Pledge Program

The American Society of Ketamine Physicians, Psychotherapists, and Practitioners’ (ASKP3) Pledge Program provides practitioners with basic guidelines and standards for the administration of ketamine to treat mental health disorders and pain conditions. Practitioners taking the ASKP3 Pledge agree to adhere to and to uphold the Basics of Administration, as detailed below. Pledge recipients are required to renew their promise to the Basics of Administration, annually, reinforcing their commitment to uphold the Basics of Administration.

The ASKP3 Basics of Administration are as follows:

1. ASKP3 serves as a forum to discuss the use of therapeutic ketamine for Non-Anesthetic Indications (KNAI).
ASKP3 serves as a forum to discuss the use of therapeutic Ketamine for Non-Anesthetic Indications (KNAI). KNAI is fundamentally different than the traditional use of ketamine as an anesthetic.

2. We recognize that therapeutic ketamine is being administered by clinicians through different routes of delivery (IV, IM, IN, PO, etc.).
We recognize that therapeutic ketamine is being administered by clinicians through different routes of delivery (IV, IM, IN, PO, etc.). ASKP3 does not endorse any particular route of delivery, however it is important that the combination of delivery and dose do not cross over from KNAI to a level of sedation inappropriate to the provider and clinical setting.

3. Screening and selection of patients for ketamine treatment should be informed by direct research supporting a given use or the rational application of ketamine’s mechanism of action towards addressing accepted medical pathophysiology.
Patients should be screened for and have been found to have a condition that is appropriate for ketamine treatment – examples include Unipolar Major Depression, Bipolar Depression, PTSD, OCD, Anxiety, Eating Disorders, Suicidal Ideation, Fibromyalgia, CRPS and other forms of chronic pain.

4. Examination and screening by medical staff before treatment should include documentation of appropriate psychiatric and substance abuse disorder history.
A full history and physical including psychiatric disorders and substance abuse disorders should be completed in the patient’s chart. The patient’s medications and allergies should also be documented to reduce reasonable risk of medication interaction and side effects.

5. Practitioners should obtain appropriate consent for ketamine treatment documenting risks, benefits and the off-label nature of ketamine for these disorders.  Given the off-label nature of ketamine use for these disorders, appropriate consent should be obtained.

6. Practitioners should always make their basic protocol and details of treatment available to the patient upon request.
Practitioners should make their established protocol and details of treatment available to patients and to the community. The use of “secret formulations” and “proprietary blends” runs counter to the concept of evidence-based medicine.

7. Practitioners should document vital signs and any monitoring that may occur during administration, as well as appropriate indicators of patient status upon discharge from the clinic.
The patient’s vital signs should be monitored during administration and return to pre-administration values before discharge from the clinic. An appropriately licensed and qualified medical provider should be present during the administration as well.

8. Practitioners should advise patients receiving ketamine that they shall not drive themselves home from their appointment or operate heavy machinery, including automobiles, for 12-hours after infusion.
Patients receiving ketamine therapeutically should not be allowed to drive themselves home from their appointment, or for 12 hours after their infusion.

9. ASKP does not currently support the use of medically unsupervised parenterally administered ketamine unless warranted by extreme circumstances.
We do not support the use of medically unsupervised parenterally administered ketamine except in circumstances where benefits clearly outweigh the risks (e.g., severe hospice pain).