Pain reprocessing therapy (PRT) is a system of techniques rooted in neuroscience to reduce or eliminate chronic pain. Based on the premise that most forms of chronic pain are not caused by physical problems in the body, but rather learned neural pathways in the brain and the misfiring of pain circuits.
Dr. Michelle Weiner gets to the root cause of one’s suffering using a biopsychosocial model to heal the whole person. Ketamine is a transformative medication that acts as a catalyst to change. With proper preparation, integration and personalizing dose and route of administration, ketamine assisted psychotherapy allows for long lasting benefits.
Ketamine is an anesthetic that was approved by the FDA in 1970 and is considered an essential medication for the management of chronic pain by the World Health Organization. Cleveland Clinic called It a “Top 10 medical breakthrough” for treatment resistant depression.
Ketamine’s unique mechanism of action means that it works differently from the typical medications used for these conditions, offering patients new hope when all others have failed them.
Ketamine offers cognitive flexibility, allowing us to unlearn beliefs that do not serve us, depattern and reinforce positive thoughts, attitudes and behaviors while promoting new neural connections (neuroplasticity). Using a team approach and evidence based medicine, Dr. Weiner and the therapist or integrative coach supports the patient to heal past trauma and change their relationship to their pain using ketamine as a tool to cultivate health and improve well-being.
$400 per ketamine infusion or $2200 for 6 ketamine infusions
$300 per ketamine session
$2400 for 6 ketamine sessions and 6 virtual sessions with our ketamine integration coach
$500 per ketamine infusion or $2700 for 6 ketamine infusions
Indicated for the treatment of:
- $500 per ketamine infusion
- $3000 for 6 ketamine infusions and 5 coaching sessions
- Indicated for chronic pain such as:
- Fibromyalgia
- Neuropathic pain
- Complex regional pain syndrome
Ketamine-Assisted Therapy Treatment of Comorbid Depression and Chronic Pain
Principal findings support ketamine-assisted therapy’s efficacy for the treatment of depression and chronic pain comorbidity and indicate its potential use for anxiety and trauma-informed indications. Results suggest that the psychedelic approach may be superior to the psycholytic approach, which implies that larger doses and intramuscular routes may be optimal.
Principal findings support ketamine-assisted therapy’s efficacy for the treatment of depression and chronic pain comorbidity and indicate its potential use for anxiety and trauma-informed indications. Results suggest that the psychedelic approach may be superior to the psycholytic approach, which implies that larger doses and intramuscular routes may be optimal.
Maintenance ketamine sessions may be warranted after the initial 4-6 sessions, to reinforce benefits.
Repeat step 2 and 3 to steer neuroplasticity
Most require 3-6 sessions of ketamine
With potential for maintenance session; objective measures used to guide treatment plan
Dr Weiner and her team are trained and certified in Pain Reprocessing Therapy which is a technique used to facilitate pain reframing, somatic tracking, breaking the pain cycle And Mindfulness Oriented Recovery Enhancement to treat depressixon related to chronic stress, PTSD, Addiction.
Group sessions for community support are also available
Ketamine therapy can relieve various types of depression, suicidal thinking, post-traumatic stress disorder (PTSD), anxiety, obsessive-compulsive disorder (OCD), other mood disorders, and chronic pain conditions.
Ketamine is an FDA approved dissociative anesthetic developed in 1962 used for general anesthesia in surgery for children and adults. It is remarkably safe as it doesn’t affect respiration. Yale University discovered that a subanesthetic dose of Ketamine can be used to treat depression, anxiety, PTSD, chronic pain such as fibromyalgia and even addiction. Ketamine is very unique as it works on the neurotransmitter glutamate as its mechanism differs from antidepressants which work on the serotonergic pathways.
The effects of a single infusion typically last up to two weeks. After a series of six sessions based on evidenced based research, most remain symptom free for months. We also offer the option of booster sessions which can be given monthly or a few times per year as needed. The idea with Ketamine is that you’re building up new neural pathways in your brain to offset the trauma or pain. Ketamine can help you depattern and adapt and be less affected by triggers allowing you to create a healthier pathway down a new ski slope instead of assuming your usual ride.
Using ketamine in a medical setting through IM injection, IV infusion or oral route with guidance and psychotherapy are the best options. We rarely prescribe ketamine for at home or daily use to avoid addiction minimizing repetitive use. The idea is that a series of sessions using ketamine may have long lasting effects so that we can decrease pharmaceutical use and addiction and feel well. We also do not prescribe the intranasal Esketamine route.
No, Ketamine is not a hallucinogenic it’s a dissociative. It can aid in connection to self. Most patients describe Ketamine as being one of the most peaceful, meaningful experiences in their lives.
