The #KetamineIsMedicine Campaign was set up in 2015 in response to calls for the UN Commission on Narcotic Drugs (CND) to ’schedule’ ketamine under the 1971 Convention on Psychotropic Substances. The UN Commission on Narcotic Drugs (CND) decided to postpone their decision on this issue in April 2016 and so the WFSA continues efforts to ensure the medical value of ketamine, particualarly as an anaesthetic medicine, is highlighted on a global scale.
As medical professionals we know that ketamine has huge therapeutic value, however it is important that we make it clear to the UN Commission and the wider public just how valuable it is. Scheduling the drug would have a catastrophic effect on safe medical care across the world, so we must work together to ensure this does not come to pass.
When a drug becomes scheduled, only government run hospitals may import ketamine, which means staff in many medical centres around the world will not be able to access the drug - particularly affecting low resource institutions in rural areas who are already the most in need.
The medical centres that are able to access ketamine will face their own problems as they must keep detailed records of how scheduled drugs are used. But it’s easy to keep records, right?
In a well-equipped hospital in a high income country, where ketamine is used relatively less often than other anaesthetic drugs, it is quite easy to keep records. In a makeshift hospital in a war zone, with constant streams of injured men, women and children with traumatised families, the constant threat of danger and access to the bare minimum of equipment, keeping exact records in not quite so simple.
International scheduling risks a chain of events that result in the manufacture and distribution of essential ketamine drying up. When morphine was similarly scheduled in India, staff became afraid of the possible legal repercussions of giving morphine to their patients, and so stopped proscribing it —resulting in medical use dropping 97%. As morphine was no longer given it was no longer manufactured, creating a chronic shortage of this essential medicine. With no safe alternative to ketamine available we simply cannot allow this to happen.
That is why it is so important to join the campaign. The more voices explaining the importance of ketamine, the stronger case we can make against scheduling it.
Anaesthesiologists around the world are united in what they do and the impact they have on patients, families and communities.
Share how important ketamine and global heath is to you by posting on social media your location and #KetamineIsMedicine. Tag us @WFSAorg on Twitter and @WFSA - World Federation of Societies of Anaesthesiologists on Facebook.
In 2015 the British Journal of Anaesthesia published an article entitled Ketamine: A growing healthcare need written by Professor Adrian W Gelb, chair of the WFSA Safety & Quality of Practice Committee, Dr Jannicke Mellin-Olsen, Deputy Secretary of the WFSA, and Dr Tina T Dong. The article explains the importance of ketamine in a medical context and the damage restrictions on this essential drug could do to global health.
The March 2016 edition of Anesthesia & Analgesia features four articles on ketamine. 'The Role of Ketamine in Low- and Middle-Income Countries: What Would Happen if Ketamine Becomes a Scheduled Drug?' was co-written by Dr Bisola Onajin-Obembe, Chair of the WFSA's African Regional Section. Read the articles below:
Ketamine focused articles also appered in the Canadian Journal of Anesthesia in 2016. 'The ‘‘war on drugs’’ you did not hear about: the global crisis of access to essential anesthesia medications' was co-written by WFSA Education Commitee member, Dylan Bould, and 'Access to controlled medicines for anesthesia and surgical care in low-income countries: a narrative review of international drug control systems and policies' was co-written Prof Adrian Gelb, Secretary of the WFSA.
In 2017 the Canadian Journal of Anesthesia also released the following article "Ketamine: We need to continue to advocate against scheduling"