Clinic facilities

Psychedelic Medicine Gains Momentum in Sonoma County; return of the ketamine clinic in Sevastopol

A psychedelic-assisted therapy center in Sevastopol that uses ketamine to help people with depression, suicidal ideation, post-traumatic stress disorder, substance abuse and anxiety has reopened after closing during the pandemic.

Evolve the well-being of the mind opened in 2018, part of a growing trend in behavioral health that foresees the wider use of psychedelics to help patients dig deeper into psychological issues, said Dr. German Ascani, a psychiatrist and co-founder of the center.

Evolve reopened in November 2021 but celebrated its official open house on Saturday.

Ketamine has been around for decades and is best known for its use as an anesthetic. But it also has uses in pain treatment and in palliative care, critical care, and procedural sedation.

“We use it in a psychotherapeutic context, which means you take the drug to enhance or catalyze a process of deeper exploration of the psyche, into the psycho-spiritual world,” Ascani said.

Ketamine is currently the only legal psychedelic that can be used by behavioral health professionals for the treatment of psychological and emotional issues.

But Ascani and others involved in ketamine-assisted psychotherapy hope to one day offer therapy services involving MDMA (or ecstasy) and psilocybin (the psychoactive compound in “magic mushrooms”) once they will be approved by the Food and Drug Administration.

Ascani said using psychedelics is simply a different tool that allows people to explore their psyches from a different perspective than traditional forms of therapy or treatment with widely used mental health drugs.

“It allows you to witness your own process,” Ascani said. memory and reconsolidate memory in a non-reactive way.”

In traditional therapy, trauma is sometimes reactivated or relived, he says.

Ascani, who trained on ketamine with Dr. Phil Wolfson at the San Anselmo Center for Transformational Psychotherapy in Marin County, co-founded Evolve Mind Wellness with Celeste Monnette, a licensed clinical social worker who worked as a therapist for about 25 years.

Ketamine doses at Evolve are either delivered via lozenges or intramuscular injections administered by a physician. Monnette said most people start with lozenges because it’s a more gradual experience.

“It’s a better way to start because they’re even more into themselves, like they’re starting to feel it coming, we’re having conversations about it,” she said, adding that the injections work faster and provide a “stronger, deeper” experience.

Because ketamine is an anesthetic, many people have a relaxing “gentle experience,” she said, adding that the experience can last between 30 minutes and an hour.

Monnette said she had her first training in ketamine-assisted therapy about four years ago. The training included an “experiential component” which for her was transformative in terms of what medicine could offer when paired with psychotherapy.

Monnette soon began working with Ascani at the clinic in San Anselmo, and when Ascani left to open a clinic in Sevastopol, Monnette joined him.

“It was a really remarkable and exciting experience, and it’s really an interesting type of work,” Monnette said. “I’m really hopeful in terms of experience of what it can offer clients…basically, reduce suffering.”

The treatment consists of a number of sessions including a 60-minute medical intake, a 60-minute psychological intake, a 60-minute ketamine preparation session, approximately 2.5 hours of ketamine-assisted therapy, and more. The first treatment costs around $2,075 and $1,200 for subsequent treatments.

Dr Suegee Tamar-Mattis, staff physician at Evolve, said most people will need three to six treatments. The sessions, she said, are an “intensive treatment model.”

“The costs are really about the time spent with the therapist, so you can think of it as paying a therapist over a period of a year, or paying them over a period of 6 sessions in 6 weeks or more,” Tamar-Mattis said. in an email.

The cost of treatment is comparable to that of the Temenos Center for Integrative Psychotherapy in Petaluma, which opened four years ago and also offers ketamine-assisted therapy.

Jessica McIninch, a clinical psychologist and co-owner of Temenos, said a full treatment protocol, which includes a preparation session, admission and drug treatment, can cost between $4,000 and $8,000. But McIninch said the clinic is doing its best not to deny people service, so if they can’t follow a full protocol, they might be given the option to do parts of it.

Payment at both centers is out of pocket, as insurance companies do not yet cover the treatment. McIninch said she welcomes the arrival of the second psychedelic-assisted therapy center — as far as she knows — in the county.

“We are happy to see this work proliferate,” McIninch said. “A lot of people at Evolve are our colleagues, some of them we train with… Sure, Sebastopol and Petaluma are close but it’s not the same demographic region. We have people coming from other states to come and get this job.

McIninch said treatment at centers like Temenos and Evolve essentially lowers clients’ defenses, “their defensive structures are good enough to do some really deep work.” In traditional therapy, she says, clients are reactivated when they talk about their trauma.

With ketamine, McIninch added, people are in a relaxed state of mind where they can do the work faster that can take years in traditional therapy.

“People will often call it a game changer,” she said. “It’s the most effective tool I’ve had as a psychologist in over 20 years doing my job. I can’t imagine doing psychotherapy now without it…it’s like going from two-dimensional therapy to three-dimensional therapy.

Ascani said the Evolve Clinic will continue to specialize in comprehensive mental health treatment using psychedelics as they come online following federal government approval.

“Psychedelics are not yet a panacea or a silver bullet, he said, but are an ‘amazing add-on modality to mental health care that will help many and may destabilize some.’

The founders of Evolve hope to become an expanded access site for MDMA. Tamar-Mattis said the certification process takes some time, but the majority of Evolve’s suppliers have completed the required MDMA training, and Ascani is involved in MDMA research.

You can reach editor Martin Espinoza at 707-521-5213 or martin.espinoza@pressdemocrat.com. On Twitter @pressreno.