Ketamine should be reclassified as class B drug, government experts say

Advisory Council for the Misuse of Drugs says new evidence of bladder damage means drug should be upgraded from class C
  • The ACMD said ketamine’s short-term effects can include stomach cramps, impaired consciousness, agitation, hallucinations and dissociative effects. 

The drug ketamine, which is widely used as an anaesthetic for humans and animals, should be reclassified from a class C to a class B drug because of new evidence of the damage it can cause to the bladder, the government’s drug experts have said.

The Advisory Council on the Misuse of Drugs (ACMD) said it was making the recommendation to the home secretary, Theresa May, despite only limited evidence of ketamine causing social harm and its recent declining popularity as a club and party drug. May had asked the council to take another look at ketamine following evidence of an increase in regular, high-dose, daily use of the drug.

The council last looked at its classification in 2004 and recommended it should be in class C, attracting the same penalties as cannabis. It said its recommendation that it should be a class B drug – meaning that illegal possession can attract a maximum of five years’ imprisonment – follows new evidence that intensive use can lead to severe bladder and kidney damage.

The ACMD report said its short-term effects can include stomach cramps, impaired consciousness, agitation, hallucinations and “out of body” or dissociative effects: “In addition, there is now good evidence that frequent and heavy ketamine misuse can cause significant toxicity to the bladder, urinary tract and kidneys.

“This can be associated with severe and disabling symptoms that typically include pain on passing urine, frequency and urgency of urination, blood in urine and incontinence.”

The council said that while many of these side-effects can be reversible if the user stops taking the drug, there were “numerous reports of individuals who are having to have surgery to remove their bladders because of severe ketamine bladder-related damage”. But it added that there was no reliable national data on how many cases have required surgery.

The council also wants to see the conditions in which doctors and hospitals store ketamine made more secure and would like to change its supply in multi-dose phials to single-dose packages. Many hospitals have already tightened the conditions in which they store the drug.

Professor Les Iversen, the ACMD chairman, saidthere would be a consultation about the proposals and added that the council did not want to do anything that would impede the use of ketamine in medical research, particularly to treat depression.

The latest crime survey of England and Wales said around 120,000 mostly male users took ketamine in 2012-13, but the latest figures showed a sharp fall in its popularity in the last year. Users are mostly clubbers who take ketamine as a second or third drug alongside alcohol. Use among 16-to 24-year-olds fell from a peak of 2.1% in 2010-11 to 0.8% in 2012-13. The ACMD said, however, that it was too early to say if the decline was likely to continue.

Harry Shapiro, of DrugScope, the drugs information charity, said: “While the reclassification of ketamine from class C to class B may be logical given the current legal framework, we do not believe that this will be sufficient to address the public health problems posed by the drug.

“Drug users, nightclub and festival staff and healthcare practitioners all need to be better informed about ketamine, its effects and potential for dependency. This is especially important in general health settings when people present with unexplained bladder problems, to prevent long-term and potentially life-changing health issues.”

The popularity of ketamine surged three years ago after the “legal high” mephedrone was banned in 2011. Drug charities said its price was a big factor, with ketamine often selling for as little as £6 a gram, which split between four people made it cheaper than a pint.

The drug was originally used as an anaesthetic to sedate wounded American soldiers in the Vietnam war and is still used widely used by the military in field hospitals and as an anaesthetic for children. It is also widely used by vets as a horse tranquilliser.

Frank, the Home Office drug advisory website, says the effects of ketamine do not last long but can reduce sensations in the body, giving users a feeling “as if the mind and body have been separated”.

It adds that some feel people feel incapable of moving while under its influence, while others may feel completely detached from their bodies and surroundings. The trip it induces can last up to an hour although after-effects may be felt for some hours.

It is only recently been discovered that ketamine can cause serious bladder problems including severe pain and difficulty passing urine, and can even result in surgical removal of the bladder in extreme cases where users are taking large amounts of ketamine every day.

The home secretary asked the advisory council to review the evidence on ketamine in March last year amid emerging concerns about its popularity and potential harm.

May recently banned the use of khat, a mild herbal stimulant widely used by the Somali and Yemeni communities in Britain, against the advice of her official drug advisers.

The recommendation to increase the penalties for use of ketamine comes as academics at Edinburgh University announced that they intend to use the drug along with cannabis in a ground-breaking medical trial for pain relief for cancer patients.