‘Soft psychedelic’ ketamine use is on the rise in Santa Cruz, taking on trauma, death and ‘becoming a better me’
Quick Take
Among a buffet table of other psychedelic drugs, “psychedelic-adjacent” ketamine is gaining popularity as a treatment option for a number of crippling conditions, as well as a means to face the end of life, and even as a method of self-improvement. Legal and legitimate ketamine use is on the rise in Santa Cruz County, where a number of doctors, psychotherapists and other professionals are offering ketamine-based services, and where an emerging support network for those interested in psychedelics is based.
For decades, Ursula Holt had been living with the profound aftereffects of being molested by her father as a child. She suffered what she described as a “low-grade infection in my soul.”
Generally, she felt, she had had a good life, “but I was just really unhappy and very sad.” As she moved into her 70s, it was time to do something about it, Holt decided.
That decision came after she encountered Michael Pollan’s “How to Change Your Mind,” a book about, according to its subtitle, “the new science of psychedelics” and how it offered solutions to people suffering from depression, addiction, post-traumatic stress disorder and other “infections of the soul.”
Holt, now 75, had grown up a child of the 1960s and, like many in her generation, had had an encounter or two with LSD in her youth. But she had put that behind her: “I didn’t have any negative feelings toward it. It just wasn’t for me.” (Holt is a pseudonym. Lookout granted the Santa Cruz resident anonymity to openly discuss her past and treatment.)
She had also experienced classical talk therapy, but she felt that had gotten her nowhere. “I need something very deep,” she said. “And I didn’t want to have to spend years fixing myself, although I had already spent years trying to fix myself.” But when she picked up the Pollan book, “it just clicked.”
Still, she didn’t know exactly what to do or where to go with this new insight that perhaps psychedelics might work for her. Eventually, it was her daughter, who had wrestled for years with depression and had found relief in treatment in Colorado, who suggested an on-ramp to psychedelics with one word:
Ketamine.
Among a buffet table of other psychedelic drugs, ketamine is gaining popularity as a treatment option for a number of crippling conditions, as well as a means to face the end of life, and even as a method of self-improvement. Legal and legitimate ketamine use is on the rise in Santa Cruz County, where a number of doctors, psychotherapists and other professionals are offering ketamine-based services, and where an emerging support network for those interested in psychedelics is based.
I think it just really went to the depths of my mind and, somehow or other, it reconnected me to my — I hate to use this world, but — essence. And it taught me that that part of me is fine and doing OK.
— Ursula Holt on ketamine
Whether ketamine is a psychedelic drug or not is still a matter of debate, though it might be best to think of it as psychedelic-adjacent. It has many of the same beneficial and potentially dangerous effects as the “classical” psychedelics — LSD, psilocybin, MDMA — but there are key differences.
Originally formulated and widely used as an anesthetic, ketamine can and does induce many of the dissociative qualities of other psychedelic drugs. But while a “trip” using some other psychedelics could last for many hours, ketamine’s effects usually come and go within an hour. Because it has been used safely and effectively as an anesthetic for decades, it is also not caught in the limbo of illegality like other similar drugs. (In 2020, Santa Cruz City Council voted to decriminalize psychedelics and the state of California is now in the midst of a similar move, but, importantly, since ketamine is legal, it’s not part of either measure.)
Yes, it is technically illegal to use ketamine outside the supervision of a doctor or medical professional, but that’s the case with many prescription drugs. The U.S. Food and Drug Administration has even approved a nasal-spray form of ketamine known as Spravato for use in treating depression.
“It’s a really soft psychedelic,” said Lisa Black, a licensed clinical psychologist who uses ketamine in her Santa Cruz practice. “Usually, it’s not going to tank you or rock your world unless you’ve been given too much or your setting is really bad. Whereas something like ayahuasca can be really harsh, ketamine is really safe. It’s a gentle journey. In under an hour, you’re back to being yourself. You’re not lost for days. So, the risk of the stuff is very low.”
