Uncloseted Media published this article on Jan. 24.

This story was produced with the support of MISTR, a telehealth platform offering free online access to PrEP, DoxyPEP, STI testing, Hepatitis C testing and treatment and long-term HIV care across the U.S. MISTR did not have any editorial input into the content of this story.

This story talks about addiction and substance use. If you or someone you know needs help, resources can be found here.

By SAM DONNDELINGER | In 2015, on the patio of Nowhere Bar, a queer nightclub in Louisville, Ky., music pulsed and bodies pressed as 23-year-old Lucas Pearson moved through the flashing lights and a blur of grinding limbs.

“I just randomly started talking to this guy,” he recalls. “He had this little spoon on a necklace, scooped out a hit of white powder, and handed it to me.”

Pearson sniffed it. Euphoria washed over him, time began to slow and the dancing bodies faded into a soft haze. For more than 10 minutes, Pearson felt “entirely present.” His social anxiety, depression, and any sadness he was feeling melted away.

While Pearson wouldn’t use ketamine again for the next five years, he says the feeling of ease the drug gave him was always “in the back of [his] mind.” So when he tried it for a second time in 2020 at a farm in upstate Kentucky, he liked the way it felt to disassociate from his childhood trauma.

“We got really messed up that night on it, and I was like, ‘I love this. I’ve missed this,’” Pearson told Uncloseted Media. “‘And I’m ready for some more.’”

Over the next three years, Pearson began using every day. Working remotely in the health care industry, no one checked in on him as long as he got his work done. He used ketamine at nightclubs, social events, game nights with friends and, eventually, at home alone.

“I was actively hooked on it,” he says. “I didn’t wanna do much of anything other than find that dissociating feeling. I just kept chasing it.”

While evidence suggests that most psychedelics have a lower risk of addiction than other drugs, ketamine is an exception, in part because it affects dopamine levels. In a 2007 bulletin from the Multidisciplinary Association for Psychedelic Studies, one researcher noted that after ketamine was invented in 1962, it developed a “reputation for insidiously trapping those who really knew better.” As a dissociative drug, ketamine induces a sense of detachment from one’s body, producing a trance-like state marked by pain relief, amnesia, euphoria, and a distortion of reality.

Despite declines in the use of other recreational drugs such as cocaine, ecstasy and nitrous oxide, ketamine use continues to rise, with one study finding that use increased by 81.8 percent from 2015 to 2019 and rose another 40 percent from 2021 to 2022. That increase is driven in part by ketamine’s growing legitimacy as a treatment for depression, anxiety, OCD, trauma, and even addiction.

As a result, ketamine clinics have proliferated across the U.S. with relatively few guardrails. At least a thousand clinics now offer off-label ketamine treatments outside of FDA-approved protections. Many commercial providers advertise same-day appointments and “almost immediate results.”

Alex Belser, a psychologist who studies psychedelic use in the queer community, says ketamine use has become pervasive among gay men. A 2025 study found that gay and lesbian adults in the U.S. are almost four times more likely to use ketamine than their heterosexual counterparts, and a 2011 study from the U.K. found that queer men were over three times more likely than queer women to use the drug.

Belser thinks ketamine use is so popular among gay men in part because of the high rates of loneliness, rejection, and trauma they experience. “Ketamine is not inherently good or bad. When used thoughtfully with integrity, with good protocols, it can be a really helpful medicine. But if left unregulated, with the amount of access and normalization we have, it can lead to addiction, harm, isolation, and bad outcomes,” he says.

Belser believes health misinformation is fueling a misunderstanding among gay men about the actual harm the drug can cause. “The medical and clinical communities have failed people by not adequately telling them that ketamine can lead to addiction and problematic outcomes,” he says. “It can serve people, but it can also damage people.”

‘Happy people don’t do ketamine’

Part of the appeal of ketamine is that dissociative feelings can relieve depressive symptoms, making it alluring to those who have trauma or mental health disorders. While properly regulated treatment works for some people, psychiatrist Owen Bowden-Jones says that he senses “the vast majority [of those addicted] are using it to self-medicate for emotional distress.”

“I always wanted to numb out my past,” says Pearson. “For the longest time, I saw ketamine as a possible way out.”

