Is Ketamine Therapy Legal? (Updated for 2023)

Ketamine has been around for a long time as an anesthetic — meaning it helps people sleep through painful procedures and operations. 

It’s also helped soldiers on the battlefield and florescent-clad partygoers at the club to remove themselves from their current situation and, occasionally, heal.

Today, there are so many options for ketamine therapy out there that it can feel difficult to know what to trust. 

Let’s go over the different forms of legal ketamine treatment and when to consider each of them.

Note: New to Ketamine? Start Here! (Ketamine 101)

Where (And When) Is Ketamine Legal In the United States?

Ketamine is categorized as a Schedule III drug in the Controlled Substances Act alongside steroids, high-quantities of the low-level opiate codeine, and testosterone. The Drug Enforcement Agency (DEA) defines these as “drugs with a moderate to low potential for physical and psychological dependence.”

However, recreational ketamine use is illegal — specifically, purchasing ketamine off the street and using it on your own. However, telehealth ketamine clinics offer very little screening and have put a lower cost (relative to infusion clinics) on obtaining ketamine with few barriers.

While this is a safer route than purchasing it on the street, they usually cut costs by removing most therapeutic support. For now, ketamine’s legality exists in a gray area where almost anyone who wants to can obtain it for the right price, but the cheapest option — the illicit market — is still illegal and rife with contamination.

What Forms of Ketamine Therapy Are Legal?

There are a few different forms of ketamine therapy that are legal — or, at the very least, not illegal. While only one form of ketamine currently has FDA approval for treatment-resistant depression, off-label use opens up a lot of doors for people wanting to see if ketamine can help.

The three main forms of ketamine therapy people legally receive include:

1. Ketamine Infusion Clinics — Usually specializing in off-label intravenous or intramuscular infusions, these clinics can screen and treat people for ketamine therapy.
2. Ketamine Prescriptions — Spravato (the nasal ketamine spray from Johnson & Johnson) is usually prescribed for at-home use. Some clinics will recommend or require the patient to take the dose under in-person or virtual supervision.
3. Ketamine Telehealth Services — Don’t expect a full-service experience or a large amount of therapeutic potential from these services, but you can get ketamine mailed straight to your door if you’d like.

Of these, clinics and prescriptions are far costlier than telehealth options — with Spravato prescriptions being excessively high. However, ketamine telehealth clinics often make up for their price difference through a lack of support or integration.

Clinics typically provide sessions before, during, and after your treatment, along with a dedicated professional to talk you through it all. Telehealth providers, by contrast, may guide few (or none) of your process, and some services may only be as extensive as an app on your phone you can journal in.

Where Is Ketamine Therapy Legal

Here’s a breakdown of where some other major countries stand when it comes to ketamine therapy:

Country	Legal Forms of Ketamine Therapy
United States	Off-label and telehealth clinics or clinical prescription (Spravato)
Canada	Legal for clinical use only
Mexico	Legal for clinical use only
United Kingdom	Off-label and telehealth clinics or clinical prescription (Spravato)
Spain	Legal for clinical use with non-medical use decriminalized
Germany	Off-label and clinical use only
Australia	Legal for clinical use only
Portugal	While all drugs are technically decriminalized, there are no legal forms of ketamine therapy

When to Check Out Ketamine Therapy

Ketamine therapy has shown a good amount of potential for several conditions. Often, the effects of ketamine therapy are rapid and can provide nearly instantaneous relief from symptoms.

The trade-off for the quick onset is a lack of longevity, however. Many who use ketamine therapy to relieve symptoms of depression, PTSD, or other conditions wind up returning regularly.

Still, this doesn’t mean there isn’t a good time and place for the three ketamine clinic options mentioned above.

What are Ketamine Clinics Good for?

Ketamine clinics offer a lower-cost option than the patented prescription option of Spravato. They’re a good choice for someone unsure if ketamine will provide the relief they need but want to check it out.

It’s also less rigorous than the requirements to obtain a Spravato prescription, which can make it more attractive as well. Ketamine has shown rapid — and, again, brief — relief for problems related to mental health, addiction, and pain management.

What Is Spravato for?

Spravato prescriptions are for severe cases of treatment-resistant depression (TRD). Patients take their ketamine dose while remaining on their current medication, and the combination is more likely to provide a longer-lasting effect.

Since TRD is the only condition the medication is approved for, you can’t get a Spravato prescription for any other cause.

When are Telehealth Ketamine Clinics a Good Idea?

Ketamine telehealth is unlikely to provide much more of an impact than using ketamine recreationally. However, for experienced psychonauts who feel comfortable with ketamine and can do their own preparation and integration, this can be a less expensive way to get a safe supply of ketamine.

This isn’t to belittle the potential to use ketamine on your own to treat health conditions. However, the idea that simply taking ketamine with little support or education can “cure” depression, PTSD, or other complex disorders IS worth belittling.

Related: The Hypocrisy of Modern Mail-Order Ketamine Clinics

Is Ketamine Safe?

Ketamine can be safe when taken responsibly and in reasonable quantities, but it has far higher potential for health concerns than other psychedelic solutions might. Even occasional users can experience problems with their bladder and cramping in the abdomen.

While ketamine may be available in legal and semi-legal ways, don’t interpret this to mean it’s safe.

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