WMA warns against making essential anaesthetic a controlled drug

(06.03.2015) The World Medical Association is urging its 111 member associations to lobby their governments to oppose scheduling the anaesthetic agent Ketamine as a controlled drug.

The United Nations Commission on Narcotic Drugs is due to vote next Friday (March 13) on whether to schedule Ketamine because of concern about its use as an illicit recreational drug in many countries. But the WMA warns that if it is made a controlled drug, it would effectively prevent the drug’s use in many poor countries where it is the only alternative for short term pain relief in surgery.

Dr. Xavier Deau, President of the WMA, said: ‘We understand that the UN Commission on Narcotic Drugs is concerned about Ketamine’s use as a recreational drug. However the action it is proposing would make the drug unavailable and increase the level of suffering for 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 countries and in rural settings are then unable to receive treatment with those drugs.  So this is likely to further worsen the absence of drugs for anesthesia in many health care settings globally.’

The World Health Organisation has strongly advised against scheduling Ketamine. But the WMA is concerned the UN Commission may disregard this advice. It has now written to all its national medical association members urging them to contact their governments to oppose the change.

The WMA says that pain relief is an important component of health care and  strongly advocates for such medications to be available. It recommends tackling the illicit use of Ketamine by tightening the control of the drug’s availability through the pharmaceutical industry and by applying and enforcing legislation on prescription of drugs.

The WMA is supported by the World Veterinary Association which is also opposed to the change. In its press release today Dr. René Carlson, President of WVA declared: ‘Ketamine is essential for veterinary use, because it is the only injectable anaesthetic that is safe and well tested in the full range of species that the veterinarian must treat. This includes both large and small domestic animals, children’s pets and laboratory animals, large, wild and zoo animals, as well as birds and reptiles. It is safely used by virtually every veterinary practice throughout the world. It has been used safely as prescription only medicine.

‘Scheduling of Ketamine would restrict its availability worldwide, which again would lead to harmful impact on animal health and welfare, as well on public health. It would have economic consequences for agricultural production; it would affect unified efforts of medical and veterinary professions to control a wide range of emerging and re-emerging zoonotic diseases on human-animal-environment interface.  A number of such diseases (i.e. Ebola) may take the form of pandemics, especially the ones with their reservoir in wildlife; since veterinarians can administer ketamine by dart-gun injection, it contributes to professional safety when a dangerous animal needs to be approached. Without Ketamine there would be huge difficulties in managing many field programmes in epidemiology or conservation medicine e.g. blood sampling and radio-tracking collar attachment.’

* on 9 March, 2015, the WMA sent a letter to the members of the Commission on Narcotic Drugs of United Nations.