Not every client who is suffering is a good candidate for KAP. Discernment matters. Timing matters. Safety matters. Some rule-outs are medical and non-negotiable. Intranasal esketamine, for example, is contraindicated for people with: Certain vascular conditions A history of intracerebral hemorrhage Hypersensitivity to ketamine Ketamine can also cause transient increases in blood pressure, which means cardiovascular risk must be taken seriously and screened medically. Other c

What matters is what happens before and after, in relationship, in community, in real life. It feels bizarre to see ketamine splashed across newspapers as a problem while I’m watching it change people’s lives here in my office. I never want to minimize the real dangers. And it’s still frustrating to hear it spoken like a four letter word or a cheap shot to make us feel more powerful against abusive leaders or out of touch elites. In fact, it hurts. It’s as if using a story ab

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