Clinics have shut down and patients have been cut loose in what could be a massive backward step in the campaign to make ketamine a registered treatment for mental illness in Australia.The clinics in question were a chain run by Aura Medical Corporation, where patients suffering from depression, bipolar disorder, and PTSD were receiving injections of the controversial drug.In Australia, the restrictions around treating mental illness with ketamine are not cut and dry. The drug's indicated use is anesthesia, but doctors are able to obtain it under its Schedule 8 prescription status for use in "off-label" treatment, which is not governed by the Therapeutic Goods Administration. It's therefore legal to use it outside its intended purpose.
Aura claims patients responded well to the treatment, which is consistent with a raft of local and international research. The chain believes the closures had more to do with negative publicity surrounding their programs and links to the Advanced Medical Institute, a splashy erectile disfunction clinic which used to advertise with billboard slogans such as "BONK LONGER."Speaking to VICE, the Australian Health Practitioners Regulation Agency (AHPRA) stated the clinics were closed because of a lack of psychiatric support and the supply of contentious self-injecting packs, whereby patients were given ketamine and needles to administer themselves at home.Aura Medical Director Professor Graham Barrett resigned as part of the investigation, but defended the clinics. Speaking to Channel Ten he said, "Aura's not doing anything bad, there's nothing inherently bad about making money out of helping people."Professor Colleen Loo, a clinical psychiatrist from the University of NSW and the Black Dog Institute is one of the world's leading ketamine researchers. Over the past few years, she has run ketamine trials for depression at the Wesley Hospital in Sydney. Speaking with VICE, Professor Loo stated, "Ketamine has amazing potential and we have seen incredible promise. It's unlike any other treatment."That's not to say Loo supports Aura Medical's reportedly lax supervision standards. "There needs to be ongoing monitoring. Everybody's depression is different and it's about carefully conducting the treatment in a controlled environment, rather than letting patients take the dosages home and administer it themselves," she said.
In the wake of the Aura closures however, Loo is concerned about ketamine's future status in Australia. "The worst-case scenario would be if further restrictions were now put into place," she said. "Hearing stories like these leads to public concern, especially when a drug is being used outside the approved indication, we need to be extra careful."Her fears aren't unfounded. In 2014, the UK government decided to ban all ketamine-related drugs and put ketamine itself under harsh restrictions, in a bid to crack down on recreational use.Professor Loo says the UK was a leading player in ketamine research before it became a class B banned drug. "If that was to happen here, all our work would be over."Further revelations about Aura Medical won't help. Alarmed former staff and patients have spoken about how freely available the drug was prescribed, and the small number of consultations needed before being issued a take-home pack."They started prescribing and dispensing on the same day when the managers pushed for more patients to be seen," one former staffer told ABC.Former patient Janette Jenkins was told Aura was running a "medical trial" after visiting a Sydney clinic: "I started to question things, even the first time I saw them and how short my appointment was, they didn't require anything from me."But not all patients were as concerned. Former patient Peter Riley was disappointed when he found out Aura Medical would no longer be able to provide ketamine. After struggling with depression for a number of years, he told the ABC, "Ketamine has changed my life out of all sight, I've tried to commit suicide three times, I've been on eight different types of antidepressant."Aura Medical Corporation was contacted by VICE but chose not to comment.Follow Dan on Twitter.