American Society of Ketamine Physicians, Psychotherapists and Practitioners Recommends the Ethical Prescription and Administration of Ketamine

The American Society of Ketamine Physicians, Psychotherapists and Practitioners (ASKP3) strongly endorses the proper evaluation, prescription, administration, and monitoring of ketamine for qualified individuals. Disregard for any of these aspects sparks concern for the safety and well-being of a patient. One such example includes the unethical prescription and administration of IV ketamine in a home or even hotel room without an in-person evaluation by the prescribing provider. This would typically be illegal under the Ryan Haight Act prior to the rise of the COVID-19 pandemic in 2020.

The Ryan Haight Act of 2008 is a federal rule enacted to prevent the illegal distribution and dispensing of schedule II-V controlled substances by means of the internet. It would require at least one in-person medical evaluation of the patient. (US Department of Justice) The COVID-19 pandemic became an exception to this rule in early 2020 when the Secretary of Health and Human Services, Secretary Azar, declared a public health emergency on January 31, 2020. This meant all DEA-registered practitioners could issue prescriptions without an in-person medical evaluation. However, they did need to comply with a real-time audio-visual communication (teleconference), prescribed for a legitimate medical purpose acting in the usual course of his/her professional practice. The practitioner must also act in accordance with all applicable Federal and State laws. (US Department of Justice)

The public health emergency exception opened the door to the possibility of rogue distribution of ketamine to individuals signing up for appointments to receive IV ketamine via the internet. ASKP3 does not condone this practice. ASKP3 issued the Standards of Practice in the Therapeutic Use of Subanesthetic Ketamine in the summer of 2020 and publicly announced them in October of 2020. Their purpose is to serve as guidelines for safe and ethical administration of ketamine in practice. These include proper screening, written consent, appropriate referrals when needed, a thorough medical assessment, monitoring for adverse effects during and after ketamine administration, and basic safety monitoring of vital signs and level of consciousness. (American Society of Ketamine Physicians, Psychotherapists, and Practitioners) In addition, ASKP3 composed a comprehensive Ethics Statement for ketamine providers in 2020 that is currently pending publication.

Ketamine therapy is not a panacea for the general public experiencing stress or pain. Mainstream advertising for quick and easy access as a self-prescribed boost is a detriment to extensive research and work by ketamine practitioners. This is a controlled substance which must be administered by qualified providers to appropriate patients with diagnosed mental health and pain maladies. Therefore, patient selection is of utmost importance. Actions taken by internet companies may be in direct contradiction to basic safety guidelines as outlined by the Standards of Practice statement. Therefore, one should research the provider behind any advertisement. ASKP3 offers a directory of vetted providers as one option to get started. (Directory - ASKP)

About ASKP3: The American Society of Ketamine Physicians, Psychotherapists, and Practitioners is a non-profit organization comprised of a group of professionals dedicated to the safe and effective clinical use of ketamine for mental health disorders and chronic pain conditions. With over 400 active members worldwide, ASKP3 is in a prime position to further awareness and education regarding the safe, effective, and ethical use of ketamine treatment. www.askp.org

Bibliography

US Department of Justice. "Implementation of the Ryan Haight Online Pharmacy Consumer Protection Act of 2008." U.S. Department of Justice Drug Enforcement Administration Diversion Control Division, 2020, 2020 - Implementation of the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 (usdoj.gov). Accessed 7 February 2021.

US Department of Justice. "COVID-19 Information Page." U.S. Department of Justice Drug Enforcement Administration Diversion Control Division, 2020, COVID-19 Information Page (usdoj.gov). Accessed 7 February 2021.

American Society of Ketamine Physicians, Psychotherapists, and Practitioners. "Standards of Practice in the Therapeutic Use of Subanesthetic Ketamine." ASKP3: American Society of Ketamine Physicians, Psychotherapists, and Practitioners, 2020, ASKP3 Standards - ASKP. Accessed 7 February 2021.

Source: ASKP3