In the United States, military veterans—especially those with PTSD symptoms—are among the most at-risk populations for suicide. The numbers are bleak and getting worse: According to data collected by the Veterans Administration, the suicide rate for veterans is more than double the general population and has “increased substantially” for veterans, ages 18 to 34, since 2005.

For Mike Zapolin (OPM 33, 2004), this was a seemingly intractable problem that deserved a radical solution. Zapolin, who goes by “Zappy,” is a longtime Internet brand investor who has become an advocate for alternative mental health therapies, including the use of psychedelics. In recent years, that has included exploring the use of ketamine as a treatment for depression, through the creation of the Ketamine Fund with his business partner, Warren Gumpel. Their goal is to make ketamine treatments more affordable and accessible. The opportunity for impact is massive, notes Zapolin. Depression affects more than 264 million people worldwide, according to the World Health Organization, which considers depression to be a leading cause of disability.

An FDA-approved anesthetic, ketamine has gained attention in recent years as an off-label medication for treatment-resistant depression. Zapolin says that unlike plant medicines that involve intense psychedelic explorations, ketamine has a short period of onset lasting about an hour, with an even briefer reintegration phase. And unlike commonly prescribed antidepressants, which can take weeks to have an effect, ketamine’s impact is almost immediate. It also seems to have particular potential as a counter to suicidal ideation.

“That’s the Western medicine approach that people need,” Zapolin says. In a clinical setting, a patient comes into a doctor’s office for a dose of ketamine and remains under the care of medical professionals for about an hour while the ketamine does its thing. Ketamine can induce out-of-body experiences, so a safe setting is an important part of the therapeutic process.

Yet exactly what the ketamine does during this process is not entirely clear. It appears to increase the amount of a neurotransmitter called glutamate, which then helps build new neural pathways in the brain. Ketamine has the potential, Zapolin says, to not only help reset the brain’s neurological functions, but also provide the means to reframe negative experiences in a more productive manner. That’s especially important for severely depressed people who may feel hopeless or suicidal.

As it set out to start treating the veteran community, the Ketamine Fund negotiated with a handful of clinics to make treatments more affordable. (Treatment usually entails six sessions spread out over several weeks, with booster treatments every few months.) The organization focused its attention on a clinic in Utah with a sizable veteran population. In December 2019, the Ketamine Fund announced it had paid for treatments for 400 veterans at Ketamine SLC to establish a pilot program.

“A lot of these guys were homicidal, suicidal,” Zapolin recalls. “One guy said he was on 22 medications. He’s down to zero medications, aside from coming in to do his booster meds. We gave him six free treatments. The first time he did the ketamine, he felt like he had hope. He said, ‘I went home and hugged my kids. I haven’t felt love like that in 10 years.’”

Zapolin hopes this is only the beginning. Because the pandemic has made in-person treatment a difficult proposition for many people, he and Gumpel are developing an at-home protocol, called KetaMD, which they plan to make available to the public in Q1 2021. Instead of administering the ketamine intravenously, they are experimenting with a lozenge that can be taken orally. Zapolin has also been taking meetings with corporate executives who have become increasingly worried about the mental health of employees who are working remotely during the pandemic.

“This is the starting point,” Zapolin says. He hopes to broaden the availability of the treatment dramatically, with a long-term goal of bringing suicide rates down by 75 percent. “We want it for everyone who needs it.”

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