Based on current evidence, off-label ketamine use for severe, treatment-resistant depression does not violate ethical principles, but clinicians and professional bodies must establish guidelines for good practice, register all trial data, and continuously monitor risks. The analysis reviews evidence for ketamine's antidepressant effects and safety profile, concluding with recommendations for oversight bodies to support safe, effective, and ethical treatment.
Young adults who use ecstasy in the United Kingdom and the Netherlands show three similar patterns of polydrug use: traditional polydrug use (UK 28%, NL 40%), stimulant and ketamine use (UK 48%, NL 52%), and extensive polydrug use involving stimulants, depressants, and psychedelics (UK 24%, NL 8%). UK users more often consume MDMA as powder/crystalline at higher doses, while Dutch users prefer tablets. Most respondents in both countries intend to reduce but not quit their use. The patterns are structurally similar across countries, though individual substance frequencies and preferred MDMA form differ.