The explosion in demand for ketamine-assisted psychotherapy (“KAP”) has garnered significant media attention over the past few years—and the federal government has taken notice. In a case that should sound the alarms of every ketamine provider and clinic, prosecutors in the Eastern District of Missouri have escalated enforcement against ketamine providers, issuing criminal charges that resulted in prison time, probation, and a surrendered DEA license. Read below to learn more about the case and what it means for the future of DEA oversight of KAP.

Background

On January 11, 2024, the U.S. Attorney’s Office indicted two St. Louis area doctors on 22 felony counts, alleging illegal ketamine administration and fraudulent billing related to ketamine therapy services provided at COPE Ketamine Clinic, a psychiatric clinic offering KAP and other ketamine-based treatments for depression, anxiety, and PTSD.

The indictment charged Dr. Asim Muhammad Ali and Dr. Mohd Azfar Malik with participating in conspiracies to illegally distribute controlled substances and maintain a drug involved premises, twelve counts of illegal distribution of controlled substances, and seven counts of making false statements related to health care matters. The indictment stemmed from allegations that the providers were administering intravenous ketamine infusions and esketamine nasal sprays without authorization.

The Allegations

The government’s allegations outline a pattern of conduct that should give any ketamine provider pause. Specifically, the government alleged that the clinic’s physicians administered ketamine IVs and nasal sprays without authorization, did not have a proper DEA license, billed claims to Medicare under another provider’s name and billing number, and failed to properly store ketamine and esketamine at their clinic. If convicted, the providers faced decades of prison time, millions of dollars in financial penalties, and debarment from future participation in federal health care programs.

This case makes one thing abundantly clear: prosecutors are willing and ready to pursue criminal charges relating to providers’ practices in administering, billing for, and providing ketamine services.

Guilty Pleas and Sentencing Outcomes

Both doctors ultimately admitted wrongdoing in connection with these charges in 2025. Dr. Ali pleaded guilty to conspiracy to illegally distribute controlled substances and to maintain a druginvolved premises, resulting in a sentence of 70 months in federal prison. Dr. Malik pleaded guilty to two counts of making false statements related to federal healthcare matters based on ketamine treatment claims he submitted to Medicare, Medicaid, and private insurers, resulting in a sentence of five years’ probation, tens of thousands of dollars in restitution and fines, and surrender of his DEA controlled substance registration.  

Why This Matters to Ketamine Providers

While this case quickly gained national attention as a striking example of the federal government’s increased focus on ketamine enforcement, the case is merely an example of what ketamine providers can expect moving forward. This case makes one thing abundantly clear: prosecutors are willing and ready to pursue criminal charges relating to providers’ practices in administering, billing for, and providing ketamine services. Those charges can result in not only substantial fines, but significant professional (and even criminal) liability.

For clinics and providers offering intravenous ketamine infusions, esketamine nasal sprays like Spravato, or other therapies involving controlled substances and psychoactive medications, this case emphasizes that serious federal exposure is possible if authorities challenge how services are structured or delivered.

Takeaway: Awareness Alone Isn’t Enough

If your practice involves ketamine administration, infusion models, or federal program billing, the St. Louis indictments and outcomes should serve as a stark reminder: federal prosecutors are watching and ready to pursue charges that can result in prison time, financial penalties, and potential revocation of your medical licensure.

Are you a provider facing a DEA audit or allegations relating to your ketamine services? Providers who engage counsel before an investigation disrupts their operations are more likely to come out with their reputations intact. Don’t wait—contact us today to learn how we can help.