketamine to ensure that it is a safe option for you.

Is ketamine safe? Is it addictive?

Ketamine is a medication that has been used safely as an anesthetic and analgesic agent in hospitals and emergency rooms since 1970. Over the past 20 years, lower (sub-anesthetic) doses of ketamine have also been safely used for mental health treatments as an adjunct to conventional psychotherapy. Ketamine is known for its general safety profile, and the fact that it plays nicely with many other medications.

While ketamine is safe to use in controlled medical practice, it becomes hazardous if someone takes it for recreational use, particularly when used repeatedly at higher doses. Because of its pain-relieving and mental effects, ketamine can cause dependence, and with the need to take higher doses to get the same effect, addiction can develop. 

As with any medication, there is always the risk of an allergic response in a small percentage of people.

Do I need a referral from my doctor?

No, you do not need a referral to work with us. 

We do, however, welcome referrals from other doctors and health providers who believe their patients might benefit from our approach. We encourage open communication with your current providers if you do decide to add us to your health team as that is how we all serve you best.

Who can we work with?

We can work with anyone who is either a resident of Oregon or who can travel to establish care in person in Bend, Oregon. We cannot ship ketamine across state lines, so care must be delivered in the state of Oregon. We prioritize safety for our patients above all else, so we can work with anyone who does not have any contraindications and whom we deem could safely take ketamine within the safety setup and guidelines we require.  

We can work with anyone 16 years and older. Treatment and full care-coordination is required from a legal guardian for anyone younger than 18 years of age. 

As a naturopathic doctor, why are you prescribing ketamine (which is not natural)?

We get this question a lot. Naturopathic medical philosophy rests firmly on first employing tools that encourage the utilization body’s innate healing wisdom and process, and in addressing the root cause. This is precisely what ketamine does, particularly when the emphasis is on proper integration counseling. 

It’s also important to share that NDs are not inherently against all conventional tools (as they all certainly have their place), and are not blind proponents of all “natural” treatments. Conventional medicine performs miracles in acute medicine and severe pathology. Naturopathic medicine tends to shine in the treatment of chronic, complex, and functional conditions. 

Our training is in the discernment of the right tool at the right time. We find that quite often a more gentle tool that supports health (rather than controlling or suppressing the body’s function) would be a wiser first step that tends to have fewer side effects and result in better overall health. Used correctly, many natural tools tend to work more often in support of function, and often work so well in chronic conditions that high-force (and suppressive) interventions are not necessary. We are proponents of the tools that bring balance and healing back to the body as efficiently as possible, without the need for a perpetual prescription if it can be avoided. 

Ketamine can act as a ladder for someone to climb out of a dark place and give them the breathing room and clarity to address the parts of self care that previously felt too difficult. It can also help someone get to the true root cause of their emotional disharmony and change a behavior that perpetuates it, as outlined above in the “What is integration counseling like?” question.

During Your Visit

How is ketamine taken?

Ketamine can be taken in many ways: orally, rectally, nasally, topically, and it can be injected into veins and muscles. At Medicine Within, we prescribe ketamine at various doses for oral ingestion. We work very closely with our patients to determine the lowest effective dose in order for them to achieve their goals. Ketamine is considered to have moderate to high abuse potential, so working with a qualified health professional is key.  

 Ketamine is not a one-size-fits-all approach. We offer various dosing strategies catered to your needs and comfort, including both a low-dose/microdose ketamine and macro-dose/psychedelic journey dose. Dosing is based on the patient’s needs, safety, and comfort. Both dosing strategies are intended to act as a bridge to better function, not a long-term prescription to be forever reliant on. This differs greatly from how many antidepressants and anti-anxiety medications are prescribed. This is also why we love pairing ketamine therapy with holistic mental health: to provide support and relief while we work on addressing the other factors in a plan to support mental health.

What is psychedelic ketamine therapy like?

At a psychedelic dose, ketamine can be compared to other psychedelics/entheogens, but is unique in several ways. People sometimes describe it as a vivid dream-like state, a feeling of being outside their bodies, blissful, calming, and sometimes challenging. People may experience heavy sedation (dosage-dependant) and body dissociation with tingling in the hands, feet, and head. Physical euphoria is common and can be accompanied by out-of-body experiences. Ketamine creates a short-lived but intense experience that can invite significant changes in the way people perceive and create their reality. Ketamine tends to quiet the “mind chatter” and enhance creativity, allowing for new insight through highly abstract thoughts. 

Microdosed ketamine can ease anxiety, stress, and depression as well as reduce physical aches and pains. At this dose, ketamine does not alter the patient’s state of consciousness, but it may make them a bit drowsy. For this reason, it is typically dosed in the evening before bed.

What can I expect from start to finish with psychedelic ketamine therapy?

