August Innerbloom Newsletter
Aug 21, 2025 5:01 pm
August 2025
This August marks an important milestone—three years since Innerbloom opened its doors in San Luis Obispo. As we look back, we’re deeply grateful: to the courageous individuals who have trusted us with their care, to the supportive community that has welcomed us, and for the privilege of witnessing so many journeys of growth and healing. We have a lot to share this month, so let’s get to it.
Circa 2022 — Innerbloom’s Grand Opening
🌎 News
FDA Approval of Ketamine for Post-Surgical Pain
Since 1970, ketamine has been FDA-approved only for anesthesia, yet for more than two decades, providers have used it off-label to treat mental health conditions and chronic pain. Off-label use does not mean ineffective or unsafe; in fact, an estimated 20% of prescriptions are written off-label. On Aug. 8, 2025, the FDA approved KETARx—PharmaTher’s branded generic (racemic) ketamine—for post-surgical pain. It’s the same active medication used in IV ketamine infusions. Uses for mental health and chronic pain remain off-label, but this approval is a meaningful step that may broaden access and influence future coverage.
📕 Education & Science
Are We Rushing Psychedelics?
Psychedelics are making headlines and stirring hope—especially among people with treatment-resistant conditions who have exhausted conventional options like antidepressants. But the reality is that most clinical trials remain in their earliest phases, and nearly all psychedelics are still illegal in the US. These medicines hold immense healing potential, but also carry very real risks of harm.
At Innerbloom, we’ve seen firsthand how transformative ketamine can be when delivered safely and responsibly. Still, we recognize that lasting solutions demand patience, rigorous science, and thoughtful care. Before we rush forward, we must ask: are we building this movement on solid evidence, or on enthusiasm alone?
Australia made headlines in 2023 as the first country to legalize psilocybin for treatment-resistant depression, but new research suggests the benefits may not be as dramatic as early trials indicated. On a recent episode of ABC’s Health Report, Professor Fredrik Hieronymus discussed a study comparing outcomes from psilocybin, SSRIs, and esketamine trials.
The findings suggest psilocybin’s effect may have been somewhat overestimated in tightly controlled clinical settings, raising important questions about how well these results translate to real-world patients. While psilocybin remains a promising option, this emerging evidence highlights the need for careful research and balanced expectations as the field of psychedelic medicine evolves.
IV, IM, Nasal, Oral Ketamine: What’s the Difference?
Not all forms of ketamine are equal. At Innerbloom, we specialize in IV, IM, and nasal esketamine—the methods supported by the strongest research and proven safety standards. Here’s a closer look at how each route works and what sets them apart.
- IV and IM ketamine have the strongest track record, with by far the most studies consistently showing the fastest, most significant, and most reliable reductions in depression and suicidal thoughts.
- Intranasal esketamine (Spravato®) is the only FDA-approved option. It tends to require more sessions to reach remission compared to IV/IM ketamine, but it has insurance coverage behind it.
- Oral ketamine is being explored in newer extended-release forms, but its bioavailability is low, and results remain inconsistent. It is considered the least effective route of administration, with outcomes varying widely depending on the formulation, source, and treatment setting.
🌼 Innerbloom Recommendations
When I’m off the clock, I love unwinding with podcasts—sometimes to learn, sometimes just for fun. Here are three I’m especially enjoying right now. I’d love to hear your recommendations too—hit reply and share your favorites so I can add them to my queue. And don’t worry, none of these are political or doom-and-gloom news shows.
- Perform: Dr. Andy Galpin is a leading exercise physiologist who uses the latest science-backed research to help people maximize performance. Whether he’s working with world-class athletes or bigwig CEOs, his focus is on dialing in the basics like sleep, diet, workouts, and daily habits to squeeze out as much performance as humanly possible.
- The Dr. Hyman Show: Mark Hyman, MD, one of the leading voices in functional medicine, digs into the root causes of health and disease. What I like most is that he always brings the conversation back to simple, practical steps—usually without relying on drugs or expensive, flashy tools.
- Armchair Expert: Hosted by actor Dax Shepard, this podcast is a mix of humor and real conversation. It’s more lighthearted than my usual health podcasts, but still full of great stuff. One of my favorite episodes is with Matt Damon—especially the part where he hilariously describes what it’s like to be around Brad Pitt. It makes me laugh and is a good reminder that even big Hollywood stars have insecurities and quirks, and can be just as weird as the rest of us.
📢 Stay Connected
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Thank You!
I appreciate your continued support and for taking the time to read! If you have questions, feedback, or topics you'd like to see covered, reply to this email. I would love to hear from you!
Warmly,
Ray Rivas, MD
Innerbloom Ketamine Therapy, PC
San Luis Obispo, CA
(805) 321-8471
