At lower doses, ketamine acts a weak stimulant. When dosage increases, ketamine hits users as an intense psychedelic. As a dissociative drug, ketamine causes users to feel painlessness by impeding messages between the brain and body. Ketamine distorts perception and users often experience an effect known as "the K-hole" at high doses, where the reality of a user involves abstracted thought and pseudo-spiritual experiences. In fact, many ketamine users report depersonalization and de-realization, causing out-of-body or near death experiences. While some ketamine users find these dissociative effects pleasant, others experience them as a deep sense of loneliness or emptiness. Hallucinations, both visual and auditory, can also take place during a ketamine trip. Ketamine trips do not tend to lend themselves to social interaction at high doses, but are introspective experiences as users withdraw into themselves. Within 10 to 20 minutes, the effects of ketamine become discernable for users. Muscle paralysis sets in, making it difficult to move. Ketamine users often fall into a "trance" state, finding themselves encountering difficulty speaking and cognitively processing. Ketamine trips are short lived, lasting between 45 minutes and an hour and a half, depending on tolerance. Users often feel drained and exhausted after a ketamine trip and muscle aches often tend to set in as users come down from a ketamine high. Ketamine users experience temporary paralysis of the muscles, loss of physical coordination and become prone to accidental falls and injuries. Research studies indicate that ketamine addiction can lead to brain damage, particularly the formation of vacuoles, also known as "Olney’s lesions." Ketamine use does not usually result in overdoses from self-administered use, largely because unconsciousness sets in before the body reaches the level of overdose. However, if ketamine a user intakes ketamine from a third party, overdose can occur if dosage continues after loss of consciousness.

Buprenorphine

Buprenorphine is a partial agonist of opioid receptors that carries a low risk of overdose. Buprenorphine reduces or eliminates withdrawal symptoms associated with opioid dependence but does not produce the euphoria and sedation caused by heroin or other opioids. In 2000, Congress passed the Drug Addiction Treatment Act, allowing qualified physicians to prescribe Schedule III, IV and V medications for the treatment of opioid addiction. This bill created a major paradigm shift that allowed access to opioid treatment in general medical settings, such as primary care offices, rather than limiting it to specialized treatment clinics. Buprenorphine was the first medication approved under the Drug Addiction Treatment Act and is available in two formulations: Subutex®, which is a pure form of buprenorphine and the more commonly prescribed Suboxone®, which is a combination of buprenorphine and the opioid antagonist naloxone. Suboxone is a unique formulation with naloxone that causes severe withdrawal symptoms when addicted individuals inject it to get high. Physicians who provide buprenorphine treatment for detoxification and or maintenance treatment in office must have special accreditation. The government requires these physicians to have the capacity to provide counseling to patients when indicated or to refer patients to those who do. Treatment of opioid addiction in an office can be cost-effective approach that increases the reach of treatment and the options available to patients. Many patients have life circumstances that make treatment in the office of a physician a better option for than specialty clinics. For example, a recovering addict may live far away from a treatment center or have working hours incompatible with the clinic hours. Addiction treatment is available in the office of a primary care physician, psychiatrist and other specialists, such as internists and pediatricians. Patients stabilized on adequate, sustained dosages of methadone or buprenorphine can function normally. Recovering addicts can hold jobs, avoid the crime and violence of the street culture and reduce exposure to HIV by stopping or decreasing injection drug use and other risky sexual behavior. Patients stabilized on medications can also engage more readily in counseling and other behavioral interventions essential to recovery and rehabilitation.

OB/GYN

An obstetrician/gynecologist, commonly abbreviated as OB/GYN, can serve as a primary physician and often serve as a consultant to other physicians. OB/GYNs can have private practices, work in hospital or clinic settings, and maintain teaching positions at university hospitals. OB/GYNs may also work public health and preventive medicine administrations. Obstetrics and gynecology are the two surgical–medical specialties dealing with the female reproductive organs in their pregnant and non-pregnant state, respectively, and as such are often combined to form a single medical specialty and postgraduate training program. This combined training prepares the practicing OB/GYN to be adept at the surgical management of the entire scope of clinical pathology involving female reproductive organs, and to provide care for both pregnant and non-pregnant patients. Obstetrician/gynecologist is a physician specialist who provides medical and surgical care to women and has particular expertise in pregnancy, childbirth, and disorders of the reproductive system. This includes preventative care, prenatal care, detection of sexually transmitted diseases, Pap test screening, and family planning. An obstetrician is a medical doctor who specializes in the management of pregnancy, labor, and birth. They also receive specialized education in the health of the female reproductive system and surgical care. Much of their education focuses on the detection and management of obstetrical and gynecological problems. OB/GYNs have a broad base of knowledge and can vary their professional focus. Many develop unique practices, providing high-quality health care for women. OB/GYNs may choose to specialize in the following areas: An obstetrician closely monitors their patient's health during pregnancy and delivery. They diagnose fetus abnormalities or health issues of their patient and offer healthy living advice and treatment. They see their patients on a regular basis for health consultations, ultrasounds, and any of their patient's prenatal medical needs including forming a birth plan. The frequency of a patients check up often depends on risk factors and resources. Gynecology is a branch of medicine specializing in the disorders of the female reproductive system. Modern gynecology deals with menstrual disorders, menopause, infectious disease and development of the reproductive organs, disturbances of the sex hormones, benign and malignant tumor formation, and the prescription of contraceptive devices. A branch of gynecology, reproductive medicine, deals with infertility and utilizes artificial insemination and in-vitro fertilizations, a human egg fertilized in a test tube, and then implanted into the womb. Some gynecologists also practice obstetrics.

Executive Health

Executive Health Practitioner Associations are coming together to customize health programs for groups of executives and independent businesses with an objective of reducing the lost productivity time. At the core of many Executive Healthcare packages is an Executive Physical. In many instances, the doctor will travel to company facilities in order to perform a basic physical for all executive members. In others, as in the case of Elite IPA (Independent Practitioner Association), the office visit is an option, but executives are given the benefit of in-depth diagnostic treatment, which allows for an even more in-depth analysis of their health than what is typical. This level of the physical exam, given at a time that is convenient for the executive, is to have a positive impact on the bottom line. The average wait to see a physician is 68 minutes. There is no wait with the IPA Health associates for executives. IPA works around the schedule. Nor does IPA rush the visit. The visit is complete only when all of the concerns and questions answered. For those who prefer to communicate in writing, IPA is only an e-mail away. IPA physicians travel with hand-held e-mail devices for quick responses. Furthermore, IPA does not rush the visit. The visit is complete only when all of the concerns and questions are answered. Of course, there are times when one just wants to speak directly with the doctor on the telephone. One of the first things given to a new IPA patient is the doctor’s personal cell phone number. Wherever business or pleasure takes you, IPA is just a phone call away. Turn to IPA’s Executive Health for a complete executive physical that looks at health from all angles. True health and wellness is only achieved when there is a good understanding of the family history and personal medical history. IPA offers the latest in both non-invasive and blood-based cardiovascular screening testing. For early cancer detection, there may be reason to consider modern scanning approaches, including the PET technology. The integration of state-of-the-art cancer detection approach is a major feature of the program, as is ready access to leading specialists for preventive consultations.