We are currently facing an Opioid epidemic and a mental health crisis with increased disconnection and addiction and beginning a psychedelic renaissance.   Nociplastic pain is a newer phenomenon. Over time the neural circuitry around the physical and emotional perception of a chronic pain experience strengthens including peripheral and central sensitization (CS). By Using a Biopsychosocial Model of Pain, we can decrease pain and chronic stress changing the sensory processing function of the nervous system getting to the root cause. Ketamine is a dissociative anesthetic that can be personalized based on route of administration, dose, and setting.  Ketamine may play a role in reducing CS or the increased responsiveness of nociceptive neurons to normal stimuli. Psychedelics quiet the Default Mode Network (DMN) and activate the 5HT2A allowing for a Catalyst for change in perception and perspective to Overcome rigid defense mechanisms, depattern, unlearn behavior, increase Neuroplasticity and decrease neuroinflammation.  The integration of enduring memories of the particular states of consciousness that were experienced during the period of drug action is equally important. 

Learning Objectives:

1. Review the history of ketamine’s medical indications.

2. Explain the biological and psychological mechanism of ketamine.

3. Review set, setting, dose, route of administration and importance of integration.

4. Discuss legal challenges and future of psychedelics in medicine.