Policy and Political Action

Policy & Political Action

Protect Lives by Rejecting International Scheduling of Ketamine at the 58th Commission on Narcotic Drugs

Dear Prime Minister Harper,

Re: Protect Lives by Rejecting International Scheduling of Ketamine at the 58th Commission on Narcotic Drugs

The Registered Nurses’ Association of Ontario (RNAO) is the professional association representing registered nurses, nurse practitioners and nursing students in Ontario.

RNAO is deeply concerned that the Commission on Narcotic Drugs (CND), 58th Session, has been asked by China to review a proposal to place ketamine in Schedule I of the 1971 Convention on Psychotropic Substances, alongside LSD and mescaline.

Ketamine has significant therapeutic value within Canada and in jurisdictions around the world. Ongoing research suggests ketamine has promise as a treatment for severe depression, psychosis, and post-traumatic stress disorder. While ketamine is used recreationally in some jurisdictions as a "party drug," the critical fact is that the World Health Organization lists it as an "essential medicine."

Ketamine is the "only available anaesthetic for essential surgery in most rural areas of developing countries, home to more than 2 billion of the world's people." It is so widely used as an anaesthetic in human and veterinary medicine because it is readily available, easily and safely administered, and inexpensive.

The World Health Organization’s Expert Committee on Drug Dependence (ECDD) evaluated ketamine in 2006, 2012 and 2014 and each time concluded that "scheduling is not warranted." Weighing the accumulated evidence on non-medical use, diversion and relatively lower public health harm against the evidence of ketamine’s therapeutic value, the CND should not schedule ketamine under the 1971 Convention. Associations working in health, medicine, pharmacology, and veterinary science as well as civil society groups from around the world support the work of the World Health Organization and urge State Parties to abide by ECDD recommendations. RNAO supports this position as well as the procedural concern that placing ketamine on the CND agenda contravenes the terms of the 1971 Convention

Prime Minister, under your leadership, Canada has articulated our "unequivocal commitment to saving the lives of the world's most vulnerable women and children" and that "maternal, child, and health is Canada's top development priority." Decreasing access to ketamine is indeed a "potential disaster for the world's rural poor" as this safe anaesthetic agent will not be available for emergencies and surgeries, including emergency caesarean sections. Ketamine is particularly useful when anaesthetising patients in shock as it raises the blood pressure. This can be particularly helpful in obstetrical emergencies as can the dissociative state properties of ketamine that make people unaware of what is happening to them but protects their vital cough and gag reflexes. Professor Richard Laing explains that during caesarean sections, "women can die when the acid accumulating in their stomach runs up the osesophagus and then enters the lungs because that reflex has been knocked out" by anaesthetic gases.

Prime Minister, you have told the United Nations General Assembly that maternal and child health is an issue that is closest to your heart. The world's most vulnerable people, including mothers and children, need your leadership on this issue to prevent unnecessary deaths, injuries, and immense suffering from pain. Scheduling ketamine contradicts sound public health policy and contravenes human rights and the rule of law by ignoring WHO's ruling that ketamine should be not scheduled.

Ontario's nurses urge Canada to vote against scheduling ketamine.

Warm regards,

Doris Grinspun, RN, MSN, PhD, LLD(hon), O.ONT.
Chief Executive Officer
Registered Nurses' Association of Ontario

c. Thomas Mulcair, Leader, New Democratic Party of Canada
Justin Trudeau, Leader, Liberal Party of Canada
Elizabeth May, Leader, Green Party of Canada
Rona Ambrose, Minister of Health
Murray Rankin, Health Critic, New Democratic Party of Canada
Hedy Fry, Health Critic, Liberal Party of Canada
Daniel Green, Health Critic, Green Party of Canada
Kathleen Wynne, Premier of Ontario
Eric Hoskins, Minister of Health and Long-Term Care

See the full letter with references below.

Resource Type: 
Letter