Our setting allows for a very calming and peaceful experience as most describe a “floating” feeling. Dr Weiner and the therapist or coach prepares each patient with a specific intention for each session healing trauma and pain. We typically begin with a starter dose which is based on your body weight and previous experiences and can increase the dose with each session as tolerated. Unlike other treatments, the ketamine session helps get to the root of your trauma, pain or depression. Most people find the experience very healing, and afterwards they report feeling less reactive or triggered and “lighter.”
Ketamine is extremely safe, that is why they use it on children for surgery. Some report nausea, so we give you an anti-nausea medication before your treatment and recommend no eating for 4 hours before. Your blood pressure, which is monitored may elevate temporarily during the treatment but resumes to baseline following. You will need a ride home from the treatment.
We recommend you continue your medication. We do not recommend taking stimulants or benzodiazepines that morning. We have noticed that healing through ketamine assisted psychotherapy allows us to taper off pain medications as well as antidepressants and anti anxiety medications. You can continue seeing your psychiatrist while doing ketamine treatments.
Dr Weiner will see you for an initial evaluation through insurance to establish a plan including the route of administration and help prepare you for the first session. We charge $300 for an intramuscular ketamine treatment, and $500 for an IV infusions with the protocol being to receive 3-6 treatments.
Unfortunately, it is not covered by insurance. We hope this insurance coverage changes in the future. We want Ketamine to be an option for those suffering and unfortunately most who try ketamine have already tried and failed other medications.
Ketamine can provide a catalyst for change, lifting depression and minimizing pain and allowing people to more easily engage in other activities that will protect against relapse. People wake up and realize how much time was lost to their illness, how much money was spent, how many relationships ruined, how many opportunities missed. We encourage regular exercise and movement, healthy eating, socialization, behavioral activation, work/life balance, addressing activities or relationships that clash with personal values and setting better boundaries.
A Psychedelic Renaissance is underway causing a paradigm shift where science and spirituality meet. Psychedelics literally means “mind manifesting.” Cannabis is now legal for medical purposes in 33 states. Entheogens are psychoactive substances in a spiritual context such as psilocybin (magic mushrooms), MDMA (ecstasy), mescaline derived from peyote (Ayahuasca), ibogaine, mescaline, DMT. They are classified as Schedule 1 drugs yet the government is greenlighting research. Rapid changes to embracing psychedelic substances by mainstream medicine is happening. With research not just anecdotes, we are understanding that altered states of consciousness can lead to profound insight, psychospiritual exploration, personal development, and emotional release.
This helps one open his/her mind to new perspectives, improve motivation, become more engaged and focused in therapy, feel comfortable sharing past traumas, and change repetitive maladaptive behaviors.
Dr. Michelle Weiner collaborates with Mindful Psychedelics and Cannected Wellness.
Dr. Weiner is the Vice President of Mr Psychedelic Law, a not-for-profit with the mission of responsible legal reform of psilocybin mushrooms in Florida.
Of the 60 randomized participants who received a single ketamine (0.1, 0.5, or 1.0 mg/kg) infusion, 19 (34%) met criteria for remission and 27 (48%) for response, on day 3 post-infusion.
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CBT may sustain the antidepressant effects of ketamine in treatment-resistant depression. Well-powered randomized controlled trials are warranted to further investigate this treatment combination as a way to sustain ketamine's antidepressant effects.
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This randomized controlled trial provides the first evidence of efficacy of repeated ketamine infusions in reducing symptom severity in individuals with chronic PTSD. Further studies are warranted to understand ketamine’s full potential as a treatment for chronic PTSD.
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Ketamine’s antidepressive effects require activation of opioid receptors in the brain, a new Stanford study shows. The surprising finding may alter how new antidepressants are developed and administered in order to mitigate the risk of opioid dependence.
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Yale psychiatrists, pioneers of ketamine research, shed light on new FDA approval. On March 5, the Food and Drug Administration (FDA) approved the first truly new medication for major depression in decades. The drug is a nasal spray called esketamine, derived from ketamine—an anesthetic that has made waves for its surprising antidepressant effect.
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Here are some key points from this comprehensive review: Ketamine Assisted Psychotherapy (KAP) utilizes a dosage escalation strategy to achieve different levels of trance increasing to full out-of-body experiences. We begin with the sublingual induction of the trance state to find an individual “sweet spot” with respect to dosage that can be replicated at home under supervision and used in future in office sessions to aid in psychotherapy.
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MDMA, the psychoactive drug sometimes known as ecstasy, is poised to become a powerful tool in the treatment of PTSD. In 2017, the U.S. Food and Drug Administration (FDA) designated MDMA-assisted psychotherapy as a breakthrough therapy.
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Recent research suggests that psilocybin causes changes in amygdala activity opposite to those seen in conventional antidepressant treatment.
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Ketamine Assisted Psychotherapy is a new and unique methodology with a rapidly growing group of practitioners participating in its development and practice. We have presented a view of its current status combining data from three different related centers, with attendant outcomes with correlations.
