The powerful tranquiliser ketamine should be kept off a worldwide illegal drugs list despite it being abused by clubbers, doctors are arguing.
They say it should always be treated as a medicine and not be placed under United Nations illicit drug restrictions The World Federation of Societies of Anaesthesiologists is calling for global support for its initiative to protect ketamine’s status as an essential medicine for anaesthesia and pain relief.
China and other countries which have a problem with ketamine abuse want the drug included on the UN schedule for controlled drugs.
Dr Jannicke Mellin-Olsen, newly-elected WFSA President, spoke out at the group’s World Congress in Hong Kong.
She said: “Ketamine is an essential anaesthetic and painkiller, especially in countries with limited options and poor storage facilities in their hospitals.”
Ketamine is used as the sole available safe anaesthetic in many parts of the world and is widely used in adults and children alike.
Experts say it is also easily transported in situations such as disasters, in which vital lifesaving surgery can take place at the scene of the disaster, even outside the hospital.
But China and some other Asian countries, including Thailand, have problems with ketamine abuse. They want access to be restricted in the same way that morphine is a scheduled or controlled substance.
The UN’s Commission on Narcotic Drugs (CND) has so far not submitted to their demands. The World Health Organisation (WHO) has reviewed ketamine use several times since 2004 when the International Narcotics Control Board (INCB) first noted illicit use was a problem and encouraged countries to place the drug under controls.
On each occasion, WHO has repeatedly warned that placing ketamine under international control would devastate access to safe surgery for billions.
Dr Mellin-Olsen, who is based at Baerum Hospital in Norway, added: “Of course there are legitimate concerns about ketamine abuse, and these shouldn’t be discounted.
“However, it also needs to be recognised that there is little to no evidence that abuse occurs in countries where it is the most essential anaesthetic.
“The international drug control system has caused immense harm to access to medicines, and the system is still, today, out of balance.”
WFSA has launched a “Ketamine is Medicine” campaign against the drug being subjected to international controls.
Dr Mellin-Olsen added: “We call on the UN’s Expert Committee on Drug Dependence not to recommend any further restrictions on ketamine pending the collection of more reliable and complete data on the effects that this might have on the availability of this essential anaesthetic drug, and on patient outcomes around the world.”
Associate Professor Philip Peyton, of Austin Hospital and the University of Melbourne in Australia, told the Congress: “Ketamine’s unique safety profile and effectiveness make it irreplaceable in anaesthetic practice.
“However, concerns about ketamine’s recreational abuse have prompted international calls for its withdrawal.
“This comes at an unfortunate time, as there is increasing interest in ketamine’s other potential therapeutic effects on chronic pain and postoperative delirium, which are now recognised as common and serious postoperative complications, as well as a possible emerging role in management of severe treatment-resistant depression.
“Its unique value in the management of severe pain after surgery or trauma is now widely appreciated.” He added:
“Much research still needs to be done to properly define the value of ketamine and its importance in clinical practice before any decisions about the future availability are made.”