The travails of an honest entrepreneur: how to make more than a buck, legally, quickly? nnOne easy answer: depression. The number of depressed Americans is vast. Ask anybody how they feel, on a scale of 1 to 10; enough will yell “10” to constitute a market. My “10” may be your “6,” and our scores may vary with the month, the day, the moment. But seize that depressed moment, and find a product, a lucrative one, to assuage the would-be consumer’s mood.
The miracle product is ketamine.
Anesthesiologists have used it in surgeries. Veterinarians have used it to tranquilize animals. Party-goers have found it gives a great high.
In clinical practice, ketamine has been shown to relieve symptoms of depression, maybe as well, if not better, than electro-convulsive therapy. Psychiatrists have prescribed it to selected patients, after screening, with oversight. But to date there are no long-range studies of efficacy, or of side-effects. There are no standards on dosage of infusions, or the number of infusions over a set period of time. The FDA has not approved its use for depression. Nor have insurance companies routinely reimbursed treatment.
But you are an entrepreneur, not a physician who has taken some variant of an oath to do no harm. Your mandate is simple: find a product, identify a market, and sell, sell, sell.
The good news: the route from depressed patient to empowered consumer is straightforward. Your advertisements will show the way. You heed not the Hippocratic oath, but the gods of the marketplace. The rules of this marketplace are straightforward. In your hype, promise nirvana. Market to support groups for grieved parents, for first responders, for patients with severe pain. Charge from a few hundred dollars up to $1,000 per infusion, but at the same time offer monthly payment plans, even discounts for selected patients.
The explosive growth of ketamine clinics has bolstered more than a few bottom lines. The clinics demonstrate the shackles of government regulations. These unregulated clinics need not follow any standard protocols, they need not screen for cardiac disease, they need not employ mental health professionals to oversee care. Consequently, the clinics have spread as they profited.
Desperate people are eager to trust this touted solution.
Doubtless ketamine will bolster some patients’ moods. Either the treatment, or the placebo effect will kick in. Maybe a person who pays thousands of dollars for ketamine is willing to see benefits, if only to justify the expenditure. And maybe ketamine will emerge as another insulin – a revolutionary treatment for depression. Indeed, researchers and pharmaceutical companies are carefully analyzing data. Its quick action sets it apart from other drugs, which take far longer to work. Physicians acknowledge that ketamine has a place in treatment for severe depression for selected patients; but we need the boring clinical trials and studies that desperate patients – and ambitious entrepreneurs – discount.
But, again, the market is large: patients willingly accept the clinics’ promises to deliver, for a few thousand dollars, instant relief. As for the lack of government regulations, patients don’t seem to care. More power to the entrepreneurs not shackled by Uncle Sam or his minions in state Departments of Health.
Eerily, consumers’ willingness to trust marketing hype, to distrust, if not mock, science, to ignore governmental safeguards coincides with voters’ willingness – even eagerness – to embrace political campaign hype, to ignore “facts,” to ridicule government as stupid and/or inept. A wall between the USA and Mexico? Why not? A trade war with Canada? Why not? Axe environmental regulations to increase jobs? Sure. Embrace foreign despots? Absolutely: they are great people. Russian meddling in our elections? No way.
Government, like medicine, demands skilled practitioners who understand the complexity of systems – whether the body politick or our bodies. There are no easy solutions, no quick fixes. Yet we persist in trusting people who promise them.
Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email retsinas@verizon.net.
From The Progressive Populist, November 15, 2018
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