Pearson, now 33, was raised in a conservative and religious family. When he came out as gay to his mom at 16, he cried so much that he couldn’t speak and had to write it on a piece of paper and hand it to her.

“She stormed out of the house and ended up calling every member of the family and outing me. So that was really painful,” he says. “My whole childhood, I did not feel like I could be who I knew I was.”

“So when I picked up drugs, it was definitely a thought in my mind: This life that I lived as a child, I don’t want to feel it anymore,” he says. “I just want to numb it.”

One study shows that gay men are over three times as likely to develop PTSD compared to their heterosexual counterparts. Trauma can be one event or a “long string of daily hurts, such as … homophobia, bullying, and time spent in the closet,” according to Chris Tompkins, a licensed family therapist who works with gay men. Research shows that people who experience trauma are more likely to have addiction issues.

J, a 33-year-old marketing researcher based in Los Angeles, says his ketamine use began casually in his early 20s in New York’s queer nightlife scene, where the drug circulated freely. What started as an occasional escape intensified during the pandemic, when isolation, depression, and easy access turned ketamine into a daily habit.

“There’s a pretty fair connection between feelings of not being normal and my ketamine addiction,” J told Uncloseted Media. “I was bullied for being more feminine. My sexuality was a subject of speculation and that forced me to close down. So something like a dissociative drug is appealing because it either allows me to continue those blocks or to bring down the barriers.”

“There was a night when I had done K for the first time in a while, and the next couple of days, I felt so good,” he says. “I felt like my depression had lifted, and that feeling of doubt and fear I’d had throughout my life was totally gone.”

After that night, J, who asked to use a first initial to protect his identity, started using ketamine daily to chase the feeling of euphoria and relief. He got a prescription for ketamine treatment therapy, but he says it wasn’t enough.

“There were days when I would go do an infusion of ketamine and I would do more at home on my own. If I have the ability to escape feelings, to numb feelings, I will go after that.”

Many ketamine clinics in the U.S. advertise ketamine therapy as a cure-all. For example, the online clinic Better U promises that ketamine therapy will help you say goodbye to “Trauma,” “Chronic Stress,” “Depression and Anxiety,” “OCD,” “PTSD” and “Grief.”

What the clinic doesn’t note on its landing page is the possibility of addiction, which is what happened to J. While a common dose of ketamine is between 30-75 mg, J began using multiple grams a day. He spent thousands of dollars a month on ketamine and began structuring his life around the drug. “It stopped being about going out or having fun,” he says. “It just became what I did day in and day out.”

“Happy people don’t do ketamine,” Tasha, who is in recovery from a six-year-long addiction, told Uncloseted Media. She first tried the drug for fun at 17, but it became a problem after her father died when she was 26. At her peak, she was taking six to nine grams every day and up to 24 grams over the weekends.

“The wheels just fell off,” she says. “It’s an escapism drug — of course people with more trauma will do it more. You want to forget about everything so you take it and then it stops becoming fun and you don’t want to see your friends anymore. You just stay in your home behind closed doors sniffing K to get out of your head.”

The physical consequences of ketamine

Tasha didn’t know that chronic ketamine use can cause inflammation, ulceration, and damage or scarring to the bladder, liver, kidneys, and gallbladder. After using it for six years, she checked herself into the intensive care unit.

“I was just writhing in pain from K cramps, like a sharp stabbing pain under your ribs,” she says. “The trouble is, nothing works to fix them. The only thing that helps is doing more K. I had no idea it was so painful,” says Tasha, adding that she’s seen four people die from ketamine addiction in the last three years.

“There were times in my use where I would be screaming in bed in the worst agony I’ve ever felt in my life,” J says. “The only thing that made the pain better was using more drugs. It got to the point that I needed to have some amount of K in my system to function.”

“There is a massive explosion of ketamine use and addiction,” Mo Belal, a consultant urological surgeon and an expert on the severe bladder and kidney damage caused by chronic ketamine abuse, told Uncloseted Media. “The trouble is, it’s impossible to treat bladder and kidney damage when people are still using.”

Belal says that for those seeking treatment, there are no specific ketamine rehabilitation programs in the U.S. “Addiction and pain management services need to be involved in healing from ketamine abuse, because the drug’s effects often require specialized support.”

