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13 Mar 2015

Millions of patients in developing countries may be forced to undergo lifesaving surgery without pain relief if the United Nations decides to schedule the widely-used anaesthetic ketamine as a narcotic drug at a meeting later today.

The United Nations Commission on Narcotic Drugs is due to vote tonight Australian time on a Chinese proposal to classify ketamine as a controlled drug amid concern about growing abuse of the medicine for recreational purposes.

Chinese authorities have become increasingly alarmed about the illicit use of ketamine, where it often goes by the street names ket, Vitamin K or Special K, and want it to be put in the same schedule 1 category as psychedelics such as LSD, making its supply and use subject to heavy restrictions.

It would mean that any countries wanting to purchase the drug would face an annual limit on how much they could import, and a condition of supply would be that it is only administered by government employees.

Medical experts including the World Health Organisation and the World Medical Association have warned that this would be a disaster for billions of patients in developing countries, where ketamine is the only viable form of short-term pain relief.

Ketamine is one of the most commonly used anaesthetics in the developing world because it is cheap and easy to use. It is injectable, which means it can be administered by doctors and nurses in even basic settings and, because it does not interfere with coughing and gag reflexes, patients do not have to be intubated. It is also valued in cases of traumatic injury and shock because it raises blood pressure.

Professor of International Health at Boston University Richard Laing told The Guardian said scheduling ketamine as an illicit drug would be “an absolute disaster”.

“The fact that ravers in the west abuse this product should not deprive poor people in struggling health systems from access to this most vital lifesaving medicine,” Professor Laing said.

The WHO has strongly advised the Commission to reject the proposal on public health grounds, arguing that to schedule the drug would have the practical effect of denying its use to millions who undergo lifesaving surgery in developing countries every year, such as caesarean sections.

World Medical Association President Dr Xavier Deau said that although the desire to tackle the recreational abuse of the drug was understandable, scheduling it would make it unavailable and increase the suffering of people “in the most difficult of clinical circumstances”.

“We know from experience with other anaesthetics, especially pain medication, that the scheduling of drugs effectively prevents their use, and that patients in poor areas and in rural settings are then unable to receive treatment with those drugs,” Dr Deau said.

Instead of scheduling ketamine, the WMA said it would be better to tackle the problem of illicit use by tightening controls on the drug’s supply through prescriptions and by the pharmaceutical industry.

Australia will be represented at the Commission meeting by Assistant Minister Fiona Nash, and is reported to be considering a vote against the Chinese proposal.

So far, China is understood to have the backing of a number of other countries including Russia, but will need the support of around two-thirds of the 53 member states to ensure its proposal is adopted. The British Government has indicated it will abstain.

Adrian Rollins


Published: 13 Mar 2015