Ketamine
Plenty of patients considering ketamine therapy have wondered: is this legal? How does the legality of ketamine affect my treatment?
Ketamine is legal when prescribed by licensed medical professionals in the United States. It has been in use for a variety of medical reasons since its invention in 1962. The more we study ketamine, the better doctors can tailor its use for their patient's health.
In just the past few years, there have been many clinical studies studying ketamine’s role as an antidepressant and as a non-opiate medication for the management of chronic pain. In light of these findings, doctors have begun prescribing ketamine-assisted psychotherapy as a treatment for depression, anxiety, PTSD, and chronic pain.
Ketamine has plenty of legal uses [1] when it is prescribed by a medical professional. Some of these uses are more common than others, but all of them have extensive research backing their uses.
Ketamine was originally synthesized to be used as a sedative and anesthetic during surgical procedures. It gained FDA approval in 1970 and is commonly used by doctors and veterinarians to this day. It has been found to be one of the most effective and safe medications commonly used for procedural sedation whether in the operating room, the emergency department, or in austere or wilderness environments.
Ketamine has also been shown to be useful for the treatment of depression and anxiety with much lower doses than those used for anesthesia. At these lower doses, patients do not lose consciousness or become dissociated, but they do experience some of the mind-altering effects that allow patients to form new neuronal connections that improves their moods, decrease both the depth and number of depressive episodes a patient experiences, and alleviate anxiety.
Ketamine is a schedule lll substance and is a regulated medication. It can only be legally used when it is prescribed by a licensed medical professional to ensure its appropriateness for the patient. Ketamine can be used as an anesthetic or as part of therapeutical treatment for certain mental illnesses.
Ketamine was approved by the Food and Drug Administration (FDA) as an anesthetic in 1970 and can be prescribed off-label by doctors for other indications. We discuss the term “off-label” further in the section below. In more recent years, the FDA approved intranasal esketamine in the treatment of depression for adults [2].
Ketamine is listed as a Schedule III drug in the Drug Enforcement Administration (DEA) guidelines [3]. Any drugs that are classified as schedules I through V count as controlled substances. Controlled substances aren’t necessarily harmful; they need to be closely monitored by a doctor due to various degrees of additional potential. Their rating is the result of a combination of factors including the potential for mental or physical addiction, the accepted stance of the medical community, and the risk of adverse side effects. These drugs all require prescriptions by licensed health professionals to be legally used.
Schedule III classification means that the drug has been widely accepted by the scientific community as having medicinal value and it is not unusual for a clinician to prescribe it to patients. However, ketamine is only legal when prescribed by a licensed medical practitioner.
Off-label is a term in medicine that means the medication is used to treat conditions outside of its original intent. In this case, ketamine was initially approved by the FDA for use as an anesthetic during surgical procedures. However, further research on the drug has indicated its effectiveness in treating other conditions such as depression, anxiety, chronic pain, and PTSD. When ketamine is prescribed by a doctor to treat one of those, or another, conditions, it is referred to as ‘off-label use of ketamine.
Off-label ketamine is legal everywhere in the United States. Many people misinterpret the phrase off-label as meaning shady or less than legal, but that is not the case. The reason that the phrase off-label exists is that when a medicine is approved by the FDA, that approval refers to one specific purpose. approval doesn’t refer to legality, but it does demonstrate that the drug has been thoroughly researched and proven to be effective for that indication. Other indications have not yet been fully evaluated by the FDA. Many commonly prescribed medications are used in their “off-label” indications, and many eventually get full FDA approval.
Recently, the FDA approved esketamine, a form of ketamine, for treating depression [3]. However, medical professionals can legally prescribe ketamine for anxiety, depression, and PTSD, as an off-label indication. Obtaining FDA approval typically involves a manufacturer of medication conducting a large study that costs quite a bit of money. These are done when the manufacturer thinks that they will make money on the drug, but often cheaper medications are continued to be used Off-label because there is no financial incentive to obtain the label indication for the drug.
Any use of ketamine outside of a licensed medical professional’s prescription is considered illegal. In the US, it is known as special K, baby food, kit kat, vitamin k, or K hole when sold on the streets for recreational use [4]. Recreational ketamine is often a much more high dose than the ketamine prescribed by doctors. Street ketamine is frequently used because of its euphoric properties, but prescription ketamine is prescribed at a much lower dosage.
In an unsupervised setting, ketamine can cause mild to serious adverse side effects like nausea, unpleasant dissociation, or dizziness. Additionally, street ketamine is often cut or mixed with other drugs which may increase the risk of serious negative side effects.
When you’re in the care of ISHA’s medical professionals, we take your safety seriously. Our practitioners are board-certified and will only prescribe you treatments that are scientifically backed and fully legal in the United States. You can have the benefits of ketamine therapy from the comfort of your own home. We are here to ensure that you have the best experience possible and to answer any questions you might have during the experience.
Contact us today at info@isha.health for more information about ketamine-assisted therapy and whether it is right for you.
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