Legal Status of Ketamine

Ketamine is a Schedule III drug in the United States and a Schedule I drug in Canada.

Effectively, these classifications identify ketamine as a possible substance of abuse and harm while still identifying that the substance has demonstrated medical uses.

Legalization Map

Review the map below by selecting Canada, the United States, and the regions within to identify where ketamine is legal and for what purpose.

Please ensure that you read through all items before proceeding by selecting each part of the image.

Canada

Prescription required by a clinician for medical or therapeutic use by a physician or other health professional who can write prescriptions (Schedule I). Esketamine under review by Health Canada.

British Columbia

In addition to Canadian regulations, IV ketamine in B.C. is only permitted at hospitals or accredited non-hospital medical and surgical facilities (CPSBC, 2022).

United States

Prescription required by a clinician only for medical or therapeutic use by a physician or other health professional who can write prescriptions (Schedule II). Spravato® (esketamine) is approved for treating symptoms of depression in those who have not responded to two or more antidepressant treatments.

Activity

Select a country other than Canada and the United States, and research the legal status of ketamine in that country. Add your findings to this document. The password for the document is ketamine.

Note

Despite the literature surrounding its antidepressant properties, presently it is only the S-(+) enantiomer—esketamine—that has been formally approved for treating depression, having been approved by the FDA in 2019 (Matveychuk et al., 2020). This lack of formal approval, however, is linked to drug companies' inability to patent racemic ketamine which means there is no incentive for them to invest in clinical trials.

References

CPSBC (2022). Ketamine Administration via Intramuscular, Oral, Sublingual, and Intranasal Routes as Treatment for Mental Health Conditions and Chronic Pain in the Community Setting. https://www.cpsbc.ca/files/pdf/IG-Ketamine-Administration-via-Intramuscular-Oral-Sublingual-Intranasal-Routes.pdf

Matveychuk, D., Thomas, R. K., Swainson, J., Khullar, A., MacKay, M. A., Baker, G. B., & Dursun, S. M. (2020). Ketamine as an antidepressant: overview of its mechanisms of action and potential predictive biomarkers. Ther Adv Psychopharmacol, 10, 2045125320916657. https://doi.org/10.1177/2045125320916657