Ketamine

Class B controlled substance (upgraded from C in 2014). Prescription medicine.

Ketamine was reclassified from Class C to Class B in June 2014 due to concerns about bladder damage and rising recreational misuse. Medical use remains lawful.

Class A controlled drug under Misuse of Drugs Act. Severe penalties.

Singapore classifies ketamine as a Class A controlled drug with the same severity as heroin or methamphetamine. Enforcement is extremely strict.

Prescription-only anaesthetic (Anlage III BtMG). Off-label use for depression expanding.

Ketamine is widely used in German emergency medicine. Esketamine (Spravato) nasal spray approved for treatment-resistant depression since 2019.

Prescription-only medicine under the Suchtgiftverordnung.

Austria applies its standard harm-reduction approach. Ketamine is a regulated medicine, not a recreational drug category.

Controlled substance available by prescription. Used in anaesthesia and psychiatric treatment.

Switzerland allows ketamine-assisted psychotherapy under medical supervision, including for treatment-resistant depression.

List I (Opiumwet) substance since 2022. Previously unscheduled.

Before November 2022, ketamine was not scheduled under the Opiumwet, making it technically legal to possess. It was moved to List I after rising recreational use.

List I narcotic (stupéfiant). Prescription medicine for anaesthesia.

France scheduled ketamine as a narcotic (stupéfiant) in 2017, tightening controls due to recreational use. Medical use continues in hospitals.

Prescription anaesthetic. Not explicitly scheduled as a recreational drug.

Spain does not list ketamine in its drugs of abuse tables. It is regulated as a prescription medicine. Personal possession is an administrative offense at most.

Prescription medicine. Not specifically listed in narcotics schedules.

Belgium regulates ketamine primarily as a prescription medicine rather than as a scheduled narcotic. Recreational possession exists in a regulatory grey area.

Prescription anaesthetic. Classified as a psychotropic substance (Group IV-P).

Poland classifies ketamine as a psychotropic substance. Off-label psychiatric use is growing but strictly regulated.

Schedule III controlled substance. Widely used off-label for depression via ketamine clinics.

Ketamine clinics for depression have proliferated across the US since ~2019. Esketamine (Spravato) is FDA-approved for treatment-resistant depression. Telehealth prescribing was restricted by the DEA in 2024.

Schedule I under CDSA, but widely prescribed off-label for depression and pain.

Despite Schedule I classification, Health Canada allows medical use and ketamine clinics for depression have become common. This is a unique case where a Schedule I substance has widespread accepted medical use.

Prescription medicine. Controlled substance under health regulations.

Ketamine is classified as a controlled prescription medicine in Mexico. Recreational use and diversion from medical sources remain illegal.

Controlled prescription medicine (Portaria 344). Not a banned substance.

Ketamine is listed under Anvisa's List B1 (psychotropic substances), not List F (banned). It is a legally available medicine. Ketamine clinics for depression are emerging in major cities.

Controlled medicine. Personal possession of small amounts decriminalized.

Colombia's constitutional protection of personal drug use (Sentencia C-221/94) extends to ketamine for personal consumption.

Prescription anaesthetic. Regulated as a controlled medicine.

Ketamine is primarily used in veterinary and human anaesthesia. It is not scheduled as a substance of abuse, but illicit possession of any controlled medicine carries penalties.

Controlled prescription medicine used in anaesthesia.

Ketamine is used in Peruvian medical settings. There is minimal recreational market compared to other countries. Regulation focuses on medical supply chains.

Schedule 8 (controlled drug). Prescription only. Off-label use for depression growing.

Ketamine is a Schedule 8 controlled drug in Australia. Off-label use for depression is increasing, with some psychiatrists offering ketamine infusion treatments. The TGA has not specifically approved ketamine for depression (unlike psilocybin).

Class C controlled drug. Prescription medicine.

Ketamine is classified as a Class C controlled drug in New Zealand — less severe than psilocybin (Class A). Medical use is lawful.

Schedule 5 (pharmacist-initiated) or Schedule 6 (prescription) medicine.

South Africa regulates ketamine under the Medicines and Related Substances Act, not under the Drugs and Drug Trafficking Act. It is a medical-use substance rather than a scheduled narcotic.

Prescription medicine. Not classified among the most dangerous drugs.

Israel allows medical ketamine use and has research programs exploring ketamine for depression. Recreational use is illegal but rarely subject to heavy enforcement.

Designated drug (指定薬物). Prescription anaesthetic. Strictly regulated.

Japan designated ketamine under the Pharmaceutical and Medical Device Act. It is not classified under the Narcotics and Psychotropics Control Law but is a designated drug with strict controls.

Decriminalized for personal use under the 2001 drug law. Medical use in anaesthesia.

Portugal's 2001 decriminalization covers all substances including ketamine. Personal amounts are handled by health commissions, not criminal courts.

Controlled substance (Tabella I). Personal use is an administrative offense.

Italy added ketamine to Tabella I in 2013. Personal use remains an administrative (not criminal) offense under Italian drug policy.

Scheduled substance. Small amounts for personal use are a misdemeanor.

Czech Republic treats ketamine like other scheduled drugs — minor personal possession is a misdemeanor with a defined threshold.