Episode 41: What Does It All Ketamine? with Dr. Erica Zelfand

Ketamine is one of the most versatile drugs on Earth, an amazing anesthetic that can relieve pain without the same risk of respiratory failure as opioids (nothing against them, of course.) Overwhelming evidence also suggests ketamine can rapidly reverse suicidal thoughts, making it a potent treatment for PTSD and treatment-resistant depression. 

Last year, a specialized blend of ketamine called esketamine was approved by the FDA to treat depression, the first new major depression drug in more than 30 years, but its use has proven controversial. Meanwhile, dozens of clinics are popping up across North America, offering off-label use of ketamine to treat a wide range of issues. 

Yet, somehow ketamine is most often conflated with recreational use because it can give an ecstatic, lucid, out-of-body trip known as a dissociative hallucination. According to several surveys, including one published in the journal Consciousness and Cognition, ketamine has the highest semantic similarity to a near-death experience. What is it about this intriguing drug that makes it so popular, both clinically and elsewhere?

Our guest is Dr. Erica Zelfand, an integrative and functional medicine physician, who has written about how to get the most of ketamine therapy.

You can follow Dr. Erica Zelfand on Facebook and learn more at

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Shout-out to one of our longest Patreon supporters, Trystereo, a volunteer-run harm reduction collective in New Orleans that has been one of our earliest fans. They’re doing great work in Louisiana offering overdose prevention tools and free safer drug use and sex supplies. We rely on contributors like Trystereo to keep the lights on and free of corporate influence. Find out more at

Producers: Christopher Moraff, Troy Farah, Zachary Siegel
Co-producer: Garrett Farah
Music: Glass Boy / Pictures of the Floating World
Image: louise stockton / edit: Troy Farah
Two clarifications we want to make: In the intro, we say that “no other drug will make you feel like you died and left your body.” We mean *compared to ketamine.* So there’s no room for confusion, we obviously weren’t implying ketamine is the only drug that is like a near-death experience, ketamine is simply the closest, and this semantic similarity is based on a number of surveys, which are not necessarily fully reliable as they are self-reported.

Second, around the 44:00 mark, we used Compass Pathways as an example of a company that is doing psychedelic research, but didn’t mean to also imply that they are opening ketamine clinics. Many psychedelic research companies, including Mind Medicine Inc, Mindbloom, and Field Trip Health, are going this route, but so far Compass is focused solely on psilocybin. We care deeply about accuracy at Narcotica, so this is just for clarity’s sake.

Episode 33: Party and Play—An Intro to Chemsex with David Stuart

Aphrodisiacs are powerfully attractive for a reason. Sex is, after all, crucial to the survival of our species and it feels fucking amazing, so using chemicals that can make sex last longer, feel better or otherwise enhance the act is going to be like candy to a bunch of horny primates.

But the term chemsex—using drugs, or chemical enhancement, to prolong or alter sexual experiences—is actually specific to the gay community, or men who have sex with men. Drugs used have included methamphetamine, Viagra or sildenafil, cocaine, the anesthetic GHB, mephedrone (also known as ‘bath salts,’ although that’s a broad term), ketamine, and amyl nitrates or “poppers.”

Our guest today is David Stuart, who has spent decades as a fixture in London’s gay community. Stuart is an independent social worker and activist who actually coined the term ‘chemsex’ in the 1990’s. Stuart has witnessed the fundamental changes in the gay community as homosexuality has become more acceptable, but fleeting internet-based hook ups became increasingly ubiquitous, and in some cases fraught with potential medical and mental health risks.

You can follow David Stuart on Twitter and learn more about him at

Follow Narcotica on Facebook, Twitter and support us on Patreon. Your support is appreciated! We’re on Spotify, iTunes, YouTube, Stitcher and more. Tell your friends about us!
Producers: Christopher Moraff, Troy Farah, Zachary Siegel 
Co-Producer: Aaron Ferguson 
Music: Glass Boy / Monplaisir
Photo: Linnaea Mallette / Edit Troy Farah