One of the key issues at this year’s CND is a proposal put forth by China to bring ketamine, an essential medicine according to the World Health Organization (WHO), under Schedule I of the Convention on Psychotropic Substances of 1971. Although some readers will only know of ketamine as a recreational drug sometimes referred to as special K, ketamine is also the only available anesthetic in most rural parts of the developing world. Given that Schedule I is intended for substances that have “very limited medical usefulness,” the placement of ketamine in this category is inappropriate. Moreover, placing ketamine in any schedule is deeply problematic, as it will restrict the supply of this important medicine and leave nearly 2 billion people in the world without access to an anesthetic for essential surgery. Hence, scheduling ketamine will have detrimental impacts on global health.
In addition to having detrimental impacts on global health, scheduling ketamine would also go against the opinion of the WHO. The WHO Expert Committee on Drug Dependence (ECDD) has critically evaluated ketamine on three separate occasions, most recently last year after a notification was made by China to schedule ketamine. In all three cases, the ECDD did not recommend that the CND place ketamine under international control. According to the 1971 Convention, the CND can only schedule a substance if given an explicit WHO recommendation to do so.
Despite the requirement that any scheduling be recommended by the WHO, the Chinese proposal to schedule ketamine may go to a vote this Friday. This potential disregard for procedures surrounding scheduling is of great importance. Even if the vote is unsuccessful, simply having such a vote undermines the importance of science in international drug control. As was pointed out by Christopher Hallam of International Drug Policy Consortium while speaking at a side event on Monday, the principle of scientific review by the WHO needs to be defended and strengthened. Even more importantly, allowing the Chinese proposal to go to a vote sets a troubling precedent for the future, as other countries may bypass WHO recommendations and suggest substances for scheduling without any scientific or evidence-based rationale. If such a situation transpired, the entire international drug control regime system would surely become a joke.
Many civil society groups have been lobbying member states to vote against the scheduling of ketamine, and to speak out about the procedural problems and undermining of scientific evidence that such a vote would entail (see the Fact Sheet and Extended Fact Sheet). Canadian researchers have been particularly active in this effort. As we mentioned yesterday, Canada has not publicly stated its position on this issue, meaning we will have to wait and see what stance Canada takes on Friday. CSSDP hopes that Canada shows their respect for global health, international law, and science by speaking out against the vote, and in the case that it proceeds, voting against the scheduling of ketamine.