Unsupervised Ketamine Users Rated It Just as Effective. The Hallucination Odds Were 2.5 Times Higher
People taking ketamine without medical supervision rated it almost exactly as effective as people treated in clinics. They also had higher odds of reporting long lasting hallucinations. Both findings come from the same survey, published in the Journal of Psychoactive Drugs, and clinic operators should read both halves.
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| Key Takeaway | Detail |
|---|---|
| The study | Cross-sectional analysis of the 2023 Global Psychedelic Survey, published September 23, 2026 |
| The groups | 238 people using ketamine clinically, 222 using it outside clinical settings |
| Effectiveness | 83.3 out of 100 clinical versus 81.2 non-clinical, a difference that was not significant |
| The risk signal | Non-clinical use carried 2.58 times the odds of reporting long-term hallucinations |
| Not the same people | Non-clinical users had far more experience with psychedelics and other substances |
| The limits | Self-reported, self-selected and cross-sectional, so it cannot establish cause |
What the Study Looked At
Researchers used the 2023 Global Psychedelic Survey to compare two groups. One used ketamine under medical supervision. The other used it on their own.
The clinical group had 238 people and the non-clinical group had 222. Participants rated effectiveness on a scale from 0 to 100 and reported side effects.
The team is Canadian, with authors from Sunnybrook and the University of Toronto. It appeared in the Journal of Psychoactive Drugs on September 23.
The Headline Number
Clinical users rated ketamine at 83.3 out of 100. Non-clinical users rated it at 81.2. The gap was not statistically significant.
Depression and anxiety symptoms were similar between the groups at the time of the survey. Both sat in the mild range.
Taken alone, that reads like an argument against paying for supervision. The rest of the paper is why it is not.
These Were Not the Same Patients
The non-clinical group was substantially more experienced with psychedelics, with other recreational substances, and with ketamine itself. All three differences were large.
That matters for interpretation. A confident, experienced user who seeks out ketamine independently is not the same person as a patient referred for treatment-resistant depression.
Comparing their satisfaction ratings is not comparing two treatment settings. It is comparing two populations who chose different paths.
A Rating Is Not an Outcome
Effectiveness here is a self-reported score, collected once, after the fact. It is not a depression scale measured before and after treatment.
People who felt helped are also more likely to still be using a treatment and to answer a survey about it. That selection runs through both groups.
Measurement choices change answers in this field, as we saw in our piece on how instruments shape findings about the ketamine experience.
The Safety Finding Is the Useful One
Non-clinical users had 2.58 times the odds of reporting long-term hallucinations. The confidence interval ran from 1.08 to 6.31.
That interval is wide, which means the size of the effect is uncertain. It does not cross 1, which means the direction held.
This is the part of the paper that supports supervised care without overstating it. Equal satisfaction, unequal risk profile.
Who Ran It and Who Funded It
The paper states it received no funding. The authors thank the survey sponsors, which include MAPS, Mind Medicine Australia, SABI Mind and the Tiny Foundation.
Several authors are affiliated with the Ontario Ketamine and Infusion Clinic. One author was president of SABI Mind and a shareholder during the study.
None of that invalidates the work, and the disclosures are published in the paper. It does mean a reader should notice that clinic-affiliated researchers produced a finding favorable to clinical settings.
What a Clinic Should Take From This
The patients asking about at-home options are not imagining the appeal. People who go that route report being satisfied, and that claim now has a published number behind it.
The answerable difference is risk management, not enthusiasm. Screening, monitoring and follow up are what the non-clinical path lacks.
That conversation gets more pressing with the telehealth prescribing deadline at the end of the year, and with federal attention already on online ketamine sellers.
Specialty societies have been making the oversight case for a while, including the anesthesiologists. Meanwhile the economics keep pushing work out of the clinic, which we covered in our data on at-home integration.
The Bottom Line
This study does not show that unsupervised ketamine works as well as supervised ketamine. It shows that two different populations gave similar satisfaction scores.
The finding worth repeating to a patient is the other one. Reported long-term hallucinations were more common among people using it without supervision.
Patients looking for supervised care can start with our directory of verified ketamine clinics.
This article is for informational purposes and is not medical advice. The study described is cross-sectional survey research and cannot establish cause and effect.
