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Scheduling clash: revisiting ketamine (and legislation) harms


10th December 2013

It was announced today that ketamine will be reclassified to Class B, up from C. But that's not the whole story.

Drug classification, which determines the penalties for illicit recreational use, makes the headlines. Drug scheduling, which determines the regulations for licensed use by doctors, vets and researchers is the hidden issue here. The proposal is to tighten the regulations on legitimate use of ketamine to the very toughest level, the level used for diamorphine, more commonly known as heroin.

Heroin is a valuable painkiller for dying patients, but needs the tightest controls on secure storage and documenting its movements to prevent supplies going missing, or worse, as the Shipman murders demonstrate. The risks of ketamine misuse or theft is simply notcomparable so this move is disproportionate and unnecessary. Current regulations on ketamine are sufficient. Sensible NHS guidelines already stipulate that where practical, ketamine is to be treated the same as heroin anyway, so the proposed change is not needed. But vets, especially small local and agricultural vets operating out of buildings without purpose-built drug storage rooms may be hit hard by overzealous restrictions.

The consequences of burdensome or totally obstructive rules on the legitimate use of ketamine will of course not only inconvenience vets, but may cause harm and suffering to animals when vets are less able or willing to make use of ketamine, or to afford to upgrade their drug storage facilities to stock it. Vets rely on the unique properties of ketamine as safe anaesthetic for many species. Also, research projects on wild animal populations (such as the badgers of Wytham Wood) sometimes utilise ketamine as a low-risk way to allow measurements to be taken while causing minimal stress to the animal. Such research has proved essential for understanding and protecting British wildlife, for example by collecting evidence on the impacts of climate change, and the feasibility of TB vaccination. It is very important for conservation efforts that misguided regulations do not put such vital work in peril.

The proposal to reschedule ketamine seems simply to be an automatic move to match the reclassification, rather than a considered decision to reduce harm. Before ketamine became a popular recreational drug, diversion of legitimate supplies may have been a significant source to the illegal market. However, ketamine is now manufactured and imported in large quantities for the illicit market, and diverted legitimate supplies play no meaningful role.

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