Veterinarians could lose access to ketamine if drug is reclassified

Ketamine hydrochloride is in the spotlight again as the World Health Organization (WHO) prepares to discuss the drug during a committee meeting Nov. 16-20 in Geneva. Currently a schedule 3 drug in the United States under the Controlled Substances Act, ketamine could be changed to schedule 1 internationally, which designates high risk for abuse and no acknowledged therapeutic value. The American Veterinary Medical Association (AVMA) considers ketamine critical to the practice of veterinary medicine and is lobbying for continued use by members of the profession.

Earlier this year, China proposed to the United Nations (U.N.) that ketamine be placed in schedule 1 of the international Psychotropic Convention, according to a release from the AVMA. “The AVMA advocated against this change, working with the World Veterinary Association and the World Medical Association, and the proposal was amended to suggest a schedule 4 designation,” the release states. Schedule 4 drugs are the least restricted of controlled substances. The U.N. then postponed deliberation of the proposal and requested the WHO's input, according to the AVMA.

During the last several weeks, the AVMA has collected comments from the veterinary profession and submitted them to the U.S. Food and Drug Administration (FDA), emphasizing the role of the drug as a key component in veterinary anesthetic protocols. The FDA will then submit its recommendations to the WHO in advance of the mid-November meeting. The AVMA says it has received differing opinions from the FDA and U.S. Drug Enforcement Administration on whether a more stringent international scheduling of ketamine would impact the U.S. classification.

The scrutiny surrounding ketamine results from its use as a recreational drug, often referred to as “Special K.” Here's a description from the University of Maryland's Center for Substance Abuse Research:

There are certain reactions to ketamine that make it appealing to illicit users. In some circumstances, ketamine has been known to produce illusions or hallucinations that are enhanced by environmental stimuli-this may be one reason that the drug has become increasingly popular in the past few years. The most frequent-and sometimes only way-to obtain ketamine is through the diversion or theft of legal pharmaceuticals. There have also been reports of veterinary clinics being robbed for their ketamine supplies. Ketamine has over the past few years been thought of as a “club drug” (this term is used for a number of illicit drugs, primarily synthetics, that are most commonly encountered at nightclubs and “raves”).1

The WHO has reviewed ketamine several times before, but the drug has always remained outside of international control.

Reference

1. “Ketamine,” Center for Substance Abuse Research, University of Maryland, October 29, 2013, www.cesar.umd.edu/cesar/drugs/ketamine.asp.