When delivered in a safe, guided setting, ketamine assisted therapy can be profoundly healing — offering relief for people living with depression and other mental health challenges. As research has expanded and regulations have evolved, access to ketamine therapy in Canada has become increasingly available across the country and beyond. Health Canada’s approval of esketamine (Spravato) in 2020 for treatment-resistant depression further reflects this growing recognition of ketamine’s therapeutic potential (Frontiers in Psychiatry, 2023).
However, this wider availability comes with a double-edged reality. Greater visibility can sometimes blur the line between clinically supervised ketamine-assisted treatment and unsupervised or recreational use. Some individuals may assume that ketamine is inherently safe or attempt to use it as a do-it-yourself mental health remedy, unaware of the medical oversight and psychological support required for safe and effective outcomes. Unfortunately, ketamine use outside of the therapeutic setting is on the rise.
Why Intention, Setting, and Support Matter in Ketamine Assisted Therapy
Ketamine’s potential for transformation is real — but so is the need for structure, preparation, and professional guidance to ensure that its use remains therapeutic rather than harmful. In the field of psychedelic-assisted therapy, the principles of set, setting, and support are foundational:
- Set refers to mindset—the intention and emotional state someone brings into the experience.
- Setting describes the physical and social environment in which the session takes place.
- Support means the presence of trained professionals who guide, monitor, and help integrate what arises.
When ketamine is used with the intention of escape rather than healing, or in environments that are unpredictable, unsafe, or unstructured, the experience can easily become destabilizing. The risks are amplified if the substance is adulterated, the dose is too high, or psychological safety breaks down. In such circumstances, the absence of skilled support can turn what might have been a moment of relief into a moment of crisis.
It’s important to remember that ketamine outside of a clinical context is an experience, not a therapy. A negative or confusing experience can leave someone feeling more disoriented or distressed than before.
What Are the Risks of Recreational Ketamine Use?
Recreational or repeated use of ketamine carries its own set of medical and psychological dangers. People who use ketamine regularly can develop tolerance, requiring higher doses to reach the same state. This can lead to physical dependence and a cycle of overuse.
Frequent use can also cause inflammation of the bladder, a painful condition known as ketamine-induced cystitis. In about one-quarter of regular users, this can progress to hemorrhagic cystitis, where bleeding occurs and, in severe cases, surgery may be required.
Beyond physical damage, acute toxicity can trigger severe psychological symptoms such as hallucinations, agitation, anxiety, or psychosis. These altered mental states make individuals more vulnerable to accidents, trauma, or risky behaviour. The incidence of ketamine toxicity — especially when combined with alcohol or other substances—is increasing worldwide. The tragic and widely publicized death of actor Matthew Perry serves as a sobering reminder of how misuse can turn fatal.
How Is Therapeutic Ketamine Different from Recreational Use?
Therapeutic ketamine is not about “getting high.” It is a carefully controlled medical process, tailored to the individual and designed to help the brain reset maladaptive patterns associated with depression, PTSD, and other conditions. Sessions are conducted with clinical precision — dosages are calibrated, medical monitoring is continuous, and integration support helps translate the experience into meaningful change.
When used responsibly and under supervision, ketamine-assisted therapy can be a valuable tool for healing. But outside of a regulated setting, it carries real and lasting risks that can outweigh any temporary sense of relief.
When Is Ketamine Assisted Therapy the Right Choice?
At ATMA CENA, clients are thoroughly screened for medical and psychological safety before treatment begins. Each program is designed to match the client’s needs with the most appropriate therapeutic approach, supported by licensed professionals in a compassionate environment.
Ketamine assisted therapy in Edmonton and Calgary can open the door to profound healing — but only when approached with respect, preparation, and care. The difference between therapy and use isn’t just dosage or setting — it’s the intention, safety, and support that surround the experience.
Considering Ketamine Assisted Therapy?
If you or someone you love is exploring ketamine-assisted treatment for depression, anxiety, or trauma, we invite you to learn more about our psychedelic therapy programs in Calgary
or connect with our team to discuss your next steps toward healing in a safe, supportive environment.
Sources:
Juruena MF, Young AH. Ketamine: Therapeutic potential versus recreational misuse. Journal of Psychopharmacology. 2025;39(1):3-4. doi:10.1177/02698811241308935
Kalsi SS, Wood DM, Dargan PI. The epidemiology and patterns of acute and chronic toxicity associated with recreational ketamine use. Emerg Health Threats J. 2011 Apr 15;4:7107. doi: 10.3402/ehtj.v4i0.7107. PMID: 24149025; PMCID: PMC3168228.
Mason K, Cottrell AM, Corrigan AG, Gillatt DA, Mitchelmore AE. Ketamine-associated lower urinary tract destruction: a new radiological challenge. Clin Radiol. 2010 Oct;65(10):795-800. doi: 10.1016/j.crad.2010.05.003. Epub 2010 Jul 29. PMID: 20797465.
Palamar, J.J., Rutherford, C., Keyes, K. Trends in Nonmedical ketamine use, poisonings, related deaths, pharmaceutical diversions, and law enforcement seizures: results from annual population-based repeated cross-sectional studies. The Lancet Regional Health – Americas Volume 51, November 2025. https://doi.org/10.1016/j.lana.2025.101230
