I would echo the above that ketamine has a role and purpose. It can work for many different conditions and its generally very safe.

But it's ketamine abuse season.

1. It starts with for-profit ketamine centers. Basically once you open this up to the public this way it will be abused. It's a profit-generating machine as with any cash-based medical service that is in demand, especially when it's hard to obtain via the traditional methods . It's similar to the 2000s oxycodone pain mills (Anyone remember Life Tree here in Utah?).

2. MDs aren't as likely to be tied up. Why? Because our medical license isn't worth jeopardizing. But an NP who has a lot less to lose and everything to gain will happily take that on. So when the govt pushes for full autonomy to practice medicine for any provider regardless of their qualifications then you'll have a lot more providers for businesses to exploit/use. I have a business contact who is subsidizing his brother's NP pathway because he can't find an MD to do what he's asking. But he realized he can get his brother a license in 2-3 years then will have free gain for his business ventures. Obviously these were docs in Perry's case, but the profileration of ketamine centers is >80-90% imo related to them being able to staff them with NPs. Again, not to say that medical abuse/fraud isn't physician driven, but ime, the vast majority are businesses that find a loophole and then do whatever they need to to get a medical license number.. and it's a lot easier and cheaper to find a license number from an NP.

3. When MDs are involved it's often through a concierge practice (like this scenario). When something is difficult to obtain in traditional manner the abuse often comes through concierge docs. I have a friend whose brother pays 1k/mo for a concierge physician. I looked up the physician and it was a quacky looking random doc from West Valley. Who in their right mind would pay that guy a 1k a month? Well, the guy who needs an oxycodone prescription every month. IT's also less risk for docs because where you trigger the alarms is in total number of scripts. So if you have a pain mill and write for 100 oxy scripts a day, you trigger flags. But if you find someone to give you 12k a year for 12 scripts you can fly under the radar.