Government accepts ACMD’s ketamine recommendation

Ketamine is to be upgraded to a class B drug, crime prevention minister Norman Baker has confirmed. Baker has written to Advisory Council on the Misuse of Drugs (ACMD) chair Sir Les Iversen to say that he accepts the council’s recommendation that the drug be reclassified in the light of the health concerns associated with it and the numbers of people seeking treatment (DDN, January, page 5). 

The government will now consult to assess the impact of reclassifying on the medical and health sectors, said Baker, with the parliamentary process to reclassify to begin ‘shortly’. Excessive ketamine use has been associated with a range of health harms including chronic bladder and other urinary tract damage. However, Baker acknowledges in the letter that ‘ketamine use in adults in the UK has gone down in the past two years, although it is too early to establish whether this downward trend will continue’. 

Meanwhile, the latest figures from the National Programme on Substance Abuse Deaths (NPSAD) at St George’s, University of London, show a 600 per cent increase in the number of deaths caused by new psychoactive substances between 2009 and 2012 – from 10 to 68. The prevalence of the new drugs in post-mortem toxicology reports also increased from 12 cases to 97 over the same period. 

The total number of drug-related deaths reported to NPSAD during 2012 was 1,613. Opiates – alone or in combination with other drugs – accounted for 36 per cent, up 4 per cent on 2011 and reversing the declining trend of recent years (DDN, March 2013, page 5). There was also an increase in the proportion of deaths involving stimulants including cocaine, following a decline in 2009 and stabilisation in 2010. 

London had the highest proportion of cocaine-related deaths at 15.2 per cent, while Liverpool recorded more drug-related deaths than Manchester for the first time since 2006. Deaths in Northern Ireland, however, showed ‘a marked difference from the rest of the UK’, with most linked to prescription drugs like tramadol, benzodiazepines and anti-depressants. The highest rates of drug-related deaths per 100,000 adult population were in the DAAT areas of Liverpool (12.57 per cent), Blackburn with Darwen (11.45 per cent) and the London Borough of Hammersmith and Fulham (11.34 per cent). More than 72 per cent of deaths were in males, and more than 67 per cent in under-45s. Accidental poisoning accounted for 68 per cent of the deaths. 

‘We have observed an increase in the number and range of [novel psychoactive substances] in the post mortem toxicology results and in the cause of death of cases notified to us,’ said NPSAD spokesperson Professor Fabrizio Schifano. ‘These include amphetamine-type substances, dietary supplements, ketamine derivatives, among a host of others. The worrying trend is that these type of drugs are showing up more than ever before. Clearly this is a major public health concern and we must continue to monitor this worrying development. Those experimenting with such substances are effectively dancing in a minefield.’

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