Mourning The Vivienne: Defining Abuse vs. Therapeutic Use of Ketamine

The recent passing of James Lee Williams has cast a somber shadow on the many communities they touched. Known to most as “The Vivienne” (the first winner of RuPaul’s Drag Race UK), they were beloved by countless fans, particularly in the LGBTQ+ community. James’s family recently announced that James lost their life at just 32, with their family sharing that their passing was due to “the effects of taking ketamine.”.

Without publicly released autopsy results, there is no certainty as to whether additional substances or existing medical issues could have worsened the situation leading up to their passing. Regardless, this heartbreaking event underscores the need to distinguish between the abuse and controlled, therapeutic use of ketamine.

A Tale of Two Ketamines

Originally developed as an anesthetic, IV ketamine has revolutionized the treatment of depression. There are now 30 years of clinical research supporting its safe, effective use for the treatment of Major Depressive Disorder and the depressive symptoms of Bipolar Disorder. When administered intravenously in a clinical setting, ketamine can relieve symptoms of depression for patients otherwise unresponsive to traditional approaches like SSRIs and psychotherapy. At Ember Health, we’ve treated over 2,000 patients with IV ketamine, and relieved depressive symptoms for 84% of our patients.

Ketamine can be administered safely in a clinic, with a very low risk of serious side effects. However, its potential for recreational misuse presents real dangers. Dispelling its stigma requires distinguishing these two very real faces of ketamine.

The Dangers of Non-Medical Ketamine

Non-medical use of ketamine can be associated with many health risks. Taken daily, in very high doses, ketamine can lead to sedation, memory problems, anxiety, addiction, and emotional instability. Long-term misuse can result in cognitive impairments and bladder damage. From the death of Matthew Perry (due to drowning while under the influence of ketamine), to the untimely loss of The Vivienne, there have been tragic repercussions of non-medical ketamine abuse among partygoers and celebrities, especially within the LGBTQ+, music, and tech communities.

Tragic consequences of ketamine’s abuse have begun to obscure its therapeutic benefits for patients who suffer from depression or bipolar disorder. Evidence also even points to ketamine as beneficial in treating Substance Use Disorders.

The field of mental health is in a challenging moment where the very drug we use to offer relief from darkness has a dark side when misused.

Therapeutic IV Ketamine: A Controlled Approach at Ember Health

Therapeutic use of ketamine involves thoughtful patient screening and clear protocols to ensure efficacy and patient safety. At Ember, we’ve rooted every detail of care over the past eight years in the most up-to-date literature in our field. Our protocols have drawn from the 2017 American Psychiatric Association (APA) consensus statements, decades of peer-reviewed evidence, and careful analysis of our own data from 30,000 safely administered treatments.

Led by Dr. Nico Grundmann, Ember’s Co-founder and Medical Director, our team practices a purpose-built methodology to maximize therapeutic benefits while minimizing risks. Our licensed healthcare professionals provide 1:1 medical supervision, monitor vital signs, and provide medical and psychological support when necessary. We tailor treatment to each individual’s medical history and health status to minimize risks. We check in with patients between visits, at least every two weeks, and collect data that enables us, our patients, and their care teams to make informed choices.

We partner closely with each patient’s care team—consisting of psychiatrists, psychologists, therapists, and primary care providers—to ensure the proper emotional and behavioral support for patients in conjunction with their ketamine care.

This structured approach contrasts sharply with uncontrolled, non-medical use. You will not find fentanyl or amphetamines in medical-grade ketamine. Recreational use has a risk profile astronomically higher than medical use.

A Call for Awareness, Caution, and Queer Competency

The Vivienne’s untimely death serves as a poignant realization of the potential consequences of ketamine misuse—and how it can claim talented creative minds among us.

It’s also a reminder that the queer experience is too often affected by substances—of which The Vivienne publicly spoke in 2019 regarding her addiction to “party drugs.” The American Addiction Centers report that LGBTQ+ adults are over twice as likely as their heterosexual counterparts to use illicit drugs and almost twice as likely to suffer from a substance use disorder. On the other hand, Ember Health provides safe and effective ketamine treatments for those in need, and a supportive space for folks of all gender and sexual identities.

As we reflect on this tragedy, we reaffirm our dedication to educating and serving the public with the responsible use of ketamine, and we reaffirm our dedication to creating a safe, supportive space for folks of all gender identities and sexual orientations.

The neuroplastic, healing effects of ketamine are worth our collective attention—and its potential abuse demands precaution. We hope remembrance and responsible use preserve many lives to come.