Anesthesiologists Are Asking for Stronger Ketamine Oversight. As One of Them, I Agree.
This month, the American Society of Anesthesiologists (ASA) issued new guidance calling for stronger oversight of how ketamine is prescribed and delivered — especially when it's used at home or without direct physician supervision. As an anesthesiologist who founded a ketamine practice, I want to talk about why that matters and why it bolsters my confidence in our existing practices at Vitalitas Denver.
Why this warning carries weight
Anesthesiologists aren't outside commentators on ketamine. We are the physicians who know it best. Ketamine has been part of our specialty for decades as a powerful anesthetic, and we understand — from direct, hands-on experience — exactly what it can do to breathing, blood pressure, heart rate, perception, and judgment.
So when the ASA raises a concern, it isn't coming from a fear of innovation. It's coming from familiarity with the medication's power. That's a meaningful distinction, and it's why this guidance is worth your attention.
What the ASA is actually sayinG
It's easy to misread a headline like this as "ketamine is dangerous" or "ketamine should be harder to get." That's not the message. The ASA's concern is about oversight, not access.
Ketamine genuinely helps many people living with treatment-resistant depression, PTSD, and chronic pain. The question the ASA is raising is whether every care model offering it includes enough screening and monitoring to use it safely. And right now, that varies widely.
Their core points are straightforward:
The setting matters. A hospital infusion, a supervised clinic session, and a prescription mailed to someone's home all involve the same drug — but not the same safeguards.
At-home ketamine is the biggest flashpoint. Home delivery can make treatment easier to reach, but it can also remove medical supervision during the experience itself, when a patient may be alone and unable to recognize a dangerous reaction.
Ketamine is not a low-risk wellness product. It can affect breathing, blood pressure, and heart rate, and those risks rise when it's combined with other sedating medications.
Safe care has a shape. Screening, supervision, emergency planning, and follow-up should be standard parts of treatment — not optional extras.
Why supervision isn't a formalitY
In a medical setting, ketamine is never a "take it and see" experience. We screen patients before treatment. We monitor vital signs, sedation, and mental status during it. We know the signs that someone needs intervention, and we're positioned to act immediately if they do.
That's the part a convenient, unsupervised model can quietly leave out. Convenience is real, and I understand its appeal — privacy, cost, ease. But convenience is not the same thing as clinical safety, and patients shouldn't have to guess which one they're getting.
How we already practice this AT VITALITAS
I'll be candid: the ASA's guidance describes how we've run this clinic from the beginning. Care here is physician-led and delivered in person, with screening before treatment, monitoring throughout each session, a clear plan for managing changes in anxiety or blood pressure or sedation, and structured follow-up afterward — symptom tracking and integration support, not a one-time transaction.
We built it this way because ketamine deserves to be treated like medicine. The new guidance doesn't change our model. It validates it.
The takeawaY
The best future for ketamine therapy isn't less access — it's better access. Stronger standards, clearer oversight, and more consistent protection for the people seeking help. That's good for patients, and it's good for the legitimacy of this field.
If you're considering ketamine therapy, you deserve to know exactly what safe care looks like: who screens you, who monitors your session, what happens if something goes wrong, and how you're supported afterward. We're always happy to answer those questions before you ever begin.
To learn more about supervised, physician-led ketamine care at Vitalitas Denver, contact our team.
Resources & Further Reading
American Society of Anesthesiologists — Guidance on the Safe Use of Ketamine Outside of Acute Pain Management and Procedural Sedation — the ASA's primary guidance this piece is based on.
FDA — Risks Associated with Compounded Ketamine Products for Psychiatric Disorders — the federal warning on at-home and telehealth use without monitoring.
FDA — Potential Risks of Compounded Ketamine Nasal Spray — a follow-on alert to clinicians.
A Consensus Statement on the Use of Ketamine in the Treatment of Mood Disorders (JAMA Psychiatry) — peer-reviewed consensus on safe administration and monitoring.
Regulating Ketamine Use in Psychiatry (Journal of the American Academy of Psychiatry and the Law) — scholarly overview of the oversight landscape.
