The Critical Difference Between Prescribing and Administering Ketamine

The death of 27-year-old Presley Gerber, son of supermodel Cindy Crawford, is a great sadness that has rightfully shaken his communities and fans. He had spoken openly about his struggles with mental health and substance use, and his death, which is currently being investigated as a suspected overdose, is an extraordinarily painful reminder of how vulnerable people can be when managing addiction. Reports have also emerged that Gerber had been prescribed ketamine prior to his death, although the substances involved in his death and its official cause have not yet been determined.

These moments often stir up confusion and concern about what we do here at Ember. As physicians and clinicians who have administered IV ketamine safely to people with severe depression for years, we believe this moment underscores a critical distinction about ketamine safety:

Prescribing ketamine and administering ketamine are fundamentally different models of care.

When ketamine is prescribed for at-home use, a patient receives medication to take outside a clinical setting. The clinician is not physically present when the medication is taken. They cannot directly control the amount actually consumed, continuously assess the patient's response, or intervene immediately if a medical or psychological complication occurs. This leaves vulnerable people managing risk on their own.

That distinction matters with any medication that has meaningful risks. It matters even more with a drug like ketamine, which temporarily alters consciousness and also carries potential for misuse and dependence.

The FDA has specifically warned about compounded ketamine products used at home for psychiatric conditions, citing risks including sedation, dissociation, changes in vital signs, abuse and misuse, and noting that the absence of onsite monitoring may put patients at risk.

Medical administration is different.

At Ember Health, we do not prescribe ketamine for patients to take home. We administer IV ketamine in our medical offices, at a controlled dose, under direct clinical supervision for the entire infusion.

A clinician remains with the patient throughout the entire experience. We monitor the patient's physiological and psychological response. The medication stays in the clinic. The dose is known and controlled. Treatment takes place within clear clinical protocols designed around the fact that ketamine is a powerful medicine requiring thoughtful safeguards.

This model is particularly important for vulnerable patients, including people with histories of substance use. In this setting and medical model, we have seen stunning results, relieving depressive symptoms in 84% of people we’ve served over the past 8 years.

There is a painful irony here: ketamine itself is also being researched as a promising treatment for substance use disorders. Clinical studies have found that medically administered ketamine, often combined with psychotherapy, may help reduce cravings or substance use and improve abstinence for some people with alcohol, cocaine and opioid use disorders. A recent meta-analysis found a significant improvement in short-term abstinence, while also emphasizing that the evidence remains limited and that more research is needed.

Ketamine has demonstrated substantial antidepressant effects, which is particularly relevant for people whose substance use coexists with depression. Research examining ketamine treatment for mood disorders has found relatively little evidence of misuse when treatment occurs within controlled, clinically supervised settings, —while continuing to emphasize the importance of careful dosing and monitoring.

None of this tells us what happened to Presley Gerber. We should not speculate while his death remains under investigation. But his death should prompt a broader conversation about what we mean when we talk about “ketamine treatment.”

Ketamine is neither inherently safe nor inherently dangerous. How it is delivered matters. Who is caring for the patient matters. Dose control matters. Monitoring matters. Clinical judgment matters.

At Ember Health, our responsibility is to create a setting where people seeking help—including those who may be at their most vulnerable—can receive this medicine with rigorous safeguards, evidence-informed protocols, and clinicians physically present to care for them.

People struggling with depression or substance use deserve treatment without judgment. They also deserve treatment designed around their safety.

As access to ketamine expands, we believe both principles must remain inseparable.

You can read more about IV ketamine safety at Ember Health at our safety page.