Episode 13 - Thoughts on the TMB’s proposal regarding ketamine clinicsEpisode 13 - Thoughts on the TMB’s proposal regarding ketamine clinics
Transcend Health Solutions Podcast
Will Ratliff and Annabel Morrice discuss the Texas Medical Board’s proposed regulations for ketamine clinics, contrasting in-clinic ketamine-assisted psychotherapy with high-dose medical and telehealth models. They raise questions about safety, access, cost, and the central role of therapy support in effective ketamine treatment for severe mental health conditions.
1:16:22•15 May 2026
Ketamine Clinics, Safety, and the Texas Medical Board: What’s Really at Stake?
Episode Overview
- Low-dose, slow ketamine infusions used for mental health have a very different risk profile from high-dose anaesthetic use, and clinic experience cited here reports no airway emergencies across thousands of sessions.
- Requiring a physician to be physically on site for every ketamine session may sharply increase costs without clearly improving safety, potentially pushing people towards less supervised at-home options.
- Therapist involvement before, during and after ketamine sessions is presented as critical for psychological safety, integration, and reducing dropout from treatment.
- Telehealth models that send very high-dose oral ketamine for unsupervised home use are described as a major concern, particularly around overdose risk, poor monitoring, and potential dependence.
- The regulatory framework created for ketamine is likely to influence how future treatments like psilocybin and MDMA-assisted therapy are structured and accessed.
“The groundwork that we're laying around the ketamine industry is going to radiate out to psilocybin and MDMA and just every other modality.”
Curious about how others navigate their sobriety journey and broader mental health care? This conversation from Transcend Health Solutions zooms in on a hot topic: the Texas Medical Board’s proposed rules for ketamine clinics, and what those rules could mean for people struggling with depression, PTSD, anxiety, alcohol use disorder and more. Host and nurse–paramedic Will Ratliff teams up with therapist Annabel Morrice, an LPC-Associate who has already clocked around 100 ketamine-assisted psychotherapy sessions.
Together, they break down how ketamine is used medically (from battlefield surgeries to emergency intubations) and why low-dose, slow infusions in a clinic look completely different from high-dose, rapid anaesthetic use.
Annabel likens it to making neighbourhood driving rules based on motorway crash data, saying it feels like being told “to go 30 miles an hour in the neighbourhood, there needs to be five people in the car with you… go ahead and go 90 on the toll road by yourself.” They highlight what really seems to keep people safe: thorough medical screening, continuous monitoring, and – crucially – having a therapist present to support and integrate the emotional material that surfaces.
As Will puts it, at the doses they use, “we've had thousands and thousands of infusions… we've never had to call an ambulance.” A big chunk of the chat focuses on the Board’s push for a physician to be physically on site for parenteral ketamine, and how that could double session costs without clearly improving safety.
They also call out telehealth ketamine models sending very high oral doses to people at home, often with minimal oversight, which they see as a genuine risk. If you’re interested in how policy can shape access to innovative treatments, or you’re weighing up ketamine-assisted therapy as part of a recovery path, this honest, slightly nerdy and often funny chat might give you plenty to think about.
How do you think safety and access should be balanced for life-saving mental health care?
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