Ketamine is an incredibly safe and versatile medicine, and can be taken at home with our comprehensive screening, safety protocols, and close guidance. Here is what it looks like from start to finish:

  1. Work with a physician to get a thorough virtual intake, guided intention, and dosage recommendation.
  2. Get professionally compounded medicines shipped directly to you.
  3. Receive full preparation on setting up a safe and meaningful ketamine experience.
  4. We guide you through your experience from the comfort of your own home.
  5. Follow up with deep integration counseling to create lasting changes in your life.
  6. Collaborate to determine the need for future sessions.
What can I expect from start to finish with ketamine microdosing?

Here is what it looks like from start to finish:

  1. Work with a physician on a thorough virtual intake and customized treatment plan.
  2. Get professionally compounded medicines shipped to your door.
  3. Work closely together to find your optimal dosage.
  4. Complement microdosing with integration counseling and holistic mental health support for an even more comprehensive approach.
  5. Collaborate to determine when ketamine is no longer needed.
What is holistic mental health?

Our emotional wellbeing is not separate from our physical wellbeing, in fact the two directly influence one another. There are often real, objective, and measurable imbalances in the body contributing to mental health issues which need to be addressed for sustainable results.
For example, blood sugar imbalances can trigger anxiety, and gut issues can trigger depressive episodes. Other imbalances can include allergic responses, auto-immune disorders, digestive ailments, hormonal issues, inflammatory processes, microbial imbalances, nutritional deficiencies, and sleep problems. We do a thorough deep dive into your unique health picture to find out where support is needed to optimize your mental health.

In a medical system where care is often fractured, we look at all the pieces of your mental emotional health puzzle. We work to identify how best to address the physical imbalances impacting your mood, and craft a customized plan to address them using individualized, natural medicine.

We can complement your current approach or create a new holistic plan. Learn to work in partnership with your body rather than just suppressing symptoms. We utilize creative, holistic support for your mind and heart using tools that work in harmony with your body.

What can I expect from start to finish when getting holistic mental health support?

Here is what it looks like from start to finish:

  1. Meet with a physician for a comprehensive virtual intake to review possible contributing factors to your mental health picture.
  2. Order relevant labs, discuss treatments and options, and put a plan into action.
  3. Get quality natural products shipped to your home. We partner with a virtual  dispensary and pass along a 20% savings off all orders.
  4. Follow up to review labs, get customized treatment recommendations, and adjust  support as needed.
  5. Work closely with your physician over time for ongoing support. We are here to help you get clarity and to take the journey with you.
What makes Medicine Within different?

There are several things that make us different:

  • We offer oral treatment of ketamine, meaning no needles or IVs needed.
  • We can treat patients anywhere in Oregon with our virtual model, greatly improving accessibility to these medicines. 
  • Patients get to work with a physician from start to finish, meaning you get a high level of expertise and safety in our care.
  • We understand the power of these medicines from a both clinical and personal perspective. We have the lived experience of moving through grief and “stuckness” with the help of psychedelics, and coming out stronger on the other side. 

After Your Visit

Do you bill insurance?

Medicine Within does not bill insurance, and we are not contracted with any insurance companies. We will gladly provide you with a superbill (similar to an invoice) with billing codes based on time spent with your provider. Depending on your plan, you may be able to get out-of-network reimbursement for your treatment. 

Some insurance companies will cover the cost of certain compounded forms of ketamine, but for most the cost of the medicine is out of pocket. The compounding pharmacy that we work with will help you determine whether the ketamine prescription is covered by your plan.

Please note that we do not prescribe Spravato.

What are integration sessions?

Integration involves working through the emotions and insights from your ketamine experience, and translating them into actionable steps towards your intention for treatment. Integration is a crucial part of working with ketamine in order to facilitate lasting personal growth and changes. 

Regardless of what our physical body and neurotransmitter pictures look like, we are bound to struggle if the deepest parts of us are wounded, unfulfilled, or stuck in negative patterns. While ketamine has certain potent biochemical actions that can reduce anxiety and elevate the mood, ketamine therapy also has the potential to provide key insights from the inner workings of the subconscious mind to shift away from any “stuckness.” This medicine can reveal the patterns and negative messaging in the subconscious mind that have a heavy hold on our perceptions and experience of life. When we value the mystical journey ketamine can take us on, there is an opportunity to get so much more out of this multipurpose medicine. 

Each integration session is one hour to dive deep into your journey and unearth the themes, ideas, and revelations that may have arisen. You will get the opportunity to share your hidden struggles, fears, weaknesses, and issues with a non-judgemental provider dedicated to witnessing your personal evolution. Using our extensive training in coaching and holistic counseling, our providers ask both open-ended and directive questions to help make sense of this often abstract experience. This whole process helps your conscious mind to connect the dots between your physical body, mind, emotions, and spirit. The way this medicine interacts with the individual has the opportunity to reveal their own wisdom within. Each person carries knowledge about what they need in order to heal, and we love how effectively ketamine can help people access these truths. 