Belal says that during a one-hour rehab session, someone experiencing severe ketamine-related bladder pain might need to leave every 20 minutes, making it difficult for the patient to stay engaged.

“We need more awareness,” he says. “We need more centers for ketamine rehabilitation.”

Education and awareness

While there is some research about the effects of ketamine, Belser could not point to any studies that focus on how the drug intersects with gay men experiencing trauma. “The community of ketamine researchers and prescribers has been naive historically in understanding the habit-forming properties of ketamine,” he says. “What are the effects of ketamine use, good or bad, for gay men experiencing trauma, lifelong discrimination, and family rejection? We don’t know, because critical research hasn’t been funded.”

The Drug Enforcement Administration classifies ketamine’s abuse potential as moderate to low, a designation that may contribute to limited public education about its risks, including dependence and long-term side effects. Many people who encounter ketamine on the dance floor think it’s a healthy alternative to alcohol because they believe it’s non-addictive and it doesn’t give you a hangover.

“I did think that it was pretty safe when I was using and I didn’t think it was going to be addictive,” Pearson says.

Pearson, who has been clean for two years, says it wasn’t until he reached out to a friend who had recovered from ketamine use that he began getting clean. “I saw how happy my friend was in recovery, how normal his life felt. … And I knew that was the life I wanted.”

Similarly, for J, he felt alone in his ketamine addiction. It wasn’t until he found a queer-centered substance rehab program in LA that he felt some hope.

“It helped patch some of the missing pieces to my experiences in treatment before,” he says. “I think that relapse is a part of every addict’s story and every recovery story. But I think my relapses indicated that I still had some unresolved trauma and deep wounds that I hadn’t been aware of yet. And I think being around queer people in recovery has been helpful for me to feel a lot more comfortable with myself.”

Today, J is in therapy, continuing to break down the walls of his childhood trauma. Pearson is in a 12-step program after doing intensive therapy in his first few months of sobriety to help “clear up a lot of traumatic things that happened” in his past.

“I finally realized how far I’d drifted from everyone in my life — my friends, my family, even myself,” Pearson says. “I was chasing this feeling of disappearance, and it almost cost me everything. If I hadn’t stopped when I did, I don’t think I’d still be here. Getting sober gave me my life back, and I don’t ever want to lose that again.”

Russia has designated a global LGBTQ and intersex rights group as an “undesirable” organization.

ILGA World in a press release notes the country’s Justice Ministry announced the designation on its website on Jan. 21.

The ministry’s website on Tuesday appeared to be down when the Washington Blade tried to access it. ILGA World in its press release said the designation — “which also reportedly includes eight other organizations from the United States and across Europe” — “has been confirmed by independent sources.”

“ILGA World received no direct communication of the designation, whose official reasons are not known,” said ILGA World.

The Kremlin over the last decade has faced global criticism over its crackdown on LGBTQ rights.

ILGA World notes Russians found guilty of engaging with “undesirable” groups could face up to six years in prison. The Russian Supreme Court in 2023 ruled the “international LGBT movement” is an extremist organization and banned it.

“Designating human rights groups ‘undesirable’ is outlandish and cynical, yet here we are,” said ILGA World Executive Director Julia Ehrt. “But no matter how much governments will try to legislate LGBTI people out of existence, movements will stay strong and committed, and solidarity remains alive across borders. And together, we will continue building a more just world for everyone.”

‘The Director’
By Daniel Kehlmann
Summit Books, 2025

Garbo to Goebbels, Daniel Kehlmann’s historical novel “The Director” is the story of Austrian film director G.W. Pabst (1885-1967) and his descent down a crooked staircase of ambition into collaboration with Adolph Hitler’s film industry and its Minister of Propaganda Joseph Goebbels. Kehlmann’s historical fiction is rooted in the world of Weimar German filmmaking and Nazi “Aryan” cinema, but it is a searing story for our challenging time as well.

Pabst was a legendary silent film director from the Weimar Republic’s Golden Era of filmmaking. He “discovered” Greta Garbo; directed silent screen star Louise Brooks; worked with Hitler’s favored director Leni Riefenstahl (“Triumph of the Will”); was a close friend of Fritz Lang (“Metropolis”); and lived in Hollywood among the refugee German film community, poolside with Billy Wilder (“Some Like it Hot”) and Fred Zinnemann (“High Noon”) — both of whose families perished in the Holocaust. 

