The legality of ketamine is a grey area, with many countries setting limits on the extent of what is allowed or prohibited. Where ketamine is legal for medicinal use, it must be administered in appropriate settings and by a registered practitioner. This article breaks down the parameters under which ketamine is legal or illegal in the U.S. and other parts of the world.
Ketamine was first synthesized in the 1960s by a professor of Chemistry Calvin S. Stevens, for OR use as a general anesthetic. Researchers are now looking into the potential use cases of ketamine in managing treatment-resistant depression, anxiety, and pain.
The World Health Organization (WHO) and Ketamine
WHO listed ketamine under the category of essential medicines in 1985. According to the global organization, ketamine is probably the most widely used anesthesia drug in the world. Its wide safety margin makes it the anesthetic of choice in the developing world, especially for pediatrics.
International Trade Names for Ketamine
Ketamine has different brand names that are used internationally. They include the following:
Anaket, Anasket, Brevinase, Calypsol,Chlorketam, Ereska, Imalgene, Katalar, Keta, Kalipsol, Ketalin, Ketalor, Ketamav, Ketamax, Ketamil, Ketaminol Vet, Ketanest, Ketaject, Ketalar, Ketanest-S, Ketasol, Ketava, Ketavet, Ketmine HCl, Ketolar, Narketan, Narkamon, Ralatek, S-Ketamin, Tekam, Vetaket, Vetus Ketha-Thesia.
International Street Names for Ketamine
Ketamine goes by different names on the street. Here are a few examples:
Cat valium, K, Kaddy, Kate, Ket, Kéta K, K-Hole, Kit Kat, 1980 acid, Jet, Liquid E, Liquid G, Purple, Special K, Super acid, Super C, Super K, Vitamin K, Special LA coke, Honey Oil.
Where is Ketamine Legal?
The legality of ketamine from country to country is complicated. As much as it is legally marketed in many countries, it remains a scheduled drug in most. Its recreational use has compounded the problem, with many countries scheduling the drug under different classes.
Ketamine is widely used in third-world countries for anesthesia. In Australia, it is listed under Schedule 8 of the Poisons Standard (October 2015). In Canada, it is listed under Schedule I as a narcotic. This is the same class that has drugs such as opium, morphine, and fentanyl.
India scheduled ketamine under Schedule X in 2013 after a surge in ketamine as a date rape drug. The United States listed ketamine under Schedule III of the Controlled Substances Act in 1999. Possession of ketamine is not a crime but a misdemeanor. In the UK, ketamine is listed as a class B drug; it is illegal to possess, produce, or supply it. Possession of ketamine attracts a fine or five years imprisonment.
Below is a table that shows the legal status of ketamine in some countries around the world.
| Country | Legal Status of Ketamine |
| USA | Ketamine is listed under Schedule III of the Controlled Substances Act in 1999.
Medically, it is used to induce sedation and anesthesia in short periods of time. Additionally, in the year 2019, the FDA approved Spravato®, the S(+) enantiomer of ketamine nasal spray, also called Esketamine. It was approved for treatment-resistant depression available only at a certified doctor's office or clinic. |
| UK | Ketamine is listed as a class B drug; it is illegal to possess, produce, or supply it. Possession of ketamine attracts a fine or five years imprisonment. |
| Australia | Ketamine that is legally produced is a restricted substance in Australia. It can only be prescribed or administered by a licensed doctor or vet. Every other use is illegal.
The production, selling, or driving under the influence of ketamine will attract penalties such as fines, imprisonment and disqualification from driving. |
| Russia | In Russia, Ketamine is considered a controlled substance with limited distribution. It is prohibited for animal use. |
| Ukraine | In Ukraine, ketamine, although considered to be a restricted drug, there are ketamine clinics in Ukraine that treat depression. |
| China | Ketamine is classified under Schedule I. It is illegal to produce, supply, or use ketamine for whatever purpose in China |
| Taiwan | Ketamine is classified under Schedule III. You cannot be imprisoned for possessing ketamine. However, you can be fined about $300. You may also get mandatory rehabilitation for drug abuse |
| India | Ketamine is classified under Schedule X of the drugs and cosmetics act. It is a prescription drug |
| Singapore | Ketamine is classified as a Schedule I drug. It is illegal to produce, supply, or use ketamine for whatever purpose in Singapore. |
| Canada | Ketamine is classified as a Schedule I drug. Sale, possession, or production is prohibited. |
| Mexico | Ketamine is a Schedule III drug and cannot be used for recreational purposes. |
Countries That Manufacture Ketamine
Countries that manufacture ketamine include China, Belgium, Germany, Mexico, Colombia, and the United States. The manufacture of ketamine is resource intensive which is a deterrent for clandestine production. Thus, most of the ketamine in the black market (recreational) comes from legitimate sources.
China, a producer of ketamine, has been pushing for a worldwide ban on ketamine. China representatives brought this up during the annual session of the United Nations Commission on Narcotic Drugs in Vienna, where representatives from over 100 countries.
Prof Zhimin Liu, the vice director of the National Institute on Drug Dependence at Peking University, had this to say:
"It is far from sufficient to rely on regional or national measures alone in combating a newly emerging substance such as ketamine which poses a health hazard."
However, their proposal has been opposed on the premise that ketamine is widely used as an anesthetic in the developing world, and placing a ban on it will affect the delivery of medical care.
Are Ketamine Clinics Legal?
Ketamine clinics use off-label ketamine to manage treatment-resistant depression, PTSD, OCD, anxiety, and chronic pain. The U.S. has over 100 outpatient clinics offering IV ketamine for "off-label" indications. Ketamine is also used legally in hospital O.R.s and emergency rooms, research labs, and vet clinics.
Ketamine and the FDA
Ketamine is classified under Schedule III in the U.S. The FDA has approved it as an anesthetic. However, it can only be prescribed by a licensed physician in a clinical setting. Ketamine derivatives such as esketamine have also been approved for managing treatment-resistant depression. It can also be used for off-label use, using a drug to treat a condition other than its primary indication.
Is "Off-Label" Ketamine Legal as Well?
Ketamine can be prescribed "off-label" in countries where it is legal. In the U.S., off-label use of ketamine is legal, as long as there is supporting medical evidence.
Ketamine's use for general anesthesia is the "labeled" use of ketamine. When a drug is used for a different purpose, other than its primary indication, it is considered off-label use. In cannabis, off-label uses of cannabis include the treatment of depression, chronic pain, anxiety, and PTSD.
Summary
The legality of Ketamine varies from one country to another. In most African countries, Ketamine is widely used to induce and sustain anesthesia (where muscle relaxation is not required). Most other countries have restricted ketamine use, with countries such as Russia banning animal use.
The recreational use and consequent abuse of Ketamine are precipitating factors for the scheduling of the drug worldwide. On the other hand, the relative safety, affordability, and efficiency of the drug are push factors for its legalization. It's an intricate balance and countries need to formulate laws that best serve the interest of their citizenry.
