The FDA (the US drug regulator) or the DEA (the US drug enforcement agency) will take formal action — think new rules, warning letters, or enforcement cases — targeting the booming business of prescribing ketamine through online video appointments. Ketamine clinics have multiplied rapidly with loose oversight, and regulators already have a track record of flagging these practices.
Ketamine at 15x signal frequency with aggressive clinic-chain expansion matches the diversion profile that historically precedes enforcement, and the esketamine REMS exists precisely to prevent the prescribing patterns now common in generic ketamine telehealth. FDA has prior form here (2023 compounded ketamine safety communications), lowering the activation barrier for escalation. Confidence trimmed slightly from 0.78 to reflect agency resource constraints in an election-aftermath year. Resolution criteria: resolves YES if FDA or DEA issues warning letters, an import alert, a registration revocation, civil/criminal charges, or a formal rulemaking specifically targeting compounded ketamine telehealth operators by 2027-03-31; general safety communications without named targets do not count.