How do you think this approval affects the broader ketamine therapy landscape? Should generic ketamine have similar approval pathways?

This creates a two-tier system: expensive pharmaceutical esketamine for those with insurance coverage, and cash-pay ketamine clinics for everyone else. The same molecule, different access points, vastly different costs.

But here's the contradiction: while esketamine requires certified facilities and strict monitoring, generic ketamine operates in a regulatory gray zone. The FDA warns about unmonitored compounded ketamine use, yet the approval pathway for generic ketamine remains unclear.

This represents a significant shift in how regulators view psychedelic medicines - acknowledging they can be primary treatments, not just last resorts. About a third of adults don't respond to oral antidepressants alone.

But geography, cost, and regulatory barriers still determine who gets help.

What questions do you think Oregon's upcoming research should prioritize? How do we learn from these 8,000 experiences to expand access nationwide?

But the bigger story here is about access and equity. Most service centers cluster near Interstate 5, leaving eastern Oregon underserved. Here's what this tells us about the economic structures shaping psychedelic access: when we create legal pathways, demand is enormous.

The challenge is holding space for the transpersonal while maintaining clinical grounding and safety.

What's your experience working with transpersonal material in therapy?

Traditional therapy models don't always have language for these phenomena. Transpersonal psychology gives us tools to:
- Normalize these experiences
- Integrate them therapeutically
- Support clients in making meaning
- Bridge personal healing with larger purpose

This framework acknowledges that psychological wholeness often involves connection to community, nature, spirituality, or universal consciousness. In psychedelic work, clients frequently report experiences of ego dissolution, unity consciousness, or profound spiritual insights.