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Condition · Chronic Pain

Ketamine infusion therapy for chronic pain in DC, Maryland & Virginia

Chronic pain can limit your mobility, strain relationships and take over daily life — and for many, it becomes a lifelong burden standard treatments have not fully resolved. Ketamine interrupts pain signaling in a different way than opioids, with some patients feeling relief after the very first infusion.

Book a free consult(301) 381-8381
Comfort items for a long infusion session
10+ yrsTreating patients in the DMV
4.9★Average Google rating
5Clinics across DC, MD & VA
1,000+Patients treated to date

Ketamine treats chronic pain on two fronts: it interacts with opioid receptors to raise your pain threshold, without the addictive properties of opioids, and it blocks NMDA receptors that make an overactive nervous system more sensitive to pain. At Avesta, we follow the Johns Hopkins protocol — 3 to 5 infusions over consecutive days, each four hours long, customized to your specific pain condition and history.

You may recognise yourself here

If several of these describe your last few months, a consult is worth thirty minutes of your time.

  • Pain that persists for months or years despite standard treatment
  • Pain that limits your mobility or strength for everyday tasks
  • Relying on opioids, or considering them, with concerns about dependence
  • Pain flares that derail work, sleep or relationships
  • A diagnosis like CRPS, fibromyalgia, Ehlers-Danlos syndrome or long-COVID pain
  • Pain following surgery that has not resolved as expected
  • Migraines that have not responded to standard treatment
  • Nerve pain that feels like burning, shooting or electric sensations

And you have already tried things

  • Opioid medications that come with dependence risk or diminishing returns
  • Physical therapy or nerve blocks with limited or temporary relief
  • Being told there is nothing more to try beyond managing the pain
  • Multiple specialists without a plan that actually moved the needle

That history matters — it is exactly what makes a different mechanism worth considering.

Why It Persists

Why chronic pain can stall — and how ketamine works differently

A different target than opioids

Ketamine interacts with some of the same opioid receptors in your central nervous system that opioid medications affect, raising your pain threshold. Unlike opioids, ketamine has no physical addictive properties.

Quieting an oversensitive nervous system

Ketamine also blocks N-methyl-D-aspartate (NMDA) receptors, which make your nervous system more sensitive to pain. Interrupting these misfiring signals is part of why relief can begin as early as your first infusion.

The Johns Hopkins protocol

We follow the Johns Hopkins protocol for ketamine and chronic pain: 3 to 5 infusions over consecutive days, each about four hours long, with the possibility of feeling relief right after your first session.

Customized to your pain, not a template

We treat pain related to complex regional pain syndrome (CRPS), fibromyalgia, Ehlers-Danlos syndrome, migraines, long COVID, Lyme disease, pre- and post-surgical pain and opioid withdrawal symptoms, among others — your plan is built around your specific diagnosis.

A clinician stays with you and monitors vitals for the entire session — never a room left unattended.

How Avesta Treats It

Our treatment options

We do not sell one package to everyone. After screening, your clinician builds a plan around your specific pain diagnosis and history.

Johns Hopkins protocol

IV Ketamine Infusions

Our primary treatment for chronic pain

  • 3 to 5 infusions over consecutive days
  • Each session is about four hours, with supporting medications alongside ketamine
  • Some patients feel relief after the very first infusion
  • Customized to your specific pain diagnosis
Treatment details →

IV Vitamin Infusions

Nutrient-rich infusions that support your body's broader recovery alongside pain treatment

  • Complements your ketamine protocol
  • Tailored to your individual needs
  • Delivered same-day at most clinics
Treatment details →

Integration Coaching

For the toll chronic pain takes beyond the physical

  • 1:1 sessions between infusions
  • Coping strategies and pacing work
  • Support adjusting daily routines as pain changes
Treatment details →

What To Expect

From first call to maintenance, step by step

  1. 01

    Free 30-minute consult

    A clinician reviews your pain history, prior treatments and current medications, and tells you candidly whether ketamine is a reasonable next step. No referral needed, no cost, no obligation.

  2. 02

    Medical screening

    Blood pressure, cardiac history and current prescriptions are reviewed before anything is scheduled.

  3. 03

    Your first infusion

    Sessions run about four hours in a private room with a clinician present. Arrive with a ride home arranged — some patients feel relief the same day.

  4. 04

    The full protocol

    3 to 5 infusions delivered over consecutive days, following the Johns Hopkins protocol, customized to your pain diagnosis.