Ketamine offers the doorway into the knowing, and integration counseling is how we apply what was revealed to our day to day life. Without properly digesting and applying the lessons learned in our day to day life, no amount of mountain top psychedelic experiences will actually shift your real life. As we always say: The medicine is the knowing and the integration is the being. This is why if the goal of a psychedelic is real and lasting healing, a skilled therapeutic container is essential (both during and after their use). As integration specialists, we are always holding the vision of you healing, expressing your truth, making peace within, and living as the empowered individual who has the freedom to create an enjoyable and fulfilling experience of life.

Providers

Who is a good candidate for ketamine therapy?

This is for patients looking for a new approach to mental health for anxiety, depression, PTSD, trauma, grief, and substance use. It has been studied most in depth for treatment-resistant depression. Ketamine is also being researched for various chronic and intractable pain syndromes (fibromyalgia, migraines, neuropathic pain, CRPS, phantom limb syndrome, etc). If you have patients who are stuck or have plateaued in treatment, they may be a good candidate. Ketamine therapy is time intensive, and patients will need to have some financial resources in order to follow through on treatment. Ketamine has a profound ability to interrupt or quiet down the “mind chatter,” which can offer patients with very loud internal dialogue or looped thoughts incredible relief and clarity.

Who is NOT a good candidate for ketamine therapy?

We conduct a thorough screening with every patient before prescribing ketamine to ensure that it is a safe option for them. While ketamine is a generally safe medicine, there are certain conditions which would rule this out as a treatment option:
– Cardiovascular conditions such as uncontrolled hypertension, multifocal PVCs or other malignant arrhythmias, or any unstable vascular conditions
– Glaucoma
– Uncontrolled hyperthyroidism
– Pregnant or trying to become pregnant.
– Active mania or a history of psychotic illnesses (like schizophrenia), or psychotic breaks
– Current alcohol abuse or current/past ketamine abuse
For anyone who has a current or recent history of suicidality, we will require that they work closely with a therapist or psychologist in tandem with our ketamine treatments. For acute suicidality or very severe depression we generally recommend working with an in-person provider using ketamine infusions so that the dosage and session can be more closely monitored.
We require that clients have another person present with at-home treatments (a “Safety Sitter”) due to the way ketamine impacts mobility and coordination. Any patient that cannot find a trusted Safety Sitter to be present for their ketamine sessions would need to wait until an in-person option is available.
As holistic doctors, we have a vast toolbox of support for patients when ketamine is contraindicated through our holistic mental health support.

How do I refer a patient to Medicine Within?

Send them to our home page and direct them to click Get Started to schedule a free introductory call.
If you would like to schedule a Provider Referral Consult to discuss a potential referral with us directly, you can schedule that here: https://medicinewithin.as.me/providerreferral

Can ketamine be destabilizing?

Ketamine IS initially somewhat destabilizing, and this should be expected after treatments. This is a benefit and a part of the treatment itself. A treatment can “shake the snowglobe” to allow new patterns and ideas to settle, which is a good thing for those with stuck patterns and circular thoughts or beliefs. But for a patient who is not in a place where some destabilization would be welcome (ie severe psychological distress, psychotic illness, complex PTSD, etc.), ketamine may not be appropriate in psychedelic doses. Microdosing ketamine may still be appropriate in some cases. They will need ongoing psychological support if they are in a more fragile state, which is why we love partnering with local mental health providers to ensure our patients are resourced during this process.

How many sessions are needed?

This is a very individual question, but for macro-dosing ketamine in most patients, the answer lies somewhere between 2-6 sessions. For microdosing ketamine clients will take this anywhere from 6-14 months. Most patients who work with us on holistic mental health are with us anywhere from 6 months to several years. These timelines depend not only on their need, but upon their engagement in treatment (including integration) and willingness to address lifestyle or health factors that impact their condition.

Schedule your free introductory call.

Get Started

Serving all of Oregon
Operating out of Bend, OR
541-316-0092

Office Hours
Tuesday - Friday 9am - 4pm
Two Saturdays a month 9am - noon

Medical Disclaimer
This website and its contents should not be used as a substitute for professional medical advice, diagnosis, or treatment.

If you think you may have a medical emergency, please call 911 immediately. You can also call, text, or chat 988 or 1-800-273-TALK (8255) for immediate mental health support.

Serving all of Oregon
Operating out of Bend, OR
541-316-0092

Office Hours
Tuesday - Friday 9am - 4pm
Two Saturdays a month 9am - noon

Medical Disclaimer
This website and its contents should not be used as a substitute for professional medical advice, diagnosis, or treatment.

If you think you may have a medical emergency, please call 911 immediately. You can also call, text, or chat 988 or 1-800-273-TALK (8255) for immediate mental health support.