International ketamine rescheduling: can you help us protect veterinary access to this drug?

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Protecting access to critical drugs

Use our template letter to personalize your own comments to the FDA for more impact.

Update 10/13: We’ve been notified by AVMA members that they’ve been unable to submit comments electronically via the site. We’ve contacted the FDA to inquire about this problem. In the meantime, comments can still be mailed to: Division of Dockets Management (HFA-305), Food and Drug Administration, 5630 Fishers Lane, rm. 1061, Rockville, MD 20852. 

Update for clarification, 10/8: Ketamine is not controlled internationally under either the Psychotropic Convention or the Single Convention on Narcotic Drugs. The WHO Expert Committee on Drug Dependence reviewed ketamine at its 34th, 35th, and 36th meetings. On March 13, 2015, the UN Commission on Narcotic Drugs decided by consensus to postpone the consideration of a revised proposal concerning the recommendation to place ketamine in Schedule IV of the Psychotropic Convention and to request additional information from the WHO. The original proposal brought to the March meeting of the UN Commission on Narcotic Drugs by China was to place ketamine in Schedule I, and we have been given different opinions by FDA and DEA on whether a more stringent international scheduling of ketamine would impact the US’s classification. Hence AVMA’s concern and continued engagement and advocacy on this issue.

It appears that the World Health Organization (WHO) may be considering another proposed change to the international scheduling of ketamine, and the AVMA is seeking your help in asking the FDA to protect veterinarians’ access to this critical drug.

In April, we informed you that the WHO had received a proposal from China to regulate ketamine hydrochloride as a Schedule 1 drug. The AVMA, in cooperation with the World Veterinary Association and the World Medical Association, fiercely advocated against this change, because international regulation of ketamine as a Schedule 1 drug could mean that it would no longer be available to U.S. practitioners. As a result of those advocacy efforts, ketamine was not rescheduled at that time.

But this week, on Oct. 5, the FDA issued a request for comments regarding the abuse potential, actual abuse, medical usefulness, trafficking and impact of scheduling changes on the availability for medical use of 10 drug substances – including ketamine. The comments will be considered as FDA prepares a response to the WHO regarding the abuse liability and diversion of these drugs.

The AVMA is drafting a letter to the FDA that will outline how critical ketamine use is in veterinary medicine and how important it is that it remain available to U.S. veterinarians as we treat our patients. But our voice is made stronger when it is joined by the voices of individual members. So we’re requesting your help during this urgent time to reinforce our message.

Will you consider writing to the FDA yourself to explain how critical ketamine is in veterinary medicine and why it must remain available to veterinarians? We’ve created a template letter that will allow you to personalize your response to make more impact. Comments are due to the FDA by Oct. 15 – next week – and the FDA’s comments will be provided to the 36th Expert Committee on Drug Dependence (ECDD), which will meet in Geneva Nov. 16-20.

Among the information requested by WHO is the following:

  • Ketamine use in clinical settings – when is ketamine the anesthetic, sedative or analgesic agent of choice for any of the following: emergency situations; conducting procedures with pediatric patients; short surgical procedures; long surgical procedures; surgery conducted outside a hospital without respiratory support facilities; and other?
  • Veterinary therapeutic indications approved for ketamine (choices offered: anesthesia; pain management; sedation; no approved uses; other)
  • Current use of ketamine in medical or scientific research (including clinical trials)

Please submit your comments by Oct. 15 to the FDA regarding your professional use of ketamine and its importance to patient care. Detailed instructions for submitting comments either electronically or on paper can be found here:

Feel free to copy us on your comments to the FDA, as this can also help guide us as we write the AVMA’s response. We will post our own letter with comments to the FDA on our website as soon as it’s completed.

Thank you in advance for helping us protect veterinarians’ ability to continue using ketamine to treat patients. Your voice will make ours even more powerful and effective in advocating on behalf of our member veterinarians and our patients.

14 thoughts on “International ketamine rescheduling: can you help us protect veterinary access to this drug?

  1. Its bad enough that junkies in the US helped cause ketamine to be classified such that you need a DEA license to get it. That effectively put me out of the tiny bit of small animal work I could have done when I graduated.

    I have a hard time believing China doesn’t know ketamine is a really useful injectable anesthetic for human and animal medicine, and wonder what the real reason is behind pushing for such strong international restrictions.

    Another observation-doesn’t the US have at least one factory in this country that makes ketamine? Even if international scheduling were to become ultra-strict, if we made the stuff in the US we could still get it for veterinary use.