  5. 05

    Reassessment

    Your provider evaluates your response against your baseline and adjusts the plan accordingly.

  6. 06

    Maintenance

    Booster infusions scheduled by response, not by package. If you are not responding, we say so and help you look at other options.

Free 30-Minute Consult

  • No cost, no referral needed
  • Benefits checked up front
  • A clinician on every call
Book my consult(301) 381-8381

Please do not include medical details in web forms. In a crisis, call 988.

Other Conditions We Treat

Dr. Ladan Eshkevari, PhD, CRNA, FAAN, founder of Avesta Ketamine and Wellness, with a patient
Who Sets Our Protocols

Dr. Ladan Eshkevari, PhD, CRNA, FAAN

Founder & Co-CEO · Georgetown University faculty

Dr. Eshkevari led a study with her Georgetown graduate students published in the Journal of Psychiatric Research, supporting ketamine therapy for people living with treatment-resistant depression. She sets the clinical protocols used at every Avesta clinic.

Read the published study (PDF)Watch her interview

Patient Reviews

What real patients say on Google

ExcellentBased on 225 reviews
Write a review
Amy GutierrezAugust 18, 2026BethesdaGoogle
I have had the pleasure of going to 3 locations- Bethesda, Tyson, and DC. Every experience has been phenomenal and the staff makes sure you are heard and happy. Both before the infusion and afterwards. They are all amazing and have the best bedside manners!
Wendy LaffermanSeptember 25, 2026ColumbiaGoogle
This was my first visit to Avesta for a Ketamine infusion for chronic migraine pain comorbid with mental health diagnosis.

Coming in with a lot of anxiety due to past experiences, I was greeted by Nyla who was kind, patient, and empathetic throughout my entire visit. She was there to answer any questions I had. The environment was quiet and peaceful; with a sign as a reminder.

My practitioner, Nate, was amazing. He was caring and intentional. Communicated every step of the process and eased all my fears; specifically getting the IV on the first stick!! Both checked in on me often throughout the infusion to ensure I was having the best possible experience.

I’m incredibly grateful that I found this place and am looking forward to my next visit!
Kate GowingAugust 2, 2026Norfolk/Virginia BeachGoogle
Great treatment, been coming to Avesta in DC for a while. Glad they finally opened closer to me.
Spencer AgostiniAugust 2, 2026TysonsGoogle
Avesta is the best ketamine clinic in Northern Virginia. I did my research and I'm so glad I decided to go with Avesta.
Matthew ConnorsSeptember 10, 2026Washington DCGoogle
Nice atmosphere, professional staff that are also warm and friendly. I won't go anywhere else.
Paul ThompsonJuly 3, 2026BethesdaGoogle
Meghan was well informed, polite, answered all of my questions clearly and in the context of our conversation she provided information she discerned to be important to me.
Toby KatesAugust 2, 2026ColumbiaGoogle
Excellent clinic for Spravato treatments, they are so friendly and welcoming.
Carole WilkinsFebruary 10, 2026TysonsGoogle
As always the experience was top notch. Nate and Gillian saw to it that my needs were met and questions answered. I always feel like I’m in the best hands when I’m there. These treatments are life savers for me.
Elsa AlaswadJuly 18, 2026Washington DCGoogle
This place is a haven for me. What makes it the most special are the people who work here, especially Abigail and Arielle. They make the whole experience feel safe and comfortable. Abigail is a wonderful and caring future physician who makes you feel right at home. She’s a joy to have around. Arielle is an expert at IV placement in addition to being an amazing healthcare provider with impeccable bedside manner. I love to see she’s the NP on because I know I’m gonna be in extremely capable hands. Avesta is my happy place. Thank you for making my life better.
D SMay 3, 2026BethesdaGoogle
Excellent service and facility.
Carolyn ErwinAugust 1, 2026ColumbiaGoogle
No complaints. Always feel better after my sessions!
B CJanuary 16, 2026TysonsGoogle
I love this place. It’s comfortable and the staff is so nice. Dion Gillian and Mimi are the best. I highly recommend them.

What The Care Looks Like

Measured, not promised

Days, not weeksTypical onset

Some patients feel relief after their very first infusion.

3–5 infusionsJohns Hopkins protocol

Delivered over consecutive days, each session about four hours long.

8+ conditionsPain types treated

From CRPS and fibromyalgia to post-surgical pain and migraines.

