The growing popularity of at-home ketamine therapy has raised questions about safety, oversight, and clinical integrity, especially in light of a recent wrongful death lawsuit filed in North Carolina.
While ketamine can be a powerful and healing tool for treatment-resistant depression and anxiety, its use outside of supervised clinical settings is coming under increasing scrutiny. If you’re considering at-home ketamine therapy, or advising someone who is, here’s what you need to know.
A Tragic Case: What Happened in North Carolina
In October 2023, a man named Phillip Ward died from what was later identified as “ketamine toxicity in the setting of hypertension.” In October 2025, a wrongful death lawsuit was filed by his father against several parties involved in a national telehealth ketamine provider offering at-home treatment.
According to the lawsuit, ketamine troches (lozenges) were shipped to Phillip without adequate medical oversight, despite known medical risk factors including hypertension, tachycardia, and missed clinical appointments. The complaint alleges that the product shipped to him was a compounded formulation not approved by the FDA, and that the service failed to monitor his use or respond appropriately when red flags arose.
“Defendants prescribed, manufactured, and shipped a potent, unapproved, and dangerously unpredictable anesthetic for Phillip to use at home without adequate instructions, warnings nor direct medical supervision…”
— Wrongful death lawsuit, North Carolina Superior Court, 2025
While the lawsuit is ongoing and the companies involved deny liability, the case has cast a spotlight on the growing number of companies offering ketamine therapy by mail.
What Is At-Home Ketamine Therapy?
At-home ketamine therapy typically involves a telehealth intake, after which ketamine lozenges (or troches) are shipped to a patient for self-administration. The patient may have remote check-ins with a guide or clinician, but there is no in-person supervision during dosing.
These services market themselves as more convenient and cost-effective alternatives to in-clinic treatments, often bundling sessions into monthly subscriptions and shipping pre-dosed packages to the patient’s home.
But ketamine is not a typical antidepressant. It’s a powerful dissociative anesthetic that can rapidly shift consciousness, alter perception, and affect vital signs like heart rate and blood pressure. Without real-time supervision, complications can go unnoticed until it’s too late.
The Difference Between At-Home and In-Clinic Treatment
One of the biggest misconceptions is that all ketamine therapy is essentially the same. In reality, the delivery method, supervision, and drug formulation matter. A lot.
In-Clinic Ketamine
- Administered via IV or IM (intravenous or intramuscular)
- FDA-approved as an anesthetic, used off-label for depression
- Patients are monitored in real-time by trained medical staff
- Vitals are checked before, during, and after the session
- Emergency protocols are in place if adverse effects occur
At-Home Ketamine
- Typically administered via oral troches or lozenges
- Compounded formulations not FDA-approved for psychiatric use
- Monitoring relies on self-reporting and remote check-ins
- Patients are responsible for their own safety during dosing
- No immediate access to emergency medical care
Why Regulation Matters
Esketamine (Spravato), a derivative of ketamine, is FDA-approved for treatment-resistant depression. But here’s the catch: it’s only allowed to be administered in a certified medical setting, with at least two hours of post-dose monitoring, because of known risks related to blood pressure, dissociation, and sedation.
By contrast, the ketamine used in at-home models is often a compounded drug that hasn’t been subject to the same approval process. This creates a regulatory gray zone. While it’s legal for a pharmacy to compound and ship these drugs under certain conditions, that doesn’t mean it’s safe, especially without robust patient monitoring.
The recent lawsuit highlights the dangers of treating ketamine like a mail-order medication, particularly for patients with pre-existing conditions.
What This Means for Patients and Providers
If you’re considering at-home ketamine therapy, or you’re a provider navigating this evolving space, the key takeaway is simple: convenience should never outweigh safety.
Ask These Questions Before Starting At-Home Ketamine:
- Am I being thoroughly screened for physical and mental health risks?
- Is a clinician involved in my treatment planning and follow-up?
- How is my vital sign data being collected and reviewed?
- What happens if I miss a check-in or report symptoms?
- Is someone physically present with me during dosing?
- What emergency protocols are in place?
If a service can’t answer those questions clearly, it’s a red flag.
A Better Way: Supervised Ketamine Therapy
At Anew Therapy Utah, ketamine is administered under medical supervision using FDA-approved formulations or established clinical protocols. We believe the therapeutic potential of ketamine is real, but so are the risks if it’s used carelessly.
That’s why we:
- Conduct comprehensive medical and psychiatric evaluations
- Monitor vitals in real time
- Provide in-room support during dosing
- Offer integration therapy and structured follow-up
We don’t take shortcuts with safety, and neither should any provider.
Final Thoughts
At-home ketamine therapy might sound like a modern answer to mental health care access. But the risks are real, especially when medical screening, supervision, and accountability are missing.
For anyone seeking healing through ketamine therapy, the safest choice is one that includes clinical oversight, clear protocols, and hands-on medical support. Convenience should never come at the cost of safety.
At Anew Therapy Utah, we offer in-person ketamine treatments, including IM ketamine and FDA-approved Spravato, in a setting built for both safety and care. Our licensed team is with you every step of the way – from your first consultation through integration and follow-up.
To find out if ketamine therapy is right for you, call us or text us at (801) 980-2690, or schedule a free consultation online.
You don’t have to wait weeks for relief, and you don’t have to take unnecessary risks just to feel better. Help is closer than you think, and you don’t have to figure it out alone.
Note: The lawsuit referenced in this article is ongoing, and all parties are presumed innocent unless found otherwise in court. Allegations are not findings of fact.
