Ketamine, discovered in 1956 and approved in 1970, is a dissociative anesthetic with psychedelic traits. It first became famous in battlefield settings like Vietnam for its ability to maintain stable blood flow, gaining a reputation as a safer anesthetic than opioids and being listed on the World Health Organization’s List of Essential Medicines. Besides being an alternative to opiates, recent studies highlight its potential for treating depression, PTSD, and other mental health conditions, making it the only legal psychedelic medicine at the federal level.

While it can certainly help transform someone’s life, the drama boils down to whether it’s a good idea to promote it as a medicine that could provide a magical entry into another dimension. Is that just a nice way to describe a medically induced k-hole, or is it irresponsible for IG to allow it to be posted? Fast forward to August of 2023, and Meta’s Oversight Board didn’t just overturn Meta’s decision to keep the post alive, but also used it as a jumping off point for more sweeping recommendations.

The board expressed concerns over what they termed “inconsistently enforced” guidelines about the selling or promoting of substances that sit in the gray areas of legal medicine and recreational fun, such as ketamine, which doctors prescribe off-label for depression and other mental health conditions.   However, despite members of the psychedelics community believing that Meta is far too strict, censoring content, they responded to the board’s recommendation with resistance. While they agreed to the board’s suggestions regarding clarifying “paid partnerships,” they chose to ignore the stricter guidance on users posting about ketamine and other psychedelic medicines.

Regarding the audit that the board’s been championing, Meta used the tried-and-tried technique of procrastination. They responded that they would “assess the feasibility” in 2024, responding that their current “machine-learning automation” already does a good job at flagging potentially dangerous content in violation with their boundaries. Meta’s surprising but welcome (for the psychedelics community) decision came after input from about 15 different parties, including Mindbloom, the telehealth company that prescribes ketamine at-home.

Mindbloom has been lobbying for Meta to chill and allow posts containing psychedelic content. But the board isn’t happy. “The board is concerned about inconsistent enforcement of Meta’s policies with regards to pharmaceutical and non-medical drugs,” Dan Chaison, an Oversight Board spokesperson, said in an email, writes Bloomberg. “It stands by its recommendation that Meta should clarify the policy language around content that admits to using or promoting pharmaceutical drugs. The board will closely monitor Meta’s progress toward the recommendations from this case.

” The standing policy permits content that “admits to using or promotes the use of pharmaceutical drugs,” even if it might induce a “high,” provided it’s framed within a “supervised medical setting.” The board emphasized the need for Meta to be clearer about what this setting entails. In the past, the Oversight Board, funded by Meta, has tackled topics such as COVID-19 misinformation. But Meta isn’t bound to follow its recommendations, and perhaps felt that sharing information, even magical, about ketamine, is different than allowing people to promote faux remedies for a potentially fatal illness such as COVID-19.

Companies such as Mindbloom would have lost out on opportunities to promote their mail-order ketamine services. Michael Petegorsky, Mindbloom’s General Counsel, expressed, “This decision is a big win for people who use ketamine therapy and other psychedelic medicines.” He believes it paves the way for individuals to “speak freely about these emerging mental-health treatments using their own words, and without revealing private health information. However, playing devil’s advocate, as the research behind ketamine’s use for depression is still rolling in, there are those who would make the case that posts calling ketamine magical for depression, which is also a deadly disease, is also irresponsible.

Ketamine’s side effects vary based on factors like dosage and how it’s taken. Generally speaking, users might experience feelings of being out of their body, dizziness, altered perceptions, and euphoria (which is usually welcome). Nausea and vomiting are among the most reported negative side effects. While overdosing on ketamine is rare, people must be careful to avoid activities like driving post-intake. Notable, excessive consumption can lead to bladder, urinary, and kidney issues. Responsible providers will share all of this information with patients before they begin treatment, but as it exists in a legal gray area, and considering that not all medical providers have their patient’s best interest at heart, deciding how and where ketamine should be promoted as a treatment for depression and other mental health conditions is sure to be a continued hot topic not just for Meta, but for the psychedelic community.

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