Ketamine infusions cost hundreds per session but offer relief for some chronic pain patients
While off-label ketamine therapy is gaining traction, insurance gaps and high costs keep it out of reach for many, prompting doctors to push FDA-approved alternatives.
By Mariana Flores ·
Chronic pain affects millions of Americans, yet many suffer in silence because traditional treatments fail to provide lasting relief.
Medical professionals are increasingly turning to ketamine infusion therapy for patients who have not found success with standard pain management. The treatment works by slowing down the nerves that transmit pain signals to the brain, offering a different mechanism than opioids or other common medications.
Elanor Koch, a resident of Nebraska, began the therapy in 2023 after years of struggling with severe pain. In 2020, doctors discovered a tumor on her cervical spine that had compressed her spinal cord by more than 60 percent. Following neck fusion surgery, Koch had to relearn how to walk and use her left arm, but the pain remained debilitating.
"Opioid pain therapy did not feel like a good long-term solution, and other alternative pain-management areas were not working," Koch said. She found ketamine infusion therapy at the Mind and Body Wellness Center, where she underwent hour-long sessions that caused a state of dissociation. During these sessions, patients describe feeling detached from their physical bodies.
After six treatments in one month, Koch reported that she was pain-free for three months. While she still experiences minor flares, they are less frequent and shorter in duration. She now requires maintenance infusions every few months to manage her condition.
The cost of the treatment remains a major barrier for many patients. Infusions range from $400 to $500 per session and are typically not covered by insurance because the therapy is used off-label. Dr. Stephen Salzbrenner of Nebraska Medicine noted that while the scientific community widely accepts its effectiveness, the lack of FDA approval for depression limits insurance coverage.
Salzbrenner also prescribes esketamine, an FDA-approved nasal spray that is chemically related to ketamine. This alternative is covered by insurance for depression and can show results within hours, a stark contrast to traditional antidepressants that often require six to eight weeks to take effect. He emphasizes that talk therapy remains indispensable alongside medication, a view shared by Koch, who no longer takes antidepressant pills.
However, ketamine infusion is not suitable for every patient. Those with certain medical histories, such as schizophrenia, uncontrolled high blood pressure, heart disease, or kidney and liver disease, may not be good candidates. Substance use disorders are also a factor in determining eligibility for the therapy.