Individual results vary. Ketamine is not FDA-approved for chronic pain management and is used off-label for this indication, following protocols such as the Johns Hopkins ketamine infusion protocol. Nothing here is a promise of outcome or a substitute for evaluation by a clinician.

Candidacy

You may be a candidate if…

Screening happens before anything is booked. Being told no is a legitimate outcome of a consult.

Likely a good fit

  • You have a diagnosed chronic pain condition lasting months or longer
  • Standard treatments (medication, physical therapy, nerve blocks) have not given you enough relief
  • Your blood pressure and cardiac history are stable or well managed
  • You can arrange a ride home after each session (sessions run about four hours)
  • You can commit to 3 to 5 consecutive treatment days for the initial protocol

We would pause or refer out if

  • Uncontrolled high blood pressure, or recent heart attack or stroke
  • Active, untreated psychosis or mania
  • Pregnancy or breastfeeding
  • Active, unmanaged substance use — we will help you sequence care first
  • A history that points to a different treatment; we refer out rather than sell you a series

Safety standards on every visit

  • Full medical and psychiatric history reviewed before your first visit
  • A clinician is present and vitals are monitored for every dose
  • Emergency protocols and medications on site at every clinic
  • LegitScript-certified practice, REMS-certified for Spravato
  • Written coordination with your therapist, psychiatrist and primary care team

Insurance & Cost

In plain terms, before you commit

We verify your benefits and give you an out-of-pocket estimate on your consult call.

Spravato

In-network with many commercial plans. We run your benefits and give you an out-of-pocket estimate before you commit to anything.

IV ketamine

Generally out-of-network. We provide superbills for reimbursement claims and HSA/FSA funds are usually eligible.

Veterans & military families

We work with VA Community Care and TRICARE, and our Hampton Roads clinic serves military families directly.

Federal employees

Discounted pricing is available for terminated federal employees — ask on your consult call.

Locations

Our Ketamine Clinics in Washington, DC, Maryland & Virginia

Every Avesta location is staffed by a licensed clinician for every session.

Washington, DC clinic
Washington, DC

1400 16th St NW, Suite 101

(202) 735-1183
Bethesda, Maryland clinic
Bethesda, Maryland

4833 Rugby Ave, #400

(301) 200-9333
Columbia, Maryland clinic
Columbia, Maryland

5840 Banneker Rd, Suite 270

(301) 381-8381
Tysons, Virginia clinic
Tysons, Virginia

8000 Towers Crescent Dr, Suite A150

(703) 646-6343
Norfolk / Virginia Beach, Virginia clinic
Norfolk / Virginia Beach, Virginia

6275 E. Virginia Beach Blvd, Suite 103

(301) 381-8381

FAQs

Common questions about chronic pain

Is ketamine FDA-approved for chronic pain?

No. Ketamine is FDA-approved as an anesthetic; its use for chronic pain management is off-label, though it is supported by protocols developed at institutions like Johns Hopkins. On your consult we explain what the evidence supports for your specific condition.

What is the treatment protocol?

We follow the Johns Hopkins protocol: 3 to 5 infusions over consecutive days, each about four hours long. Some patients feel relief after the first infusion; the full protocol is recommended for the most complete response.

What kinds of pain can ketamine treat?

We treat pain related to complex regional pain syndrome (CRPS), fibromyalgia, Ehlers-Danlos syndrome, migraines, long COVID, Lyme disease, pre- and post-surgical pain and opioid withdrawal symptoms, among others.

Is ketamine addictive like opioids?

No. Ketamine interacts with some of the same opioid receptors that raise your pain threshold, but it has no physical addictive properties, unlike opioids.

What does a session actually feel like?

Most people describe a floaty, dreamlike state with altered sense of time and body. It is not painful and you remain able to communicate with the clinician in the room. Nausea and mild dizziness are the most common side effects and are treatable on the spot.

How much does it cost?

IV ketamine for pain is typically out-of-network, and we provide superbills for reimbursement claims. We verify your benefits and quote your out-of-pocket cost before you schedule — no surprise billing.

Do I need a referral?

No. You can book a free consult directly. If you have a pain specialist or primary care provider, we will ask permission to coordinate with them, because outcomes are better when your care team is aligned.

Which clinic should I go to?

We have five: Washington DC, Bethesda, Columbia, Tysons and Norfolk/Virginia Beach. Not every clinic offers every treatment, so we match you to the nearest location that offers the route you need.