As a clinician, Black is convinced that ketamine, as well as other hallucinogenic psychedelics, holds great promise in liberating patients from the often life-destroying cycles of addiction, depression, anxiety and trauma. Her training focused on more traditional modalities of psychology. “None of this was even mentioned,” she said of the potential of psychedelics. “Not even a whisper.”
It wasn’t until 2019, when the FDA approved Spravato, that Black changed gears and began pursuing in earnest specialty training to work with ketamine. She lived and worked in San Diego at the time, and part of her new approach entailed moving from San Diego to Santa Cruz, where there were more physicians who were willing to partner with her in prescribing ketamine for depression.
In the ongoing renaissance of the therapeutic use of psychedelics, Santa Cruz has continued to play a prominent role. It was, for instance, the home of the Multidisciplinary Association for Psychedelic Studies (MAPS), a nonprofit that has done pioneering work in getting the government to sponsor clinical trials in the use of MDMA (also known as ecstasy or molly) as a treatment for addiction and trauma. The efforts of MAPS were instrumental in pulling psychedelics out of the shadows of taboo, where they had existed since Richard Nixon’s war on drugs began, and into legitimate above-ground research. (After many years in Santa Cruz, MAPS relocated its main office to San Jose in 2021.)
Black works with a number of local doctors to administer sessions that include intramuscular (IM) injections of ketamine, management of the ketamine experiences, and post-experience follow-up therapy. “Many people were much more open to it here even than in San Diego,” said Black, “which is a bit of a surprise since San Diego is so much bigger. But I couldn’t really find anyone there willing to do IM ketamine.” Black said that the rules regarding FDA-approved Spravato simply don’t have the flexibility around dosage and use needed to tailor treatment to individual patients.
But does it work?
Like many patients, Ursula Holt began with tiny doses of ketamine. Only after that period of priming did she take on a “journey” involving a higher dose of IM ketamine, in a comfortable setting with a blindfold and earphones.
“It was a profound experience, number one,” she said of her initial Ketamine journey a year ago (when I spoke to her, she was a few days away from her second experience). “I think it just really went to the depths of my mind and, somehow or other, it reconnected me to my — I hate to use this word, but — essence. And it taught me that that part of me is fine and doing OK.”
She had known, at least on an intellectual level, that her past sexual trauma and her depression were linked in some way. But “I was very surprised that all of that pain was still there and I hadn’t healed. This, though, has healed me. It’s still work. It can still be very painful doing the therapy because you’re opening yourself up to things you’d rather not deal with. But when you have the epiphany or the realization that you need, that’s a spiritual experience when you have that moment. And it’s a release.”
Rabbi Paula Marcus of Temple Beth El in Aptos has not used ketamine herself. But she witnessed her late husband’s use of it during the final weeks of his life. He had been to retreats with the famous psychedelic spiritual leader Ram Dass for many years, so he was aware that psychedelics often brought insights and a sense of comfort for those at the end of life. He had also had a near-death experience years before he was diagnosed with cancer. But he was debating whether to take psilocybin (magic mushrooms) or ketamine as a way to ease his experience of dying.
“I think he just really wanted to come to a place of resolution,” said Marcus of her husband’s final days. “He knew he was going to die from this cancer for quite some time. And he thought the ketamine would take him out of his intellectual self. As Jews, along with many others, we can be big thinkers. And I think for him it was important to kind of remove that, and it not have to be such a factor, and have it be more of a spiritual journey. And he could do that with ketamine.”
But, said Lisa Black, you don’t have to be ill or dying to get value from ketamine treatment. “It saddens me that people think that they need to be sick to do this kind of work,” she said. “Some of my favorite patients are like, ‘I just want to kind of look inside, and, you know, be a better me.’ And I think that’s a beautiful thing when people do that. [You can ask yourself] what are my values? And what makes my life better and how can I improve while thriving? You don’t have to be sick to do that.”
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