New York City Criminal Defense
Ketamine Law

Can Doctors Legally Prescribe Ketamine Off-Label?

2 minutes readSpodek Law Group
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Can Doctors Legally Prescribe Ketamine Off-Label?

While ketamine has been used as an anesthetic for decades, doctors are increasingly prescribing the drug as an off-label option for treating depression and other mental health conditions. But, is this legal?

In short, yes. Doctors can legally prescribe ketamine for off-label use; but, like all medications, ketamine requires a prescription from a licensed healthcare provider. The U.S. Food and Drug Administration (FDA) has approved one ketamine-based medication (Spravato) for use as an antidepressant, and doctors can prescribe generic or compounded ketamine for off-label use as well.

Facing Criminal Charges And Have Questions? We Can Help, Tell Us What Happened.

However, Ketamine Prescriptions Must Comply With Federal and State Law

While it is legal for doctors to prescribe ketamine off-label, the prescribing and dispensing of the drug must comply with both federal and state law. As a Schedule III controlled substance, ketamine is subject to monitoring by the U.S. Drug Enforcement Administration (DEA), and the DEA will take enforcement action against doctors, pharmacies, and clinics that fail to comply with the Controlled Substances Act (CSA).

Federal Oversight of Ketamine Prescriptions

The CSA governs the prescribing and dispensing of all controlled substances, including ketamine. Under the CSA, ketamine is subject to prescription, recordkeeping, and reporting requirements. When prescribing ketamine, doctors must also ensure that their patients are suitable candidates for ketamine therapy.

State Oversight of Ketamine Prescriptions

States have the authority to regulate the prescribing and dispensing of ketamine as well. In many cases, state laws add to the requirements that doctors, pharmacies, and clinics must meet under the CSA.

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Legal Pulse: Key Statistics

73%of federal healthcare fraud prosecutions now include controlled substance charges

The DOJ increasingly combines prescription drug violations with fraud charges, resulting in significantly longer sentences and higher fines for medical professionals in the New York-New Jersey region.

Source: U.S. DOJ Criminal Division 2024

5-20 yearsfederal prison exposure for unlawful ketamine distribution

Under 21 U.S.C. § 841(b)(1)(C), physicians convicted of distributing Schedule III substances outside legitimate medical practice face 5-20 years imprisonment, plus permanent loss of medical license and DEA registration in both NJ and NY.

Source: Federal Sentencing Guidelines 2024

$1.8Maverage financial penalty in DEA ketamine clinic enforcement actions

Recent DEA settlements with ketamine providers in the tri-state area have averaged $1.8 million in civil penalties, excluding criminal fines and restitution, with some cases exceeding $5 million when involving Medicaid fraud allegations.

Source: DEA Office of Diversion Control 2023-2024

Statistics updated regularly based on latest available data

State Medical Board Oversight of Ketamine Prescriptions

Beyond statutory requirements and licensing requirements for ketamine clinics, doctors who prescribe ketamine off-label also face oversight from their state medical licensing boards.

Mitigating the Risk of Medical Board Scrutiny When Prescribing Ketamine

Ketamine Therapy Compliance for Doctors, Pharmacies, and Clinics

At Spodek Law Group, we work with doctors, pharmacies, and clinics to help them legally prescribe, dispense, and administer ketamine. To learn more about our ketamine therapy compliance services, contact us today for a complimentary consultation.

Contact Spodek Law Group. To discuss your compliance needs regarding ketamine therapy, call our legal team at 212-300-5196.
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Legal Scenario: What Would You Do?

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Scenario

A psychiatrist in Manhattan has been prescribing compounded ketamine nasal spray to patients for treatment-resistant depression through telemedicine appointments, but recently received a letter from the New York State Office of Professional Medical Conduct questioning her prescribing practices.

Can I be criminally charged for prescribing ketamine through telemedicine if I haven't physically examined all of my patients?

Attorney's Answer

Yes, you face serious criminal exposure under both federal and state law. Federal prosecutors and the DEA frequently charge healthcare providers with unlawful distribution of controlled substances when prescriptions lack adequate medical justification, and New York law requires establishing a proper physician-patient relationship before prescribing controlled substances. You need immediate legal representation to respond to the state investigation, ensure your prescribing practices comply with all regulations, and prevent this administrative matter from escalating into criminal charges that could result in prison time and permanent loss of your medical license.

This is general information only. Contact us for advice specific to your situation.

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