Ketamine’s Journey: From Queer Club Floors to Clinical Therapy

In the late 1990s, ketamine spread in gay clubs. Gregory, a Black gay man from Virginia, first tried it at an after-party at age 18, saying it made music and laser lights feel more vivid. Therapist Michael Mancilla noted the search for relief from emotional pain drove its use.

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Ketamine blocks NMDA-glutamate receptors, prompting a surge of neurotrophic protein that promotes growth. Dr. Jeffrey Leary of MindPeace Clinic describes this as “a hiking trail” that creates pathways around circuits. A 2022 Virginia study of 424 patients reported 50 % improvement within six weeks, 72 % response after ten infusions, and 85 % resolution of suicidal thoughts after fifteen infusions. 2025 Canadian trial found booster infusions sustained antidepressant effects for months, lowering suicidality.

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Short-term effects include dissociation, dizziness, nausea, and blood-pressure spikes; long-term use can lead to dependence, cognitive changes, and bladder damage. Insurance coverage for IV ketamine is sparse, creating a “patchwork” described by therapist Andrea Kirincic in Montreal. Critics argue that out-of-pocket costs and regulation exacerbate inequities.

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Clinicians cite ketamine’s rapid onset, short duration, and lack of respiratory depression as safety benefits. The FDA approved Spravato, confirming its medical status. Shelby Hartman, co-founder of Double Blind, notes that the LGBTQIA+ community showed how “being on the dance floor… with the support of a substance… can be a deeply therapeutic experience.” In February 2024, the Virginia Board of Medicine temporarily suspended Dr. Patrick Oliver’s license after an investigation into an intimate patient relationship, underscoring ethical oversight.

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Short-term effects include dissociation, dizziness, nausea, and blood-pressure spikes; long-term use can lead to dependence, cognitive changes, and bladder damage. Insurance coverage for IV ketamine is sparse, creating a “patchwork” described by therapist Andrea Kirincic in Montreal. Critics argue that out-of-pocket costs and regulation exacerbate inequities.

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Efficacy data stem primarily from a single Virginia clinic, limiting broader generalizability. The sources do not report safety outcomes beyond several months.

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• “I realized whatever it is, we did the same thing, but it affects me differently,” — Gregory, 45

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• “Think of it like a hiking trail,” — Dr. Jeffrey Leary, MindPeace Clinic

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• “ Most patients report the same thing first: the mental noise quiets.” — Alexis Nock, registered nurse, MindPeace

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• “is that being on the dance floor, being in community, with the support of a substance that can help you feel connected to other people and your body, can be a deeply therapeutic experience.” — Shelby Hartman, cofounder, Double Blind

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Researchers are evaluating booster-infusion protocols to extend benefits, while advocates push for broader insurance coverage and clearer ethical standards as ketamine clinics proliferate.

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