Shalom Baer Gee/MDN Melinda A. Howe, APRN, CRNA prepares a room for a Ketamine infusion at her infusion clinic, Ascend Wellness. Ketamine can help with chronic pain and persistent mental health issues. Ascend Wellness also offers hydration and vitamin infusions.

Ascend Wellness on Main Street in Minot is decorated much like a salon or spa. A spacious room around a corner from the lobby features a wall with exposed brick, a sofa with decorative pillows, small rock water fountain and recliners. There are also several private rooms where people receive intravenous (IV) infusions of Ketamine.

Some negative connotations have surrounded Ketamine, an anesthetic drug, but Ascend Wellness administers only small dosages to patients who struggle from mental health conditions and chronic pain that have been resistant to traditional treatments or medications.

Ketamine has garnered a number of street names when used recreationally at raves and parties. Special K, Vitamin K and Super K are a few listed by the United States Drug Enforcement Administration (DEA). The DEA describes Ketamine as a “general, short-acting anesthetic with hallucinogenic effects. Sometimes used to facilitate sexual assault crimes.”

According to The Encyclopedia Brittanica, Ketamine was first synthesized in 1962 by an American scientist Calbin Stevens. Stevens was looking for an anesthetic to replace PCP, which caused severe hallucinogenic effects when the patient began to regain consciousness. The U.S. Food and Drug Administration (FDA) approved the drug for use in humans in 1970, and it was used to treat soldiers in the Vietnam War.

“It kind of got a bad rap in the Vietnam War. They were getting flashbacks and hallucinations that was kind of from that anesthetic, so we veered away from it for many, many years,” said Melinda Howe, an advanced practice registered nurse (APRN) and certified registered nurse anesthetist (CRNA) who opened Ascend Wellness in November of 2021. “About 10 to 15 years ago, it started kind of reemerging in low dose.”

Howe said Ketamine works by increasing production of Glutamate, an amino acid that is needed for healthy brain function, and people with depression frequently have low levels of Glutamate.

“It increases Glutamate, which is helpful in depression states and then regenerates the brain, so forms new connections,” Howe said.

A National Center for Biotechnology Information article states that Ketamine can reduce suicidal ideations for at least seven days following a single infusion, and the anti-suicidal effects may be sustained through repeated infusions.

Individuals must have a referral with follow-up from a primary care provider to receive Ketamine infusions. Howe said that a patient coming in for an infusion receives approximately one-tenth the dose that would be administered in an anesthetic setting. The number of sessions needed is determined on a case-by-case basis with a medical provider.

“High doses, you might feel almost an out-of-body experience, but lower doses you can disassociate and see kind of vivid colors, visions, so that’s why it’s really important when people come in here, I say, have good intention with your infusion, think about healing, processing some of the trauma that you’ve been through in a positive way. Think all these things when it’s infusing,” she said.

There can be negative side effects during a Ketamine infusion, such as nausea or high blood pressure, or patients can experience something negative emotionally. Howe said that she has medicine available that can counteract the physical side effects, and she monitors patients’ vital signs during the treatment. Patients are also equipped with a call button if they need assistance, and Howe prepares patients before the infusion for some of the emotions they may experience.

“I tell everybody, it’s going to be a little bit of a roller coaster,” Howe said. “You can relive some trauma if you’ve been through some trauma, and that’s scary, but we try to walk them through that. If you have a person that you want to sit in the room with you, that’s totally fine. I’ll sit in there if they really want me to sit with them the whole time.”

The treatments last for about an hour, and Howe encourages patients to wear an eye covering and listen to soothing music.

Howe earned her nursing degree at Minot State University, and after working at Trinity Health for five years, she studied anesthesia at Mayo Medical School in Minnesota, where she earned a master of science. After earning her master’s, she moved back to Minot and then worked in Maine, Arizona and California before again returning to Minot and opening Ascend Wellness. The clinic also offers hydration and vitamin infusions, which do not require a doctor’s referral.