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As dozens of groups spread across the country with the purpose of decriminalizing entheogenic plants and fungi, a new group has emerged in Florida, Mr. Psychedelic Law, stacked with doctors, lawyers, spiritual leaders, lobbyists, therapists, and other industry-leading professionals. As explained on their website, the mission of Mr. Psychedelic Law is to use medical and spiritual research to drive responsible legal reform in Florida for psilocybin mushrooms and other entheogenic plants and fungi.
Read More
A Psychedelic Renaissance is underway causing a paradigm shift where science and spirituality meet. Psychedelics literally means “mind manifesting.” Cannabis is now legal for medical purposes in 33 states. Entheogens are psychoactive substances in a spiritual context such as psilocybin (magic mushrooms), MDMA (ecstasy), mescaline derived from peyote (Ayahuasca), ibogaine, mescaline, DMT. They are classified as Schedule 1 drugs yet the government is greenlighting research. Rapid changes to embracing psychedelic substances by mainstream medicine is happening.
Read More
Psychedelic drugs seem to be everywhere lately. The Silicon Valley glitterati are all a-twitter about "microdosing" with LSD and magic mushrooms to improve creativity. Nicole Kidman's character in the fictional Hulu series Nine Perfect Strangers doses her guests' morning smoothies with psilocybin. And new documentary films on psychedelics seem to drop almost monthly. But would the FDA really approve drugs for medical use that are mainly known as party drugs? The answer may surprise you.Read More
A new study conducted in Turku reveals how symptoms indicating depression and anxiety are linked to brain function changes already in healthy individuals.
First consultation covered by insurance
(all others accepted Out-of-Network)
— list updated often —
© 2023 Dr. Michelle Weiner, DO, MPH
Literature suggests that the use of virtual reality distraction for adjunctive pain control has been successful. In clinical settings and experimental studies, participants immersed in a virtual reality experienced reduced levels of pain, general distress/unpleasantness and reported a desire to use virtual reality again during painful medical procedures.
There has been research into the use of virtual reality distraction for adjunctive pain control with significant success. There has been growing evidence for the use of EEG for the measurement of pain. It has also been suggested that virtual reality could be used an alternative to marijuana and opioids for pain management. Further implications have been seen specifically among chronic pain sufferers. This is especially interesting since there is a reduced risk of addiction as is seen associated with marijuana and opioid use. This study aims to investigate the effect of virtual reality distraction on pain perception.
Additionally, we intend to create a body of open source content for potential use by other investigators utilizing similar tools.
The intervention has the potential to relieve chronic pain sufferers of their pain with a non-invasive mechanism and minimal risk. The participants may experience a temporary decrease in the perception of pain during the course of the experiment or a distraction from said pain.
Pending IRB approval at UM
The purpose of this study is to identify what is effective and safe for older adults with chronic pain to develop an understanding of what educational materials are required for facilitate access to appropriate products at medical marijuana treatment centers (MMTC).
Survey older adults (> 50 years) with chronic pain who have MM access cards and receive their product from state-approved dispensaries to document: demographic/health data; patterns of use; product specifics; pain effects on daily life; pain-related medical conditions; education prior to MM purchase; helpful and problematic effects of MM use.
The proportion of Florida’s population that is 60 and older is growing more rapidly than other components of the population. Musculoskeletal disorders with associated chronic pain are a common problem in later life. Symptom management in older adults, including chronic pain management can be challenging (Briscoe, 2018). Medications, especially opioids, can increase the risk of confusion, constipation, falls and injury (Briscoe,2018). Medical marijuana (MM) is often recommended by doctors in the treatment of these medical conditions, guided by state law that defines qualifying conditions.
Medical marijuana use among older adults is growing at a rate more rapid than younger age groups (Lum, et al, 2019). The 2016 National Survey on Drug Use and Health estimated a 2.9% prevalence of marijuana use among this older population. However, the survey did not ascertain if use was for medical or recreational purposes (Han et al., 2016). Older adults may have important differences in pathophysiology, pharmacological interaction of medications, comorbid conditions, and toxicological responses to cannabis.
There is little evidence to evaluate the differences associated with medical marijuana use among older adults, such as individual reasons for use and problems arising with use (Haug et al., 2017).
Chronic pain is a major public health problem. Approximately 178 million (41%) adults in the U.S. age 18 and older suffer from at least one painful health condition (Nahin, et al, 2019).
In Florida, there are 327,492 medical marijuana card holders and chronic non-malignant pain was the No. 1 diagnosis for which patients are registered (The Florida Department of Health, Office of Medical Marijuana Use, 2020). Yet, it is not a qualifying condition, creating challenges for physicians wishing to support patient use of MM for chronic pain.
Chronic pain accounted for nearly 34 percent of diagnoses at certified dispensaries (The Florida Department of Health, Office of Medical Marijuana Use, 2019).
