Ketamine is scheduled in many jurisdictions. Below are some examples of the legal status of ketamine internationally.
Ketamine is extensively metabolized. In a placebo-controlled study in 11 healthy volunteers, who were given intravenous S-ketamine 0.1 mg/kg or oral ketamine 0.3 mg/kg, rifampicin reduced the mean AUC of intravenous and oral ketamine by 14% and 86% respectively. It greatly reduced the Cmax of oral S-ketamine by 81% but only moderately shortened the half-life. Rifampicin reduced the ratio of AUC to ketamine AUC after intravenous S-ketamine by 66%, but increased it by 147% after oral administration. These results were mainly attributable to the induction of the first-pass metabolism of S-ketamine.
Ketamine is scheduled differently within and between countries. Below is a brief overview of the legal status of ketamine in a number of key jurisdictions. Within Australia prior to December 2003 ketamine was a scheduled drug in New South Wales under the Poisons and Therapeutic Goods Act, which meant that there were strict regulations on the sale and distribution of the substance. In response to increasing trends in ketamine use, the government added it to the list of prohibited drugs in New South Wales. This means that it has now been listed under the Drug Misuse and Trafficking Act 1985, ensuring that tougher penalties are in place for dealing with its illicit use. New penalties for those caught manufacturing or supplying the drug include fines between AU$5500 and AU$550 000 and anywhere from 2 years to life imprisonment or both. These penalties particularly apply to veterinary and medical practitioners who have an authority to purchase ketamine for legitimate purposes and then supply it to others for illicit use. Similar laws apply in some other states of Australia, however, in other states it remains legal to possess ketamine.
Ketamine is Schedule 1 in Canada, pursuant to a February 2004 notice that it “is an analog of phencyclidine (PCP), and is, therefore, captured as item 14 in Schedule I of the CDSA and item 14 in the Narcotic Control Regulations (NCR).” Affected researchers were expected to have complied with the Schedule 1 protocol for the handling of ketamine by August 31, 2005.
Ketamine is a Class II psychiatric drug; trade is limited to licensed wholesalers and retail sales are prohibited. In July 2004, the state of Sichuan placed ketamine in Class I; other provinces are expected to follow suit.
Ketamine is a Category 3 drug under Mexico’s General Health Law; Category 3 drugs “have a therapeutic value but constitute a problem for the public health.” Medicines Administration Regulations restricts the acquisition of ketamine to licensed veterinarians only and sets strict rules regarding the management and follow-up of the products.
Ketamine is treated as a medication and is not in List 1 or 2 in the Netherlands.
Prior to January 1, 2006, ketamine was not controlled in the United Kingdom under the Misuse of Drugs Act, making it legal to possess. However, sales and distribution were controlled under the Medicines Act making it illegal to sell or distribute without a license. Ketamine became a Class C drug on January 1, 2006, following a 2004 report to the government that recommended moving ketamine into Class C.
Ketamine was unscheduled until August 1999. In early July 1999, the DEA added ketamine to Schedule III with an emergency ruling that took effect on August 12, 1999. It is now a federal offense to possess ketamine in the United States without a license or prescription. Since that time, ketamine has been scheduled in many individual states, and laws are pending in many more. Where ketamine is not scheduled in a specific state, all prosecutions for possession or sales occur at the federal level.