Frequently Asked Questions
What about Ketamine?
While many people in Georgia and neighboring states have benefitted from ketamine therapy traveling to places like Atlanta and Gainesville, Georgia for treatment, clients living in Athens, Georgia and nearby areas now enjoy the convenience of getting the treatments locally with Help Specialist, the ketamine experts. Many other potential new clients are curious about how ketamine infusion therapy works. These individuals are happy to learn that the procedure for ketamine infusions is pleasant and provided by a team that includes trained anesthesia providers. After all, ketamine is an anesthetic and who better to direct the infusion of an anesthetic agent.
At Help Specialist, our goal is to ensure your visits are as comfortable and pleasant as possible. Most of our clients find the procedure painless and they are usually surprised to realize that they may be experiencing positive benefits as soon as a few hours after the treatment.
What should I expect during my Ketamine Infusion?
The word infusion alone can create some questions. Some studies have demonstrated that the infusion method of delivery often provides benefits that may be optimal to injections that are more like "shots" as people may call them, meaning intramuscular or subcutaneous injections.
A ketamine infusion at Help Specialist will be typically administered over 40 minutes to treat mood disorders and can be longer for applications where augmentation of chronic pain therapy is the goal. The doses used for mood disorders are less than used in an anesthetic application so you won't lose consciousness during the ketamine treatment. While receiving the infusion, some clients have an altered perception of color and time. And most patients find the experience, scientifically referred to as a dissociative experience, to be pleasant.
Once the treatment is complete, the immediate drugs effects usually wear off over 15-30 minutes. Clients leave the clinic feeling like themselves except for a mild tiredness. There are no "flashbacks" or other delayed effects. However, the therapeutic action in the brain and the mood stabilizing benefit continues even after a client leaves the clinic. What's more, these benefits can even have a compounding effect, getting better and better after subsequent treatments with ketamine infusion therapy from Help Specialist.
Do I have to get an IV?
Ketamine can be taken orally, by injection through either subcutaneous or intramuscular routes, and by intravenous (IV) infusion. The oral, intramuscular, and subcutaneous routes have all been shown in various studies to be inferior to the intravenous administration of ketamine in that the onset of therapeutic benefits is protracted. Other advantages of intravenous administration include fewer needle punctures than the frequent dosing subcutaneous or intramuscular injections require, less potential of abuse than having a large supply of oral medication on hand, and the meticulous dosing, monitoring, and supervision that is provided when receiving IV ketamine in the safe, controlled setting of the Help Specialist clinic. In short, IV ketamine infusion therapy has been shown to deliver faster benefits, a more profound response from the very first treatment in those who experience a benefit, and a greater compounding of benefit from a series of infusions in a shorter period of time than other routes of administration. All these factors are especially important when one considers the life-saving potential of ketamine with regard to treatment of suicidal ideations and other thoughts of self-harm either acutely or as potential sequelae of treatment resistant depression and other mental health disorders.
Moreover, the substantial benefits to so many ketamine infusion therapy patients that have been widely documented have resulted in a new ketamine derivative called esketamine to be developed by Johnson & Johnson. It will be marketed under the brand name SPRAVATO™. Esketamine has been fast-tracked by the FDA to bring the amazing results so many ketamine infusion therapy patients have enjoyed to exponentially greater numbers of patietnts. Esketamine under the brand-name SPRAVATO™ will only be available for administration and use under the supervision of approved centers, like your friendly and experienced clinical team at Help Specialist in Athens, Georgia.
Will ketamine infusions help Treatment Resistent Depression?
While no outcome of ketamine therapy can be guaranteed, the experience of the team at Help Specialist is very positive and encouraging. There are many clinical trials and peer reviewed research studies that have demonstrated that ketamine infusions result in positive benefits for between 70-80% of those who have the therapy. Since we are not in clinical trials, we can tailor a treatment regimen that individualizes the dosage and frequency of infusions that may optimize the chances of success.
How many infusions will I need?
For clients who experience a benefit from initial ketamine treatments, our team will review all aspects of your comprehensive history, including your response to the initial therapy. We may recommend a series of infusion in close proximity to maximize ketamine's cumulative and brain repairing benefits. This could be 4 to 6 infusions over a period of several days or a few weeks. Each person has unique needs.
Most clients who undergo a series of infusions see more improvement a day or so after the subsequent infusions. Even though this may seem to peak after two or three infusions, it is very important to complete the entire prescribed regimen. Once the series of infusions is complete, together the client and our team collaborate to design a maintenance program that keeps the benefits at a level that is best. The duration between maintenance infusions or "boosters" can be a few weeks to as much as 3 months or more. The average period of relief between maintenance infusions is around 4-6 weeks.
Will my infusions be covered by insurance?
Typically, ketamine infusion therapy is not covered by insurance companies. Help Specialist does not file insurance claims. We take cash, debit, and most major credit cards. We have sources of third-party healthcare lender funding that you can apply for.
How soon can I be evaluated?
Usually, we can accomodate new clients within a matter of a few days and on occasion, the same day. Our goal is to have new clients begin treatment as soon as possible, when the therapy is appropriate.
Do I have to see a psychiatrist?
A referral from a psychiatrist or other specialist is not required for Ketamine Infusion Therapy. Our team will conduct a pre and post treatment depression assessment and counseling that our medical team reviews to establish the efficacy of ketamine treatments for you and they monitor your progress to best ensure a successful treatment plan is delivered.
