The World Health Organization (WHO) Expert Committee on Drug Dependency has once again recommended that ketamine not be placed under international control, citing concerns that international scheduling could limit medical access to an important treatment drug.
The recommendation is in line with the position taken by the AVMA and many other veterinary and medical organizations worldwide, and with the input received by AVMA from more than 130 members who helped us craft a position statement on the matter for the U.S. Food and Drug Administration (FDA) to consider in responding to international efforts to push worldwide ketamine scheduling. Details of the WHO committee’s discussion are not available, but according to a report on WHO’s website “the Committee 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 committee’s recommendation will now go to the United Nations Commission on Narcotic Drugs for a final decision in March 2016, according to the WHO statement.
Concern regarding the impact of potential international scheduling of ketamine first came to our attention in February 2015. We learned that the previous year, China notified the United Nations secretary general of its proposal to place ketamine in Schedule I of the 1971 Convention on Psychotropic Drugs. China later amended its original proposal and at the next meeting of the U.N. Commission on Narcotic Drugs, held in March 2015, recommended placing ketamine in Schedule IV, a less restrictive classification than Schedule I.
The World Veterinary Association, of which the AVMA is a member, and World Medical Association, along with many other organizations advocated against any international scheduling, and ketamine was not scheduled at that time. Instead, the U.N. Commission on Narcotic Drugs referred the matter to the WHO Expert Committee on Drug Dependency for further review.
In October 2015, the FDA requested public comment on the abuse potential and medical usefulness of ketamine and several other drugs, saying it would consider the comments in preparing its own statement to the WHO Expert Committee on Drug Dependency regarding the abuse liability and diversion of those drugs.
The AVMA responded by submitting formal comments asking the FDA to continue to protect veterinarians’ ability to use ketamine as needed to treat our patients. Those comments were informed and guided by input from AVMA members who responded to our request for information detailing their need to continue using ketamine to treat patients.
The AVMA’s comments were among more than 1,600 comments that were submitted to the FDA; all of them supported a drug schedule that maintained the availability of ketamine. The FDA compiled the comments and submitted information to the WHO.
The AVMA will continue to monitor this matter as it goes before the U.N. Commission on Narcotic Drugs this spring.