Ketamine for Chronic Pain

A Safer Alternative to Opioids

One of the most interesting things about ketamine infusion therapy is that it is not only effective for the treatment of depression and other mental health conditions, but it is very effective at breaking the cycle of many forms of chronic pain. It does each of these through different mechanisms, but the net result is a very impressive synergy because, for most patients who endure chronic pain, there is frequently coexistent depression and/or PTSD. Since its inception in 2015, Klarisana has been one of the most progressive centers in the US at using ketamine to derail chronic pain and help patients decrease or eliminate the use of dangerous opioid pain medications.

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Which Pain Conditions Can Ketamine Treat?

  • Migraines
  • Neuropathy
  • Cancer pain
  • Fibromyalgia
  • Rheumatoid arthritis
  • Intractable back pain
  • Complex regional pain syndrome
  • Trigeminal neuralgia
  • Lupus
  • Chronic Lyme disease
  • Gastroparesis
  • Cyclic vomiting
  • Phantom limb pain
  • Chronic pancreatitis

Ketamine and the Opioid Crisis

Opioids require increasing doses to achieve the same effect over time. Patients become tolerant to them and they start taking higher and higher doses. At the same time, the dark side of opioids can creep in…Central Sensitization. Central Sensitization is a fairly complex process but basically it is when the opioids themselves start to sensitize one’s pain receptors and they actually start causing pain. There is a very counterproductive feedback loop set up in the back part of the spinal cord (dorsal horn) where a process called “wind up” sets in. The net effect is that pain begets more pain. Imagine a microphone placed in front of a speaker and it causes a squealing feedback sound. Many chronic pain patients are living this feedback loop.

Targeted Receptor Therapy

At Klarisana we use ketamine and other complementary medications to target several different pain receptors at the same time and achieve a synergistic effect to derail chronic pain. At the heart of many forms of chronic pain is the destructive feedback loop of Central Sensitization. This feedback loop however is mediated by the NMDA receptor which is what ketamine blocks. When we add medications like lidocaine and magnesium in appropriate patients, we can then attack the pain from several different angles. Given that chronic pain is very heterogeneous it can be challenging to predict exactly who will respond but published reports and our own clinical experience shows that over 70% of patients have meaningful relief and can significantly decrease their use of opioid medications.

Ketamine Redefines Pain Management

Thousands of Americans die every year through the accidental overdose of opioid pain medications. Patients with severe chronic pain do not set out to become a statistic. The problem is that the traditional model of narcotic pain medications leads them down a dark and predictable pathway. Opioids suppress the ability of a person to breath which is a very dangerous quality. At the same time many of these patients are prescribed benzodiazepines such as Xanax or Valium. These “benzos” also suppress respirations and they also have a powerful amnestic effect. If a patient takes opioids and takes some Valium and maybe has an alcoholic drink or two it is not hard for them to lose track and take another dose and become more forgetful…and before long you have the ideal situation for an accidental overdose. At Klarisana we feel if clinicians would embrace the concept of breaking the cycle of chronic pain with ketamine (which incidentally does NOT suppress respirations) then the whole paradigm of pain management would change, and thousands of lives would be saved every year.

Never underestimate the pain of a person, because in all honesty, everyone is struggling. Some people are just better at hiding it than others.”

Will Smith

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