What is Opioid or Opiate Medication-Assisted Treatment (MAT)?
When people refer to heroin and pain medications that include heroin-like active ingredients, like Morphine, Dilaudid, Fentanyl, Carfentanil, Sufentanil, Alfentanil, Remifentanil, Meperidine, Demerol, Hydromorphone, Oxycodone, Hydrocodone, Codeine, Methadone, and others, they are referring to compunds, some naturally occurring and others synthetic, that bind to opiate receptors in the central nervous system. Opioids bind to the same receptors as opiates. But there is a fundamental difference in the two terms. Opioid is a term that indicates the compound being referred to is synthetic, meaning a synthetic or man-made derivative of the chemical compound which naturally occurs, while the naturally occurring compounds that bind to opiate receptors are referred to with the term opiates.
Simply put, medication-assisted treatment, also known as MAT, is the use of medications with counseling and behavioral therapies to treat substance use disorders and to prevent overdose. Pharmacological agents used at Help Specialist for opioid use disorder (OUD) include buprenorphine, naltrexone, Suboxone®, and Zubsolv®. Together with your input and goals, the team at Help Specialist will make recommendations as to which regimen is the best option for you and your unique needs.
While MAT is primarily used for the treatment of opioid use disorders or OUD such as heroin and prescription pain relievers that contain opiates, the concept of medication-assisted treatments can be used to treat other substance use disorders (SUD) as well. An example of this would be the use of medications such as, naltrexone, Revia®, Vivitrol®, or acamprosate (Campral®), and others to help treat alcohol use disorder (AUD).
Therefore, medication-assisted treatment or MAT most often refers to the treatment of opioid or opiate use disorders. Opiate or opioid use disorder (OUD) refers to a chronic, life-long disorder, with serious potential consequences including relapses, also known as return to use, disability, and death. The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition describes opioid use disorder as a problematic pattern of opioid use leading to problems or distress, with at least two of the following occurring within a 12-month period:
- Taking larger amounts or taking drugs over a longer period of time than intended.
- Persistent desire or unsuccessful efforts to cut down or control use.
- Spending a great deal of time obtaining or using the opioid or recovering from its effects.
- Craving, or a strong desire or urge to use.
- Problems fulfilling obligations at work, school, or home.
- Continued use despite having recurring social or interpersonal problems.
- Giving up or reducing activities because of use.
- Using opioids in physically hazardous situations.
- Continued use despite ongoing physical or psychological problem likely to have been caused or worsened by opioids.
- Tolerance, i.e. a need for increased amounts or a diminished effect with continued use of the same amount.
- Experiencing withdrawal (opioid withdrawal syndrome) or taking opioids (or a closely related substance) to relieve or avoid withdrawal symptoms.
What about Methadone?
Methadone is the drug first used in MAT for opiate use disorder, and it comes with serious side effects. Because of those dangers, it has to be given one dose at a time under a doctor's supervision, which results in opiate use disorder clients having to go to a methadone clinic every single day to get the methadone. In addition, Methadone is a drug of abuse, because clients can actually get high from methadone, making the dangers of the drug even more profound. In short, daily methadone use keeps the cravings alive rather than treating them.
What about Buprenorphine?
Buprenorphine is far superior to methadone. Once the dose is titrated by our skilled clinicians, the client doesn't get high on it, and taken as directed, clients will not overdose on it. Because Buprenorphine is so safe, you can take home more doses than Methadone, giving our clients more time to enjoy their new lives, and not waiting in line at a Methadone clinic every day.
How does Buprenorphine work?
Buprenorphine the generic name for the drug found in preparations such as Suboxone, Bunavail, Zubsolv or Subutex, is in the opiate family, but it was engineered to do unique things to fight opiate use disorders. Those unique characteristics mean that clients on buprenorphine don't get high on it, and they do not get a tolerance either. Buprenorphine works by tricking the opiate receptors in the brain to think the opiates of abuse are in the client's system. Once at the optimum dosage of buprenorphine clients don't experience any withdrawal or cravings. It allows them to be themselves again, and return to a useful & happy existence.
Buprenorphine acts like a guard at the opiate receptor gates, protecting the brain against other opioids. In other words, if there is a therapeutic dose of buprenorphine in the client's system and if the client uses opiate pills or heroin, they don't get high. This aspect of the medication can stop the relapse cycle in its tracks. This also allows buprenorphine clients to get right back on the path of recovery again without a protracted relapse.
Our goal in buprenorphine therapy is to use the medication to abate the symptoms of opiate use disorder, thereby giving our clients the ability to make necessary life changes, getting back to the life they desire. Once stabilized, when the client becomes ready, we can very slowly taper the buprenorphine over weeks, even months, to a lower dose or off the drug completely. We always use a plan that is congruent with the goals and desires of the client.
Am I just replacing one addiction with another?
No. As mentioned earlier, you won't get high on buprenorphine even though it is technically in the opiate family. Think of it in this way – Buprenorphine, taken as directed can put the underlying opiate addiction in a remission of sorts, so you don't have to worry about it. When clients stop the buprenorphine abruptly without a slow taper, as the buprenorphine gradually leaves the opiate receptors, the underlying opiate use disorder becomes active again. Mild withdrawal symptoms are the first manifestation, not because they are addicted to buprenorphine, but because they still have the underlying opiate use disorder. By sticking to the prescribed regimen and working with our care team, clients when ready, are able to gradually taper down and eventually be off all opioids, including buprenorphine.