Emily Ryan
CNN  — 

Emily Ryan’s life changed quite literally overnight when she was a freshman in college.

She was studying for final exams and returned from the library around 10 p.m. She crept quietly to bed because her roommate was already asleep.

Around 3 a.m., she woke up with intense pain radiating across her back.

“I could not feel my legs anymore,” Ryan said.  She also smelled urine.  The sheets underneath her were soaked.

“And as a 19-year-old person, you know, I didn’t pee the bed and so it was very surprising.”

That terrifying episode launched what would become a 10-year odyssey to find relief from unrelenting pain. Ryan says she finally found it in what some experts think is an unexpected and controversial place — the psychedelic drug ketamine, which she gets through intravenous infusions every 90 days.

Ketamine has been used as a surgical anesthetic since the 1970s. It became widely used in field hospitals during the Vietnam War because it doesn’t depress breathing and heart rate the way some other kinds of anesthesia can. At the same time, it raises blood pressure and heart rate, which can be helpful for patients who’ve lost blood.

Like some other psychedelics, ketamine has also proven to be helpful for treating depression and trauma.

A derivative of ketamine — esketamine — was approved by the US Food and Drug Administration in 2019 as a nasal spray for patients with depression that hasn’t responded to other treatments.

Some hospitals and specialty pain clinics also use infusions of ketamine off-label to treat intractable pain, like the kind Ryan has.

“A lot of pain docs sort of think it’s sort of Voodoo-ish, if you will, sort of like, ‘What are you really doing here?’” said Dr. Pavan Tankha, a pain specialist at the Cleveland Clinic who is treating Ryan.

Ketamine acts quickly in the body, and it is also cleared quickly, within hours.

Yet Ryan and others who use it for chronic pain say the relief they get after their treatments lasts for months. Experts say it’s hard to understand how it could be working for that long, and they point out that while preliminary evidence is promising, there’s just not a lot of high-quality research to help explain why it might work or what kind of patient could see the most benefit from it.

Tankha says he is hoping to raise enough money to properly study ketamine’s utility for chronic pain.

“The binding to the receptor is over in maybe 10 to 15 minutes, maybe a couple hours, if you’re lucky. But why does it work so long?” Tankha said.

“We’re studying what I would call the downstream effects from the binding of ketamine. What else is it doing in the brain to cause this lasting relief?” he said.

A long road to relief

Emily Ryan, who is now 29 and lives in Cincinnati, Ohio, said she doesn’t mind that doctors don’t understand exactly how ketamine helps. She just feels that it does, and she’s grateful to have found it.

It was a long road to get to here, though.

When her parents met her at the hospital the night she woke up paralyzed in college, doctors initially suspected Ryan might have an infection or kidney stones because there was blood in her urine. They quickly ruled those out.

At the local children’s hospital, they put the teen into an MRI machine and gave her a pair of special goggles so she could watch the movie “Frozen.”

She watched it through once.  And then again.

“And on the third time, I thought to myself, ‘Something is really wrong if I’m still in this tube.’”

The something turned out to be a tumor pressing on her spine. Fortunately, it wasn’t cancer, but the doctors told her it was in a place where it was compressing her nerves. And they admitted that they didn’t know how to treat it. Because the tumor was sitting in a risky area, surgery to remove it could paralyze her.