Yet, Pabst left the safety of a life and career in Los Angeles and returned to Nazi Germany in pursuit of his former glory. He felt the studios were giving him terrible scripts and not permitting him to cast his films as he wished. Then he received a signal that he would be welcome in Nazi Germany. He was not Jewish.

Kehlmann, whose father at age 17 was sent to a concentration camp and survived, takes the reader inside each station of Pabst’s passage from Hollywood frustration to moral ruin, making the incremental compromises that collectively land him in the hellish Berlin office of Joseph Goebbels. In an unforgettably phantasmagoric scene, Goebbels triples the stakes with the aging filmmaker, “Consider what I can offer you….a concentration camp. At any time. No problem,” he says. “Or what else…anything you want. Any budget, any actor. Any film you want to make.” Startled, paralyzed and seduced by the horror of such an offer, Pabst accepts not with a signature but a salute: “Heil Hitler,” rises Pabst.  He’s in.

The novel develops the disgusting world of compromise and collaboration when Pabst is called in to co-direct a schlock feature with Hitler’s cinematic soulmate Riefenstahl. Riefenstahl, the “Directress” is making a film based on the Fuhrer’s favorite opera. She is beautiful, electric and beyond weird playing a Spanish dancer who mesmerizes the rustic Austrian locals with her exotic moves. The problem is scores of extras will be needed to surround and desire Fraulein Riefenstahl. Mysteriously, the “extras” arrive surprising Pabst who wonders where she had gotten so many young men when almost everyone was on the front fighting the war. The extras were trucked in from Salzburg, he is told, “Maxglan to be precise.” He pretends not to hear.  Maxglan was a forced labor camp for “racially inferior” Sinti and Roma gypsies, who will later be deported from Austria and exterminated. Pabst does not ask questions. All he wants is their faces, tight black and white shots of their manly, authentic, and hungry features. “You see everything you don’t have,” he exhorts the doomed prisoners to emote for his camera. Great art, he believes, is worth the temporal compromises and enticements that Kehlmann artfully dangles in the director’s face.  And it gets worse.

One collaborates in this world with cynicism born of helpless futility. In Hollywood, Pabst was desperate to develop his own pictures and lure the star who could bless his script, one of the thousands that come their way.  Such was Greta Garbo, “the most beautiful woman in the world” she was called after being filmed by Pabst in the 1920s. He shot her close-ups in slow motion to make her look even more gorgeous and ethereal. Garbo loved Pabst and owed him much, but Kehlmann writes, “Excessive beauty was hard to bear, it burned something in the people around it, it was like a curse.” 

Garbo imagined what it would be like to be “a God or archangel and constantly feel the prayers rising from the depths. There were so many, there was nothing to do but ignore them all.”  Fred Zinnemann, later to direct “High Noon”, explains to his poolside guest, “Life here (in Hollywood) is very good if you learn the game.  We escaped hell, we ought to be rejoicing all day long, but instead we feel sorry for ourselves because we have to make westerns even though we are allergic to horses.”

The texture of history in the novel is rich. So, it was disappointing and puzzling there was not an original gay character, a “degenerate” according to Nazi propaganda, portrayed in Pabst’s theater or filmmaking circles. From Hollywood to Berlin to Vienna, it would have been easy to bring a sexual minority to life on the set. Sexual minorities and gender ambiguity were widely presented in Weimar films. Indeed, in one of Pabst’s films “Pandora’s Box” starring Louise Brooks there was a lesbian subplot. In 1933, when thousands of books written by, and about homosexuals, were looted and thrown onto a Berlin bonfire, Goebbels proclaimed, “No to decadence and moral corruption!” The Pabst era has been de-gayed in “The Director.”

“He had to make films,” Kehlmann cuts to the chase with G.W. Pabst. “There was nothing else he wanted, nothing more important.” Pabst’s long road of compromise, collaboration and moral ruin was traveled in small steps. In a recent interview Kehlmann says the lesson is to “not compromise early when you still have the opportunity to say ‘no.’” Pabst, the director, believed his art would save him. This novel does that in a dark way.

(Charles Francis is President of the Mattachine Society of Washington, D.C., and author of “Archive Activism: Memoir of a ‘Uniquely Nasty’ Journey.”)

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