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In 2024, Koniver was sanctioned by South Carolina public-health officials who found, among other things, that hed failed to maintain his registration with the Drug Enforcement Administration while prescribing controlled substances, and that hed neglected to check patient vital signs before administering ketamine

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Also, depending on where they are procured (for example, directly from foreign manufacturers or via online influencers affiliate links), they also pose the risk of being inconsistent in terms of dosing and purity, which comes with inherent safety risks