After years of working to treat anxiety and depression with standard medication, Brie Silverman decided she wanted better results for some of her patients.

Silverman, who has worked for eight years in primary care as a physician’s assistant, describes herself as the type of health care provider who looks at the whole patient. Primary care providers in rural areas often end up tackling their patients’ mental health along with physical health, as there’s not as many outside resources or other places to go, she said.

She described finding a niche working with patients struggling with anxiety and depression and her license allowed her to prescribe all sorts of conventional treatments for mental health disorders. But some of her patients still weren’t seeing relief with those options, so she started looking toward alternatives like ketamine therapy, which uses small injections of the drug to help rewire the brain. The therapy has gained traction over the past decade as a successful treatment, especially for anxiety and depression.

Silverman began learning from ketamine providers and mentors to understand how the drug works.

There’s already clinics in Montrose, but Silverman saw a need to provide the option in her community in Ouray County. So she opened San Juan Integrative Medicine in Ridgway last month alongside co-owner, Dr. Cameron Berg, sharing a belief that the drug can help people get where they want to be in their life.

“It can be life changing. It can be absolutely life changing and life saving, for some people,” Silverman said.

How it works

Some people might know ketamine as a recreational drug, hallucinogenic or horse tranquilizer. It can be used in those ways, Silverman said.

“But just because it can be used recreationally, doesn’t take away from its therapeutic benefits,” Silverman said.

“It is so much more than those things,” she said.

Opening a clinic didn’t require any special licensing beyond the providers’ current medical licenses, similar to a pain clinic, she said.

Ketamine for treating mental health disorders is administered via a low-dose injection — far below a hallucinogenic dose — to help relieve the symptoms of anxiety and depression.

Like most drugs, Silverman said professionals are not exactly sure how it works, but the understanding is that it stimulates the glutamate — a neurotransmitter in the brain — to help promote growing new synapses, or connections in the brain that may have been affected by things like trauma or depression.

She said the treatment gives people distance from what they are immediately dealing with, allowing them to see things in new ways and more readily make changes in their life. Silverman said the treatment can even cut years off of traditional therapy. But she noted it’s not necessarily the right match for all people or all mental health disorders.

During a session, Silverman will usually administer two injections over roughly two hours, though some patients only use one dose. She provides noise-cancelling headphones and a blackout eye mask that allows patients to open their eyes beneath. She also has the option for patients to pair treatment with music selected by clinicians to help facilitate the experience.

The effects are felt immediately after an injection.

“It can just be so beautiful to see them, see things click, and just to see the peace and the awareness … that can come with the treatment,” she said. “I would just want to share it with as many people as is good for them.”

Silverman said she’s always available to help a patient process the experience after an injection, if they wish. Processing is healthy, and overall the treatment is most effective when coupled with therapy, she said.

Treatment plans differ by patient — some even benefit from a one-time injection — but a typical schedule is every four to six weeks.

“Our treatments have been really successful,” she said.

The clinic is located in 380 Sherman St. Unit 8C in Ridgway. Patients will find the clinic located up a staircase at the back of the building.

Silverman said people who are interested can schedule a first appointment online after completing a set of paperwork. After that she’ll determine if they need to schedule a phone call to talk through any other concerns or details. During the first appointment, patients set goals and intentions for treatment before returning for injections. Silverman said she’s also considering providing in-home treatments in the future. An appointment costs $450 and the clinic does not currently accept insurance. For more information, visit sanjuanim.com or call 970-239-1415.

Lia Salvatierra is a journalist with Report for America, a service program that helps boost underserved areas with more reporting resources.