  2. Ketamine is a safe and reliable drug in both my equine and small animal sides of practice. I see no upside to change anything about this drugs acces or composition. Prosecution penalties for distribution of ketamine by medical professionals that end in harm or criminal consequences should be where changes should be looked at. Most all veterinarians are careful and conscientious in our handeling of our controled drugs. Please let’s not create more paperwork.

    • You’re correct, Dr. Besselsen, that it’s not being proposed as a Schedule I. But we don’t say that in our blog post. Back in the spring, Schedule 1 was proposed by China. Thanks to our advocacy efforts and to that of the World Veterinary Association and others, that did not occur. Any changes to international scheduling that would put it in a more controlled category could affect the scheduling of the drug in the US, so we feel that assertive advocacy is needed regardless of what schedule has been proposed – otherwise, we run the risk that a lack of advocacy on our part could allow for more strict scheduling. The WHO is gathering information, and our members are providing valuable input to shape the FDA’s advocacy to WHO on the matter.

  3. Wow, as I say Veterinary medicine takes one step forward and yet two back. I have been using Ketamine for 15 years and never once had a reaction with it until the other day. I feel they are changing the makeup of it because of this. It’s not right and if will definitely cause a problem with horse procedures.

  4. I agree with Alan Taylor. Ketamine is used frequently in my own practice [Ireland] in combination with a benzodiazepine [usually midazolam] for induction. We also use it as part of analgesic infusions for orthopaedic surgery in combination with morphine and lidocaine. It is not as restricted here as in the UK, where I think it is now Schedule II and must be kept in a locked safe and signed in and out. I agree that it should not be Schedule I. There have been instances of veterinary premises being burgled in search of it, which is another issue entirely. Ultimately, if access to Ketamine is severely restricted for professionals, it will do nothing to curb its abuse on the street; alternatives will probably not be as good and/or be considerably more expensive, which hurts two groups – the patients and the customers.

  5. Ketamine is not the problem. I think I even remember the days when we were not even required to keep DEA records for it. I have had several persons ask me for this drug to castrate their own horses and I have never let them have it. The problem is people with unethical motives. Those being the people asking for the drug and the medical professionals that are willing to dispense it. It is kind of like saying guns kill people. If that is so then forks make people FAT.

  6. Here in Mexio we must to do a certificate recipe if we want to buy this kind of product, no only ketamine, pentobarbital, zelazol, dexdomitor etc! like DVM sharon say, why not a form?

  7. Does anyone at the FDA/DEA even read what schedule I means? Seriously? What part of NO medical use don’t they understand? This nonsense reactionary political response is how cannabis got on schedule I despite scientific evidence of medical use and low to no addiction. We cannot let this happen to ketamine. Once the politicians get it in sched I it is nearly impossible to get it off as there will be little access to the drug for clinical trials to prove anything about efficacy, safety, addiction etc. Write and visit anyone you can about this. Don’t let yourself believe that the people in charge will actually use logic or science to make a decision. It will be based on political angles.

    • Well, welcome to the world reality. If you think losing ketamine is something wait until the FDA regulates veterinary drug compounding. I personally think ketamine is an awful drug and that it is over used for the wrong reasons especially induction. But I dislike China getting in my face about how I practice and with what worse. Schedule II ketamine is restrictive enough but guess what happens to the price and availability. I guess I would start with why the request? Do they have a ketamine addiction problem in their Country? If so they should deal with it internally.

      • Ketamine is not an awful drug. As an anaesthetist I use it a lot, horse induction, balanced analgesia in most species, it is very versatile. China has a problem with ILLEGAL ketamine production which Scheduling will do nothing about. China have got it wrong and I work in China (a Brit by the way) and intend to speak out here too as I did the last time this came up!


    There are literally thousands if not 10’s of thousands of small animal veterinarians that use Ketamine almost daily in their practices. It is a mainstay of many veterinarian’s anesthetic protocols.

    Yes this is a seriously abused street drug HOWEVER, making this an schedule 1 drug is insane. That means that no veterinarian except maybe large specialty hospitals will be able to purchase this drug!

    Currently Ketamine is only a schedule III drug. If the governments of various countries want to get this drug more under control THEY SHOULD MAKE KETAMINE A SCHEDULE II drug. That way it would have to be ordered using a special ordering form. Veterinarians would have to sigh the form and have a current DEA license in order to get the drug. THAT IS FAR BETTER AND A BETTER IDEA THAN MAKING THIS A SCHEDULE I DRUG!

    The AVMA should really pay attention to this and put in a serious pitch to make this drug more accessible to licensed veterinarians but protect the morons on the streets who use this drug from themselves.

  9. For those asking why the WHO decision would affect us: since the US is a member of the WHO, a change in international scheduling would be adopted by the U.S.