Pain is one of the most common complaints among patients visiting the ER, and pain management has become a quality of care indicator. But the options available for the treatment of acute pain that isn’t controlled by over-the-counter medications are limited. With the opioid epidemic leading physicians to avoid prescribing narcotics, the anaesthetic drug, ketamine, is being reconsidered for the treatment of pain, as well as other indications. A practice article  in CMAJ argues that ketamine is an underutilized and effective analgesic and a safer alternative to opioids for the management of acute pain, with reported adverse effects at low doses occurring at the same frequency as placebo. In this episode, Blair and Mojola speak to Dr. William Silverstein, a co-author of the practice article “Five things to know about the use of ketamine in the treatment of acute pain” about ketamine’s indications and contraindications, how to prescribe it in the ambulatory care setting, and practical steps physicians can take to add ketamine to their pain-busting arsenal.They also speak with Dr. Marshall Ross, a physician who also uses ketamine as an emergency physician, but has also pioneered its use in patients with treatment-resistant depression, using cutting edge techniques.