Ketamine update
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Ketamine update

Published by November 19, 2016 4:36 pm

Reclassification of Ketamine

Update on international scheduling of ketamine following the 59th meeting of the UN Commission on Narcotic Drugs in Vienna, March 2016.

Ketamine was discussed at some length during the CND meeting. However, it was not included in the agenda for international control. The WHO’s Expert Committee on Drug Dependence (ECDD) position was upheld – that ketamine is an essential medicine and should not be scheduled. China expressed disappointment with the ECDD recommendation against scheduling and stated that it still believed ketamine should be under international control. However, it concluded by saying that it concurs that the scheduling discussion should be postponed and again called for additional data.

The strong support of the ECDD’s position from the worldwide medical and veterinary community has played a huge role in averting a crisis. Those present in Vienna deserve a medal for all they did and thanks are due to all the efforts, large and small, that has brought us this far.

However, the issue has again not gone away – the notification by China still stands, and the issue is very likely to arise again. The momentum for providing a global perspective on ketamine’s importance in both human and veterinary medicine must be continued. Lobbying against international control has to continue.

Please continue to use all opportunities to advocate for ketamine – that it does far more good as a medicine than harm as a recreational drug. New data and information will continue to be added to this website – please share it wherever possible!

WHAT YOU CAN DO:

1) Spread the word using this WFSA poster.

(WFSA is the World Federation of Societies of Anaesthesiologists)

WFSA ketamine facts poster

2) Use this information in any correspondence with MPs, government officials and anyone with clout.

Ketamine is an essential medicine for veterinary care. It is used widely across the range of developing to developed countries and is often the only available product for veterinary anaesthesia and analgesia.

The loss of access to ketamine for veterinary use would have a disastrous detrimental impact on veterinary practice and the patients being treated. It would prevent the profession from providing safe, cost-effective anaesthesia and analgesia. In some regions of the world such loss would entirely prevent any surgical treatment at all – both elective and non-elective.

International scheduling and subsequent loss of ketamine would translate into a major and global animal welfare issue of immense significance spanning all species. People would also be affected since loss of the use of ketamine would significantly undermine feral dog/cat population control which makes a significant contribution to rabies control

National implementation of ketamine drug access, storage, and recording regulations, as current in many countries, would appear the most prudent foundation for management of concerns regarding ketamine redirection and recreational use.

We urge the UN Convention on Narcotic Drugs to reject calls for international scheduling of ketamine and uphold the WHO’s Expert Committee on Drug Dependence (ECDD) declaration that ketamine is an essential medicine.

and

More useful information to quote:

Ketamine’s value as an essential medicine is unknown to many and the proposal for international control stems by and large on the widespread misconception that ketamine is just a recreational drug. We veterinarians need to ensure that global perception of ketamine is indeed as a medicine; its place as a recreational drug pales into insignificance.

The WHO’s Expert Committee on Drug Dependence (ECDD) consistently recommends that ketamine should not be placed under international control, concluding that ketamine abuse does not pose a global public health threat, and that such control would limit access for those who most need it as a life-saving anaesthetic.

Ketamine is the only anaesthetic suitable for both medical and veterinary use in LMIC (low & middle income countries). It also has particular value “in the field” – for trauma, traffic and sporting injuries, in natural disasters and in zones of conflict – any situation with limited facilities. As we know, ketamine plays an enormous and essential role in veterinary anaesthesia.

The side effects of bladder damage from chronic ketamine misuse are horrible, but this affects only a few who take very high doses; most recreational users suffer few ill effects. This should not prevent its use for the millions who really need it.

and

3) Tweet and share on Facebook

Use #ketamineismedicine hashtag

focus on

– “As the #CND2016 begins in Vienna, we veterinarians want to remind all countries that #ketamineismedicine and essential for veterinary care” (or similar) with a link to any of the resources online.

– Use the The World Federation of Societies of Anesthesiologists #ketamineismedicine hashtag which is advocacy around human medicine

here is Kate White’s “how to tweet”

4) Keep in touch with the campaign via WSAVA’s petition – go to

https://www.change.org/p/un-convention-on-narcotic-drugs-ketamine-is-an-essential-medicine-and-should-not-be-re-scheduled

MORE BACKGROUND INFORMATION

The ketamine fact sheet is exactly that.

It will be used at the CND to inform member states of the real status of ketamine throughout the world.

It includes many links providing more background.

It has been endorsed by numerous NGOs, as well as medical and veterinary associations

KETAMINE FACT SHEET FOR 2016 CND

THE WSAVA GLOBAL PAIN COUNCIL (GPC)’S STATEMENT ON KETAMINE

Access to anaesthetic and analgesic drugs is imperative for the mitigation of animal suffering and the WSAVA’s Global Pain Council was created to address inequalities in both education and access to analgesic/anesthetic modalities in differing regions of the world. In some regions, ketamine is the only analgesic/anesthetic agent available to the veterinary profession and is essential to enable veterinarians to perform their day-to-day activities in an ethical and humane manner. Restrictions on its use would have a significant and negative impact on animal welfare on a global scale. As such, the WSAVA and its Global Pain Council lend their support to the Ketamine Fact Sheet and efforts to halt any initiatives that seek to have it rescheduled.

GCP on ketamine

In 2015 WSAVA surveyed their global membership to establish how ketamine is used in small animals by the worldwide veterinary community. Here is a summary of the results:

WSAVA KETAMINE SURVEY RESULTS SUMMARY

Read this article from the Guardian from a Nigerian anaesthetist.

First hand experience of why ketamine is really important

See this letter in the Lancet: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)00681-4/fulltext

The WSAVA petition invites comments –

(see https://www.change.org/p/un-convention-on-narcotic-drugs-ketamine-is-an-essential-medicine-and-should-not-be-re-scheduled to read them all)

Of note, Will Scholten, the former Secretary of the World Health Organization Expert Committee on Drug Dependence, said this: “I confirm that ketamine is essential for human and veterinary medical practice and for wildlife conservation. To most ‘recreational’ users, ketamine does no or limited harm and only heavy users will experience serious bladder disfunction. However, the latter does not outweigh the human rights violation when ketamine availability will be restricted to many people with as a consequence that there will be no anaesthesia in case they need surgery. Nearly all illicit production is in China and therefore, the Government of China should be able to ban diversion without international restrictions”.

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