Destigmatizing Ketamine – an Interview with Tharcila Chaves

Isolde de Jong started her internship with APRA in November 2018, ever since she is reporting activities within the organization. As a student of applied psychology with a main interest in psychedelic research, she developed a strong curiosity in the biological mechanisms of certain entheogenic plants and other substances. With this internship she hopes to achieve a better understanding of psychedelic research and to help destigmatize the subject.

 


Destigmatizing Ketamine – an Interview with Tharcila Chaves

by Isolde de Jong
Edited by Jennifer Them

 

When APRA organized one of its monthly Journal Clubs on the subject of ketamine I was a bit taken aback, mainly due to stories of ketamine use and abuse in the party scene of Amsterdam. But can Ketamine also be used in a therapeutic way? I was puzzled and a bit skeptical before meeting Tharcila Chaves, an expert on the pharmacology of ketamine and the presenter of this Journal Club. I did a little bit of research on the topic myself, and reconstructed below a short timeline of what I roughly found:

1950s – History of ketamine began at Parke-Davis, the United State’s oldest drug company headquartered in Detroit, Michigan, were pharmacists searched for an ‘ideal’ anaesthetic agent with analgesic properties.

1963 – Ketamine was patented as a veterinary anaesthetic in Belgium.

1964 – The first human administration was conducted to volunteer prisoners in the state of Michigan, doctors reported patients described feeling of floating and having no feeling of limbs.

1966 – Ketamine was patented for human use as well, and became available by prescription under the name Ketalar.

1970 – The US Food and Drug Administration recognized as safe for human consumptions and because of its sympathomimetic properties, it became widely used as a battlefield anaesthetic to soldiers during the Vietnam war.

For further reading see:

History of Ketamine by Georges Mion

History of recreational use and abuse of Ketamine by Karl Jansen

Over time ketamine has been shown to have a wide range of promising effects for anesthesia, pain management and depression. However, ketamine still carries stigma, partly because of the recreational use and abuse of the substance, and it’s common practice as veterinary anesthesia. Being curious to look beyond the information found online, I was very much looking forward to Tharcila’s presentation, and interviewing her for the APRA blog.

Tharcila Chaves is a pharmacist, currently doing her PhD at the University of Groningen studying the use of ketamine in treating depression and chronic pain. She has a master’s degree in medicine and sociology of drug abuse. In her master thesis she researched cravings of crack cocaine users in a qualitative study in the city of Sao Paulo. The study became shrouded in controversy because it’s very difficult to talk about drug use in Brazil as Tharcila states when she explained how media in brazil was demonizing the use of drugs. This taboo motivated Tharcila even more to do her research with the aim of creating a more open discourse on that matter. When she studied the behavioral patterns of crack cocaine addicts and worked with the people who had such a difficult time, she started thinking about psychedelic treatments as new forms of therapy for those in despair. After finishing her research in Sao Paulo, she got an opportunity to come to the Netherlands and study more about the use of ketamine in treating depression and chronic pain.

The conversation with Tharcila went more in depth as we talked about the use of Ketamine in a therapeutic way as it is still in its infant stages. She followed by saying that when you look at psilocybin therapy there is a lot of integration work being done before and after the sessions which doesn’t really exist in ketamine therapy yet, something Tharchila would like to add if she ever would do therapeutic work with ketamine herself. For example, not too long ago a theory was formed that PTSD is linked to inflammation in the brain and that ketamine could be used as an anti-inflammatory, but one would need to have a good psychologist or other integration worker to really help release trauma. She also added that she thinks that Ketamine and other psychedelics can be used as a “therapeutic shortcut”, but integration work is essential.

I felt Tharcila’s enthusiasm reverberating through the room when she spoke of her studies. Slowly my ideas about ketamine and the possible uses as a therapeutic drug started to change in a more positive direction. I felt the urge to ask whether it was frustrating for her to fight for the recognition of the therapeutic benefits of a substance carrying such a bad reputation. Tharcila smiled for a moment and started to nod her head. “Yes, there is a frustration part, but it was way worse six years ago when I started”, Tharcila explained that she had to take out a sentence in her thesis describing a softer approach towards crack cocaine addicts and the struggles those people had because of the heavy stigma. In Brazil she explained, it is still a common practice to get the addicts from the streets and put them in hospitals. But a lot of addicts will end up at the streets again after they are released from the hospital and therefore many will fall into the same patterns as before and start using again. But the understanding is slowly growing that this way of treating addicts is not working. Therefore, Tharcila sees a colorful future in psychedelic treatment ahead of her as she is confident and enthusiastic about doing more research.

To summarize what I have learned from Tharcila’s lecture and by picking her brain, is that Ketamine has been showing positive results in treating cases of depression and chronic pain that are unresponsive to the available therapies. It is considered perhaps the biggest breakthrough in the treatment of depression in over 50 years. For decades ketamine has been used as an anesthetic in humans (including children) which has demonstrated that it is a safe drug with manageable side effects. The use of ketamine as an antidepressant and analgesic is still not officially approved, but its popularity for treating these conditions is increasing by using it off-label (i.e. legal use of a drug for different purposes than it is authorized). Although the prospects of the drug seems to be positive, there should be a clear understanding that the drug isn’t without any risks. Also, we still have a long way to go to fully understand the mediation of its therapeutic effects.

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