Restricting Ketamine Would Have 'Dire Consequences' for Surgery in Low-Resource Countries, Anesthesi

[bananas]

http://www.newswise.com/articles/restricting-ketamine-would-have-dire-consequences-for-surgery-in-low-resource-countries-anesthesiologists-warn



Restricting Ketamine Would Have 'Dire Consequences' for Surgery in Low-Resource Countries, Anesthesiologists Warn

Released: 8-Feb-2016 11:30 AM EST
Source Newsroom: International Anesthesia Research Society (IARS)

Newswise — February 8, 2016 – Proposals to restrict access to ketamine by making it a "Schedule I" drug would have a major impact on the availability of anesthesia and surgery in low- to middle-income countries (LMICs)—where ketamine is often the only general anesthetic drug available, according to a series of commentaries in Anesthesia & Analgesia.

Drs. Girish P. Joshi of University of Texas Southwestern Medical Center, Dallas, and Bisola Onajin-Obembe of University of Port Harcourt Teaching Hospital, Rivers State, Nigeria, highlight the critical importance of ketamine for anesthesia in low-resource healthcare settings. "If ketamine is placed on the Schedule I list, it will not be available in the LMICs, resulting in dire consequences" for surgery in those countries, the authors write.

Commentaries Highlight Ketamine's Importance in Developing World

Used for more than 50 years, ketamine is a potent anesthetic and analgesic drug that has some major advantages for use in resource-poor environments. Ketamine can be given by several different routes of injection and used in a wide range of surgical procedures. "It is inexpensive and easily available, and unlike modern anesthetic techniques such as inhaled anesthesia, it requires minimal equipment and training," Drs. Joshi and Onajin-Obembe write.

Ketamine can be used in settings where modern anesthesia machines and equipment are rate or nonexistent. "Therefore, in many LMICs, ketamine is the sole anesthetic," according to the authors. They note that ketamine is also an important option in responding to crisis and disaster situations.

So why are efforts being made to restrict access? Ketamine is also used recreationally as a "party drug." Sometimes called "Special K" by users, recreational ketamine has a number of potentially serious harmful effects and the potential for physical dependence. Illegal ketamine use is a major problem in China, which in 2014 called for ketamine to be classified as a Schedule I medication.

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1. WHO recommends not restricting ketamine

https://www.avma.org/News/JAVMANews/Pages/160215h.aspx

WHO recommends not restricting ketamine

​Posted Jan. 27, 2016

The World Health Organization Expert Committee on Drug Dependence has recommended that ketamine not be placed under international control.

China initially had proposed that the United Nations Commission on Narcotic Drugs place ketamine under schedule I of the Convention on Psychotropic Substances, the most restrictive category. Following input from stakeholders, China recommended to the commission during a March 2015 meeting that ketamine be placed under schedule IV, the least restrictive category. The commission deferred action and asked for additional information from the WHO.

In September 2015, the WHO asked U.N. member states to complete a questionnaire on ketamine and other drugs in preparation for a November meeting of the Expert Committee on Drug Dependence. The Food and Drug Administration requested public comments and received more than 1,600, all opposing restriction of ketamine, before completing the questionnaire. The AVMA and many members were among the commenters.

According to a WHO statement, the Expert Committee on Drug Dependence “concluded that ketamine abuse does not pose a global public health threat, while controlling it could limit access to the only anaesthetic and pain killer available in large areas of the developing world.”

The Commission on Narcotic Drugs meets again in March. Ketamine currently is a schedule III drug in the United States, and it is uncertain whether international scheduling would impact the U.S. classification.


Related JAVMA content:

Veterinarians push against restriction of ketamine (Dec. 1, 2015)

Veterinarians urge United Nations not to restrict ketamine (May 1, 2015)

[Warpy]

2. It's also showing promise in treating severe depression

China needs to clean up its own damned house. Just because a bunch of stupid kids take it (all the safer drugs being more expensive and harder to get) is absolutely no reason to deny people worldwide its benefits.

End the drug war. Let the kids party, most of them will eventually outgrow it.