A controversial depression treatment that boomed during the pandemic could become far less accessible by next year — potentially leaving patients high and dry and the internet upstarts that supply them looking for a contingency plan. Covid-era measures that allowed doctors to remotely prescribe ketamine, an often-abused drug increasingly popular for treatment-resistant depression, could unwind this spring. That could spell trouble for companies such as Mindbloom and Nue Life that will be forced to rethink their businesses amid concerns that at-home access has increased abuse of the drugs.

“I tell these folks, ‘There’s going to be a reckoning coming, and when that reckoning comes, you probably will lose everything,’ ” said Anthony Coulson, a retired DEA regional head who now consults for startups about controlled substances.

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