U.S. Military Seeks Sublingual Ketamine Wafers as a Frontline Pain Management Solution

Summary

The U.S. Department of Defense has awarded a nearly $41 million sole-source development contract to Singapore-based iX Biopharma to develop Wafermine, a sublingual ketamine wafer designed to dissolve under the tongue and deliver rapid pain relief to wounded soldiers. The manufacturer is pursuing emergency use authorization to make the drug available to troops before it receives full FDA approval, citing a September 2025 military emergency declaration signed by Defense Secretary Pete Hegseth, which identified heightened risks of chemical, biological, radiological, or nuclear attacks causing severe pain and life-threatening injuries. Following Hegseth's determination, Health and Human Services Secretary Robert F. Kennedy Jr. declared that circumstances justify emergency authorization of Pentagon-identified drugs, opening a regulatory pathway for unapproved medications to treat combat wounds. Unlike traditional injectable ketamine, Wafermine works through mucous membrane absorption, offering a non-opioid alternative for managing moderate to severe acute battlefield pain, aligning with a documented military trend of increasing ketamine use and decreasing opioid use for combat casualties since 2010. However, the initiative has already faced scrutiny, as a Politico investigation revealed that iX Biopharma's domestic manufacturing partner reportedly lacks the required Nevada operating license.