Ketamine is a polarizing therapeutic option with a long history of use at parties, festivals, and hospitals before reaching its current spot in the American marketplace.
If you’re considering ketamine, there are four basic ways to go about obtaining it:
- Spravato Prescription — An FDA-approved ketamine nasal spray psychiatrists prescribe for treatment-resistant depression.
- Ketamine Clinics — On-site clinics providing off-label ketamine for patients suffering from a variety of conditions/symptoms along with therapeutic oversight.
- Telehealth Providers — Mail-order ketamine providers with limited (often no) resources for people using their ketamine.
- Clandestine Markets — Ketamine sold illegally on the streets in the illicit market.
The “right” option will depend on a variety of factors, and each has merit along with potential downsides. We’ll break each of them down below but, as a word of warning:
Ketamine on the illicit market is frequently contaminated with other, more dangerous drugs, and you should always test your ketamine before taking it.
Who’s Eligible for Ketamine Therapy?
The only FDA-approved use of ketamine for mental health involves a proprietary formulation by Johnson & Johnson called Spravato for treatment-resistant depression.
Outside of this, clinics may be more or less lenient on dispensing ketamine off-label — depending on the route you take and each individual clinic’s beliefs.
In-person clinics may require proof of other treatment attempts failing (though they rarely do), whereas telehealth companies “screen” your need for ketamine with a 10-question survey and a 15-minute phone call.
1. How to Get Spravato
A Spravato prescription requires a diagnosis from a professional for treatment-resistant depression. If you have this diagnosis, you should be able to request Spravato from your doctor.
Typically, patients will take their ketamine dose and other medication either in a clinic under supervision or at home.
While FDA-approved, insurance will still unlikely cover Spravato prescriptions — though more likely than off-label infusions.
The frequency of their use (often up to two times per week) and the proprietary drug they use makes this one of the most expensive options.
2. How To Get Ketamine At An IV Ketamine Clinic
To get a prescription for ketamine at a specialized clinic, all you have to do is schedule an appointment. Most clinics are very lenient about who they dispense ketamine to. Depression, post-traumatic stress disorder, chronic pain, and anxiety are common reasons doctors administer ketamine in a clinic.
Ketamine clinics offer varying levels of care and psychotherapy alongside intravenous ketamine infusions, making them more useful for people concerned about taking ketamine without professional support. However, they’re also quite expensive, and ketamine’s requirement can be financially insurmountable.
Treatment is more effective if you have a psychologist or other mental health professional to openly discuss your ketamine experiences with. In many cases, telehealth ketamine treatment alongside regular therapy is cheaper than ketamine clinics, provided you have someone you trust present during doses (a trip sitter).
Occasionally, insurance providers may also cover ketamine therapy (though this is rare), making it a viable option financially.
3. How To Get A Ketamine Prescription Online
Many have expressed alarm at the ease with which telehealth companies send people ketamine. All you have to do is sign up to one of the online ketamine therapy companies on this list, fill out an intake survey, pay the fee (usually starts around $250–400 per month), schedule an appointment with a doctor, and get ready to receive your ketamine lozenges in the mail.
These companies make getting access to ketamine therapy super straightforward and are much cheaper than in-person clinics.
The problem is that the level of care is notoriously poor, and most of these companies are set up to have you using ketamine for months or years. Ketamine therapy should not look like this, so be careful when signing up.
Additionally, companies in this space rarely mention the potential for harm — and it’s not just “bad trips,” frequent ketamine use can be toxic to the urinary tract and bladder .
Furthermore, companies often uplift ketamine’s rapid-acting efficacy (which is quite remarkable) over the reality that relief usually goes away quickly as well. One study found ketamine’s reliable antidepressant effect was underscored by an average time of 18 days before depression survey scores dropped again .
Ketamine clinics answer this with repeated and frequent dosing, increasing the potential for urinary and bladder concerns.
This doesn’t mean responsible, educated, and prepared users shouldn’t use ketamine telehealth providers — there are way more harmful ways to get ketamine out there. However, if you’re going with a telehealth provider, you have to be prepared to handle your education, preparation, and integration.
