The Drug Enforcement Agency classifies ketamine as a Schedule III drug under the Controlled Substances Act. Schedule III drugs are substances or chemicals that have therapeutic or medicinal benefits with a low-to-moderate potential for psychological and physical dependence.
Ketamine’s Schedule III status makes it easier to study and access therapeutically than the classic psychedelics, nearly all of which are in Schedule I.
Things to Know
- Ketamine is illegal for people to possess and sell in the US, but ketamine-assisted therapy is legal
- Ketamine is only decriminalized for US citizens in Oregon
- Ketamine-assisted therapy is legal in many parts of the world
Ketamine U.S. Legality
In the US, ketamine can only be used in a medical context, meaning that it must be administered or prescribed by licensed clinicians. For example, ketamine is legal to use as an anesthetic for a surgical procedure when prescribed by a licensed healthcare provider. Using ketamine recreationally is illegal under both federal and state law, and the illicit ketamine supply chain is unregulated.
Unlike the classic psychedelics that are currently being studied, ketamine has been legal since the ‘70s as an FDA-approved anesthetic1 . As a result of ketamine’s FDA-approved medical use, ketamine was not initially made subject to the Controlled Substances Act. By contrast, substances like psilocybin and LSD, which did not have FDA-approved medical uses, were immediately placed in Schedule I. By contrast, it was not until 1999 that ketamine became subject to the Controlled Substances Act as a Schedule III drug as a way to control its non-medical proliferating in the club scene. Recreational use of ketamine is remains illegal in the U.S.
Research into ketamine’s off-label use as a therapeutic agent in the treatment of mental health began in the 1970s, but was relatively limited until the early 2000s. In 1999, ketamine-assisted therapy showed promising results when tested for depression and addiction using intravenous infusions, and for other early applications, including relieving chronic pain and alleviating end-of-life anxiety in terminally ill patients.
Off-label prescription and use of ketamine is also permitted under federal law in the U.S. It’s a common misconception that “off-label” is potentially illegal or otherwise untrustworthy. This term simply means that a drug or compound has a different application2 than it received initial FDA approval for.
Esketamine in the form of Spravato nasal spray received FDA approval in March 20193 for the treatment of Treatment-Resistant Depression, officially making it the first mental health application of ketamine to meet FDA requirements for both safety and efficacy.
As a result of the many studies showing ketamine’s efficacy as a treatment for mental health and substance use disorders, numerous ketamine-assisted therapy clinics have opened throughout the U.S. and Canada4 .
Ketamine International Legality
Various countries5 have legalized ketamine for medicinal and therapeutic use. Canada6 has legalized therapeutic use and ketamine clinics are providing services in Toronto, Vancouver, and other cities. Ketamine is still categorized as a Schedule I drug under the Controlled Drugs and Substances Act in Canada, making all non-medical use illegal.
The UK has legalized specific uses7 of ketamine, although recreational or personal use is still illegal. The Czech Republic8 has decriminalized possession of ketamine for all people and has legalized ketamine-assisted therapy for those with depression. Ketamine-assisted therapy is legal in Germany, but recreational use remains illegal. Australia and New Zealand have legalized ketamine-assisted therapy, but recreational use is illegal.
Ketamine remains illegal for recreational and personal use and possession throughout most of the world. Ketamine is not decriminalized in the U.S., except for in Oregon9 where the possession and consumption of small amounts of all drugs have been decriminalized since 2020. Outside of the U.S., ketamine is also decriminalized in Portugal10 , where the possession of small quantities of all drugs have been decriminalized since 2000. Drugs were never criminalized in Spain11 , so the possession and personal use of drugs like ketamine are decriminalized.