Ketamine’s journey from club drug to promising anxiety treatment

Gregory, a Black gay man from Virginia, clearly remembers the first time. He was 18 or 19, at an after-party, surrounded by grown adults with careers and lives. Someone was sitting at a table. Would you like some? A little white powder, a little white line. He said yes. Gregory felt a pleasant buzz while everyone else was dissolving into the floor. “I realized whatever it is, we did the same thing, but it affects me differently,” he says now, at 45, laughing at the memory.

For a certain generation of queer people — those who came of age in the late ’90s and early 2000s — when gay clubs were their own sovereign nations with their own customs and pharmacopeias, ketamine was simply part of the landscape. You cooked it in the oven, scraped it from the Pyrex dish, and sorted it into little vials. “I loved all that,” Gregory says. You did a bump in the bathroom, another on the dance floor, and you felt the music differently. Time stopped meaning anything. Everyone around you, their outfits and their dancing and their whole beautiful existence, became more vivid, more present, more real.

A ketamine therapy room at MindPeace Clinic in Richmond, VirginiaChristopher Wiggins

What nobody on those dance floors was thinking about was neuroplasticity, the brain’s ability to rewire itself, to break old patterns and build new ones. Twenty-odd years later, that’s exactly what scientists believe ketamine is doing.

The dissociative anesthetic used in operating rooms for more than 50 years is now producing results in treating depression, anxiety, PTSD, and suicidal ideation that leave physicians quietly astonished. The queer community didn’t invent ketamine, but it got there first.

“One of the things that the LGBTQIA+ queer community has shown us,” says Shelby Hartman, cofounder of Double Blind and coauthor of The Double Blind Guide to Psychedelics, “is that being on the dance floor, being in community, with the support of a substance that can help you feel connected to other people and your body, can be a deeply therapeutic experience.” Gregory puts it more plainly. “The laser lights feel different. The drag performance hits harder.” For a community that has long used the dance floor as refuge, the appeal was never just chemical. “Pain motivates you to seek relief,” says Michael Mancilla, an LGBTQ-focused therapist with over 30 years in the field. The same drive that sent queer people to the dance floor with a vial in their pocket is now sending them to clinics with an IV in their arm.

What’s lost in ketamine’s stigma — horse tranquilizer, rave drug, Special K — is the mechanism. Ketamine blocks a brain receptor called NMDA glutamate, releasing a protein that instructs neurons to regrow connections. The brain’s circuitry, worn into rigid grooves by depression and trauma, becomes suddenly, briefly pliable.

“Think of it like a hiking trail,” says Dr. Jeffrey Leary, a physician who administers ketamine therapy at MindPeace Clinic in Richmond, Virginia. “Our brains get hardwired in certain ways of thinking, and we keep walking the same trail. Ketamine makes new pathways that bypass that well-worn circuit.” Alexis Nock, a registered nurse who works alongside Leary, has watched the results arrive in real time. “After two or three infusions, they come in, and they have a smile. The mental noise quiets,” she says.

A room in Silva Wellness, a psychedelic therapy center in LondonBenjamin Cremel/AFPTV/AFP via Getty Images

A 2022 study in the Journal of Clinical Psychiatry tracked 424 patients at a Virginia clinic. Within six weeks, half had meaningfully improved. After 10 infusions, 72 percent had responded. Of patients who arrived with active suicidal thoughts, 85 percent had seen those thoughts resolve by 15 infusions — striking, given there are no FDA-approved oral medications specifically for suicidal ideation.

As with all medications, ketamine’s promise comes with potential risks. In the short term, patients can experience dissociation, dizziness, nausea, and temporary spikes in blood pressure or heart rate. Over time, repeated or unsupervised use has been linked to dependence, cognitive changes, and bladder damage. And yet, in clinical settings, ketamine is often considered comparatively safe because it does not suppress breathing like many sedatives, its effects are short-lived and monitored in real time, and it works quickly without requiring weeks of daily dosing.

David Schlumpf, a 43-year-old actor and stay-at-home dad in Jersey City, N.J., spent a decade cycling through medications that didn’t work. By early 2025, suicidal ideation had been his companion his entire adult life. Now 16 sessions in on Spravato, the FDA-approved nasal spray version of ketamine, he describes walking home from his first session moving more slowly than usual. His brain offered calmly: Yeah, we’re walking at the pace we want to go. “It wasn’t haunted by all the other voices,” he says. “It doesn’t lead me to the bottomless pit again. I can recognize it.”

Gregory never made it to a clinic. IV ketamine is rarely covered by insurance, and patients are charged hundreds to over a thousand dollars per session. “They want an obscene amount of money,” he says. “I’ll just buy a bag and use a tiny spoon.” In Canada, therapist Andrea Kirincic describes a coverage patchwork just as uneven. “If the setup is not good, it’s not going to have the same result.”

The experience Gregory returns to happened in Washington, D.C., in 2022. Club, laser lights, music. “I felt like a main character,” he says. “This was all that existed.” This is almost exactly how ketamine therapy patients describe the relief they feel. The queer community discovered it on a dance floor. Medicine caught up eventually.

Editor’s note: The clinic where the 2022 Virginia study was conducted was founded by Dr. Patrick Oliver, a coauthor and source in this article. In February 2024, the Virginia Board of Medicine temporarily suspended Oliver’s license after determining he had engaged in an unethical intimate relationship with a patient. Oliver acknowledged the relationship occurred but disputed aspects of the investigation to Out. The study has been independently peer reviewed.

This article is part of Out’s May-June 2026 print issue, which hits newsstands May 26. Support queer media and subscribe — or download the issue through Apple News+, Zinio, Nook, or PressReader.

Marco Calvani and Colman Domingo on the cover of Out magazine's May-June 2026 issue