They may have some tools to assist you, but the marketing surrounding ketamine on these websites has made them terrible educational resources. One study found “At-home, sublingual ketamine telehealth is a safe and effective treatment” using surveys from people who utilized MindBloom, but, notably, one person had to drop out after dose five from urinary concerns .
With all things, there are good and bad ways to utilize telehealth ketamine options.
4. How To Buy Ketamine Without A Prescription
Ketamine is widely available on the black market — we aren’t going to provide specific sources, but it’s relatively easy to find from local dealers or illicit online marketplaces.
Outside of clinical use — even off-label clinics — ketamine is illegal.
Criminal punishments aside, contamination in ketamine is rampant, and buying it from unknown sources can be extremely dangerous.
If you decide to purchase ketamine from a clandestine source, always make sure you test it before using it — even if you trust the person who gave it to you. Periodically, the market for ketamine dries up following a major bust or new tightening of prohibition, and contamination becomes even more predominant.
Never take a friend’s word a drug is safe — know for sure using a ketamine drug test kit before you take it.
What’s the Best Way To Get Ketamine?
There’s no “best” way to get ketamine because it depends on how you intend to use it and how much you want to spend.
Ketamine clinics are probably the most effective route for getting high-dose medical ketamine — but they’re expensive. These clinics often charge upwards of $400 per session.
Online ketamine therapy is a cheaper option and is by far the most convenient — but it’s also pretty expensive at around $200 per dose. There are more affordable companies selling ketamine microdoses, but we recommend avoiding these altogether — there’s no evidence this ultra-low dose ketamine offers any real benefits.
Spravato — the ketamine nasal spray, is another good option, but it’s way overpriced compared to an IV clinic — which offers substantially better care. This option is only good if you have insurance coverage.
Some generalizations on when each option might be best are available below:
|Form of Ketamine Therapy||When to Consider||When to Avoid|
|Spravato||Best for extreme cases of treatment-resistant depression under the supervision and recommendation of a mental health professional||If you’re uncomfortable with psychedelics, unwilling to spend large amounts of money/don’t have insurance to cover it, or if you’re concerned about the health effects of frequent ketamine use|
|Off-Label Clinics||When you’re interested in ketamine and want some support before, during, and after your experience with the drug — particularly beneficial for complex mental health concerns where dark thoughts may arise during treatment||While this is often a nice middle ground between telehealth sources and pricy Spravato prescriptions, it’s still important to research your clinic before you begin treatment as some are better than others.|
|Telehealth Ketamine Clinics||A great option for people familiar with ketamine, comfortable with using it with very little oversight, and willing to put in the work of preparing for and integrating the experience by themselves||It’s never wise to undergo a psychedelic experience without therapeutic oversight if you have a mental health condition.|
|Illicit Ketamine Sources||You have a reliable source, a way to test and ensure its purity, and someone you trust who is willing to be sober and sit with you while you take it.||If you have any other route to receive ketamine, fear legal retribution, or don’t have a reliable source you trust, it’s best not to seek out ketamine on the clandestine market.|
This list is a broad-stroke overview, but the right option comes down to each person and the guidance of their mental health professional. No drug is good or bad, ketamine included — but it has potentially harmful properties and can cause a lot of harm when people use it poorly.
- Srirangam, S., & Mercer, J. (2012). Ketamine bladder syndrome: An important differential diagnosis when assessing a patient with persistent lower urinary tract symptoms. BMJ Case Reports, 2012, bcr2012006447.
- Murrough, J. W., Perez, A. M., Pillemer, S., Stern, J., Parides, M. K., aan het Rot, M., Collins, K. A., Mathew, S. J., Charney, D. S., & Iosifescu, D. V. (2013). Rapid and Longer-Term Antidepressant Effects of Repeated Ketamine Infusions in Treatment-Resistant Major Depression. Biological Psychiatry, 74(4), 250–256.
- Hull, T. D., Malgaroli, M., Gazzaley, A., Akiki, T. J., Madan, A., Vando, L., Arden, K., Swain, J., Klotz, M., & Paleos, C. (2022). At-home, sublingual ketamine telehealth is a safe and effective treatment for moderate to severe anxiety and depression: Findings from a large, prospective, open-label effectiveness trial. Journal of Affective Disorders, 314, 59–67.