E-DRUG: Ketamine scheduling alert. Your action requested.
There is a scheduling proposal for ketamine for the 58th Commission on
Narcotic Drugs, although WHO recommended not to schedule ketamine.
Ketamine is an essential medicine used for anaesthesia.
Several countries protested against the placing of the proposal on the
agenda, because the procedures as set out by the international drug
control conventions are violated by this proposal. However, the CND
Secretariat seems to press through for having a vote on 10 March and
most countries seem to follow the Secretariat as sheep.
Scheduling of ketamine will affect the medicine's availability and
be disastrous for the ability to provide essential surgery to some 2
billion people in rural area's of developing countries. It will also
severely restrain veterinary practice and wild life conservation.
A fact sheet is available at:
This fact sheet has received 37 endorsements so far and more are still
NGOs can endorse the fact sheet by confirming this to
 firstname.lastname@example.org while attaching their logo.
A campaign against the scheduling is ongoing and is having some
results already, but more needs to be done. Please tell those
governments represented in the Commission on Narcotic Drugs to vote
against the proposal, by sending letter and making appointments with
the responsible officers.
The countries to focus on are:
In Europe: Hungary, Italy, Spain and Denmark (plus the European
Commission, DG Migration and Home Affairs, Unit D4 Anti-Drugs
Policy: although not having a vote, it may influence EU countries)
In Asia: India, Indonesia, Japan, Republic of Korea, Thailand;
In Africa: Angola, Benin, Cameroon, Democratic Republic of the
Congo, Namibia, Nigeria, Togo, United Republic of Tanzania,
In Latin-America: Bolivia (Plurinational State of), Brazil,
Colombia, Cuba, Guatemala, Mexico, Peru, St. Vincent and the
Grenadines, Suriname, Uruguay.
Important is to realize that not any scheduling is acceptable, as, in
some countries, even the lightest scheduling will be a barrier for
accessing ketamine. Furthermore, even if a country scheduled ketamine
at the national level, it does not mean that such a country needs to
support the international scheduling: WHO's Expert Committee on Drug
Dependence recommended that there should be not any international
scheduling, and if there is a problem at the national level, countries
can control it at their national level, while ensuring its
availability for medical and scientific purposes.
Please note that we do not have much time left: the agenda item is
expected to be discussed on 10 March, but many countries will decide
which position they will take days even weeks in advance!
The main issues are in the fact sheet mentioned above. Additionally,
after we finalized the Fact Sheet and received the first endorsements,
we received a number of considerations that can be used as additional
arguments when approaching governments requesting them to vote against
1. Essential medicines, including ketamine, are covered by the Right
to Health, in particular as described in article 12 of the ICESCR
and the General Comment 14: countries are obliged to make
essential medicines available to their populations (and have a
responsibility for the realization of the Right to Health in other
2. If ketamine is not scheduled under national substance control
legislation, this does not mean that it is completely free: most
countries have pharmaceutical legislation that makes ketamine a
prescription only medicine, e.g. because it is an injectable. If
countries enforce such legislation, it will be hard to get
ketamine for other use than medical/veterinary use and this should
therefore prevent non-medical use, including recreational use.
3. A few more reasons why ketamine is the only usable anaesthetic in
developing countries is that for administering anaesthesia with
gases an uninterrupted power supply and uninterrupted supply of
oxygen are necessary.
4. Ketamine is very important in veterinary medicine, partially for
the same reasons as in human medicine (but oxygen and power are
also in industrialized countries not always at hand at remote
farms or in the meadow etc!), but also for the safety of the
veterinarian, who can administer the ketamine with a dart
injection before approaching a dangerous animal. (See the
attached one-pager written by Dr Kathy Clarke, recently retired as
head of anaesthesia at the Royal Veterinary College).
5. Ketamine is a mainstay of many wild life conservation, zoo and
wildlife medicine initiatives and without access to the medicine
we would have huge difficulties in managing many field programmes
in conservation medicine e.g. blood sampling, radio-tracking
collar attachment, etc.
Willem Scholten PharmD MPA
Consultant - Medicines and Controlled Substances
3411 AD Lopik, the Netherlands
T: +31 348 769 029
M: +31 6 4847 3368