Ketamine Therapy in Maryland

Ketamine therapy in Maryland is governed by a combination of federal Drug Enforcement Administration (DEA) regulations and state-level oversight from the Maryland Department of Health (MDH) and the Maryland Board of Physicians. Ketamine is classified as a Schedule III controlled substance under the federal Controlled Substances Act, meaning that any practitioner who administers or prescribes it must hold a valid DEA registration. In Maryland, physicians, nurse practitioners, and other licensed prescribers must also maintain active state licensure in good standing before offering ketamine-based treatments. Clinics operating within the state are subject to inspection and must comply with applicable pharmacy and controlled substance handling protocols established under Maryland law.

The administration of ketamine for mental health conditions such as treatment-resistant depression, PTSD, and anxiety disorders — commonly referred to as off-label use — is legal in Maryland but requires careful adherence to the standard of care. Providers are expected to conduct thorough patient evaluations, obtain informed consent, and maintain comprehensive medical records. The Maryland Board of Physicians has the authority to investigate complaints and take disciplinary action against providers who deviate from accepted medical practices. Clinics offering esketamine (Spravato), the FDA-approved nasal spray derived from ketamine, must additionally comply with the FDA's Risk Evaluation and Mitigation Strategy (REMS) program, which requires patients to be monitored on-site for a minimum of two hours following each administration.

Maryland does not currently have a standalone statute specifically regulating ketamine clinics as a distinct category of healthcare facility, meaning these practices generally operate under the same licensing and regulatory frameworks that apply to outpatient medical offices or infusion centers. Key regulatory considerations for Maryland ketamine providers include:

• Valid DEA Schedule III controlled substance registration for all prescribing and administering providers
• Active licensure with the Maryland Board of Physicians or the appropriate professional licensing board
• Compliance with Maryland's Prescription Drug Monitoring Program (PDMP), known as CRISP (Chesapeake Regional Information System for our Patients)
• Proper controlled substance storage, documentation, and disposal in accordance with DEA and state pharmacy board requirements
• Adherence to REMS requirements for clinics offering FDA-approved esketamine (Spravato)

Patients seeking ketamine therapy in Maryland are encouraged to verify that their chosen provider is in good standing with the Maryland Board of Physicians and holds all required federal and state credentials. As the regulatory landscape surrounding psychedelic and dissociative therapies continues to evolve nationally, Maryland providers and patients should stay informed of any legislative or administrative updates that may affect how ketamine services are delivered and reimbursed within the state.