Celebrity Death Fuels Call for Ketamine Standards

The suspected overdose death of Presley Gerber, the 27-year-old model and son of Cindy Crawford, has become the latest flashpoint in a growing debate over ketamine prescribing.

Friends of Gerber say a doctor had been prescribing him ketamine for months, despite knowing about his struggles with addiction.

In a MedPage Today opinion piece three addiction psychiatrists argue the case reflects systemic problems in how ketamine is prescribed across the country.

Tucker Avra, Renée Sorrentino and Fernando Espi Forcen, who have published on ketamine addiction, write that the reports about Gerber’s care are all too familiar.

A similar pattern appeared in the Matthew Perry case. A doctor who knew about the actor’s decades of addiction prescribed ketamine, and later pleaded guilty to distributing it without a legitimate medical purpose.

A Legitimate Drug With a Regulation Gap

Ketamine is not the villain of this story. Approved in 1970 as an anesthetic and effective for several mental health conditions, it gained FDA approval in esketamine form (Spravato) for treatment-resistant depression in 2019.

Esketamine is available only through a Risk Evaluation and Mitigation Strategy, a mandatory safety program. Off-label ketamine prescribing for depression, PTSD and obsessive-compulsive disorder has no comparable safety net.

The authors describe a shift toward chronic ketamine use, rather than short treatment courses, with the effects of long-term use largely unknown. In the U.K., the number of people starting treatment for ketamine addiction has risen more than eightfold over the last decade.

The Wild West of At-Home Ketamine

The Massachusetts General Hospital ketamine clinic, for example, has provided more than 11,000 infusions and quadrupled its treatment volume since 2018. In supervised, in-person settings like that one, the authors note that ketamine use disorder appears rare.

The risk concentrates elsewhere. Unsupervised at-home use, inadequate monitoring, prescribing through telehealth platforms without in-person evaluation and missing informed consent have produced lawsuits against companies providing at-home ketamine.

The American Society of Anesthesiologists warns that access is expanding faster than safety standards.

What Safer Care Looks Like

Both the APA and the Spravato label flag a history of substance use disorder as a reason for careful assessment before prescribing. The authors’ prescription is straightforward.

Prescribers should be trained in ketamine’s risks, document risk-benefit decisions for patients with addiction histories and withhold treatment that carries unmanageable risk, regardless of a patient’s preferences or celebrity status.

Medically supervised detox programs can provide a safe starting point for those concerned about safe ketamine use, particularly when use has become chronic or daily. Call 800-996-6135Sponsored to learn more about your treatment options.