<i>Notes from the Field:</i> Ketamine Detection and Involvement in Drug Overdose Deaths — United States, July 2019–June 2023

Ketamine, a Schedule III controlled substance* that is Food and Drug Administration (FDA)-approved for general anesthesia, can produce mild hallucinogenic effects and cause respiratory, cardiovascular, and neuropsychiatric adverse events (1).In 2019, a form of ketamine (esketamine) was approved by FDA for use in treatment-resistant depression among adults (2).Ketamine use, poison center calls for ketamine exposure, and ketamine drug reports from law enforcement have increased through 2019 (3), but recent trends in ketamine involvement in fatal overdoses are unknown.Data from CDC's State Unintentional Drug Overdose Reporting System (SUDORS) were analyzed to describe characteristics of and trends in overdose deaths with ketamine detected or involved during July 2019-June 2023. Investigation and FindingsData on drug overdose deaths with unintentional or undetermined intent come from SUDORS, which includes information from death certificates, medical examiner or coroner reports, and postmortem toxicology reports. Data are abstracted on all substances reported to cause death (i.e., involved) and substances detected through toxicology testing. Decedent demographics and other overdose characteristics were analyzed among 45 jurisdictions (44 states and the District of Columbia [DC]),** and trend analyses were conducted among * Drugs, substances, and certain chemicals used to make drugs are classified into five distinct categories or schedules depending upon the drug's acceptable medical use and the drug's abuse or dependency potential.Schedule III substances are defined as those that have moderate to low potential for physical and psychological dependance.https://www.dea.gov/drug-information/ drug-scheduling https://www.fda.gov/news-events/press-announcements/fda-approves-newnasal-spray-medication-treatment-resistant-depression-available-only-certified https://www.cdc.gov/overdose-prevention/data-research/facts-stats/about-sudors.html A drug was considered involved if it was listed as a cause of death on the death certificate or medical examiner or coroner report.A drug was considered detected if it was present on the postmortem toxicology report.A detected drug might or might not be listed as a cause of death.