State health department announces plans to review the ketamine waiver program

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For immediate release: Aug. 22, 2020

Contact:, 303-691-7870



REMOTE, Aug. 22: The Colorado Department of Public Health and Environment announced today plans to review the state’s ketamine waiver program. 


A review committee, facilitated by CDPHE’s chief medical officer, will consist of EMS provider(s), pharmacist(s), ER doctor(s), anesthesiologist(s), and others. The committee will be charged with examining the safety of ketamine administration in EMS settings. 


“Today I am calling for the immediate and thorough review of the state’s ketamine waiver program,” said Jill Hunsaker Ryan, executive director, CDPHE. “Our agency will work with medical experts to study the use of ketamine in the field-- as well as the state’s oversight mechanisms-- and produce a public report. Patient safety and program transparency are top priorities.” 


CDPHE regulates the scope of practice for Emergency Medical Service providers. Through a waiver process, EMS medical directors can obtain permission to expand the standard scope of practice and allow paramedics to administer ketamine outside of the hospital setting. CDPHE allows waivers for ketamine administration for excited delirium and/or extreme or profound agitation and pain management. EMS medical directors present waiver applications to the Emergency Medical Practice Advisory Council (EMPAC) for review. EMPAC reviews the training and oversight programs and makes recommendations for approval or denial to CDPHE. The department maintains a list of medical directors with waivers from the standard scope of practice. A condition of the ketamine waiver program requires medical directors to report to the department for every waivered ketamine administration. In the past 3 years, it has been used 902 times for excited delirium and/or extreme or profound agitation. 


The review will begin immediately and is expected to last a minimum of 12 weeks. To protect the integrity of the review, CDPHE will not provide additional information until the review is complete. At that point, CDPHE will release a final report.