Options for Ketamine Treatment in the Triangle Pro’s & Con’s
By Susan Clifton, LCSW-S/August 16, 2025
Ketamine treatment is fairly new for behavioral health treatment and currently operates like the “wild west” with few rules, regulations or guidelines in place which may place some patients/clients at risk. Understanding your options and being informed will help with solid decision making. All options are NOT created equal, and with many things in life “you get what you pay for” so decisions based only on the bottom line can come with disappointment.
Ketamine Services Available in the Triangle
| Service | Description | Pro’s | Con’s |
| Psychedelic Integration Group with MH Therapist | Open groups for all psychedelics, private use and prescribed, to gain the benefit of integration and knowledgeable support. | Locally we have licensed and highly experienced therapist providing meaningful guidance. Low cost and a great addition to augment online only support. | No one is present with you when you are administering your psychedelics. Includes other medicines besides ketamine (currently illegal) and may not feel as focused. |
| Online At-home Lozenges | Brief evaluation by possibly a MH provider with medicine and instructions mailed for solo home use. | Less expensive with a DIY model. Helpful to save money for those with no addiction risk and experienced with their ketamine needs/treatment. | Questionable corporate-market approach (incentives in place to use more & more), high risk for diversion, questionable safety, weak/self-serve supports, poor oversight & lack of medical professional contact other than required by FDA evals. |
| Online Lozenges Used at Therapist’s Office | No collaboration b/t prescriber and therapist. Client obtains their own medications and takes them in front of the therapist for support/therapy. Therapist augments the online provider with direct Preparation & Integration services. | Rounds out therapeutic side of KAP with preparation, integration, more fully utilizing the journey material. Clients feel more secure and with a better “set & setting” when taking their ketamine at the therapist’s office. Therapist usually provides additional perks like playlist, earphones, supplies. | No collaboration between the parties related to dosing, concerns. No medical supports with therapist-only, questionable practice and some therapists are in hot water with their Boards for “practicing medicine.” Adds therapist costs to online medicine costs. |
| IV Ketamine Clinics with Non-MH Providers | These are the largest in-person providers in the area, many are corporate and with competition the prices have dropped from $800/$900 to $500. No MH qualifications. | Medical safety is covered by medically competent professionals often very experienced with the medicine itself as anesthesiologist or ER staff. | CONTINUED ON NEXT PAGE Many have an “hourly rate” and conveyer belt feel. Impersonal, reports of poor responsiveness and inadequate oversight/safety concerns. No preparation or ability to handle anything emotional that emerges. Too many report traumatic experiences at these clinics because they were not supported. |
| IV Ketamine Clinics with MH Providers | More MH prescribers are now adding ketamine treatment to their services in their offices. | Prescriber is trained in mental health and understands what they are treating and can fully support any medical/emotional reactions post medication. Same price (or less) as non-MH IV clinics. Better preparation but no Integration. | May delegate out some care or be less available during the ~2 hours. Patients are alone during the majority of the medication treatment. Client responsible for own playlist, earphones, other supplies and own support during med session. |
| Ketamine with KAP Prescriber and KAP Therapists Onsite | Ketamine treatment is fully supported from beginning to end with both medical and psychotherapy integrated team. Usually have a choice of IV, lozenges, IM injections. Increased ability to be tailored (e.g. psycholytic EMDR, group treatment, etc.). | Most fully supported, turnkey approach, great for more nervous or medically impacted clients/patients or those who need attention to a custom plan. High level of collaboration between you, prescriber and therapist. Larger perspective = better decision making. Potential for reduced costs with group options. | The services of both a MH prescriber and a KAP therapist is usually (but not always) the costliest option when seeking solo treatment. |
Quality Provider Checklist
- Do they schedule at least a 45-minute medical/behavioral evaluation session with you prior to treatment?
- Do they have expertise and ability to assess your condition and evaluate progress (e.g. Mental Health for depression, Pain Management for chronic pain)?
- Are they willing to use insurance for the medication evaluation and other insurance billable items? Or are they willing to provide a Super Bill for the same if they do not accept your insurance?
- Do you have the ability to choose the number of Medication sessions or are you required to pay for a bundle upfront? If a bundle must be purchased and ketamine does not work for you, or you otherwise do not need all the sessions, are you reimbursed for the unused portion?
- Are they willing to collaborate on dosage with you or do they make decisions for you without your input?
- If you have medical conditions, especially heart related, do they request to speak to your other physician?
- Do they offer to provide nausea or blood pressure medication as part of their treatment?
- Is their messaging “you can stay until you are ready to leave” versus they have an hourly mindset or otherwise communicate a time limit.
- Is their protocol to check-in with you the day after your medication treatment?
- Do they provide options to contact them in the days after your treatment if you need them?
- Is there clinic/office quiet, comfortable and well-equipped to provide a good setting?
- Does the provider seem to have ample time to address questions, prepare you, perhaps providing helpful written material?
- Does their website list their full name and credentials with accurate information about ketamine success rates (currently up to ~70% in research)?
- Does their website list their full name and credentials with accurate information about ketamine success rates (currently up to ~70% in research)?
Disclaimer: This post contains information from research, expert consensus and personal observation/opinions. It is not a substitute for individualized, professional consultation. To learn more about our services reach out to Living Arts via our Contact Page.