Ketamine Prohibition Across the Globe Has Deadly Effects

Ryan Lau | @RyanLau71R

For decades, the war on drugs has raged its way across the world, taking a particularly strong hold in America. With politicians from Reagan to Biden fathering policies that have incarcerated millions and killed many more, the world is beginning to see the disastrous effects of drug prohibition. For one thing, it actually can increase deaths from drug overdoses; when Portugal decriminalized all drugs, their addiction and overdose rates plummeted. But another drug, ketamine, offers solutions to the opioid crisis and many other medical problems.

Much like the ancient drug kratom, ketamine has a wide potential to get addicts off of heroin and other hard drugs. Its medical uses are plenty and the dangers, though present, are relatively low. Despite this, the United States and many other countries classify it as a controlled substance. Canada even ranks it as a Schedule I narcotic. Without a doubt, this hard-on-drugs approach that many nations are taking has deadly consequences.

What Is Ketamine?

Ketamine is an anesthetic drug that researchers first developed in 1962. Though many people know it as a horse tranquilizer, this was not the initial purpose. In actuality, the drug was for human use, and the United States used it extensively as an anesthetic in the Vietnam War.

Since that time period, it has also been a popular recreational and medical drug. Veterans coming home from Vietnam commonly used it to counteract the effects of PTSD. Scientists also experimented with it as a drug conducive to psychotherapy; some even mixed it with LSD to increase the effects.

Since then, ketamine has evolved to become a popular club drug. Going by names such as “Special K” and “K”, it grew into a common alternative to MDMA (ecstasy), which was much more expensive.

At low doses, the drug can produce jerky motions, tingling body-highs, increased breathing, and dizziness. At higher doses, hallucinations are common. They can be visual or auditory, and many studies report that they often are incredibly realistic. The drug does have some negative effects, especially for users who consume it frequently; paranoia, nausea, and amnesia are the most common. As a result, the government has spent decades fighting it.

The Drug War’s History

In 1971, Richard Nixon asserted that “drug abuse” was the number one enemy to the American public. As a result, he started a now half-century-long battle to combat use and abuse. In carrying this out, Democrats and Republicans alike have instituted policies that have ruined millions of lives. Cracking down hard on marijuana and other drugs, the prohibition-like policy did little to stop abuse.

drug war spending abuse
Drug control spending vs drug addiction rate, 1970-2010

As the graph from Reason clearly shows, the drug war has not reduced drug abuse rates. (Note: the total area under the graph represents roughly $800 billion. When including additional costs of the drug war, such as housing and feeding prisoners, the total rises to $1.5 trillion). Though it is possible that the spending stopped addiction from rising more, no evidence suggests this. On the contrary, it points to the idea that our situation is getting worse; during the time of the drug war, overdose rates rose sharply.

Interestingly, though, ketamine largely escaped the crackdown initially. But in recent years, this has begun to change. In 1999, the United States added the drug to its controlled substances list via a change to the Controlled Substances Act.

Ketamine Scheduling and Prohibition

Since this update to the law, ketamine has been a Schedule III drug in the United States. As a penalty for just possessing the drug, Americans in some states may face a year in prison and hefty fines. The penalties for selling or distributing ketamine are significantly greater, even for medical purposes (if selling without a medical license to do so).

Different states, of course, have different punishments for ketamine and many other drugs. But even the most liberal ones currently punish it harshly. California, for example, levies 15 to 180-day jail sentences for a first drug possession offense. However, some other states have punishments far worse. Kentucky is one of the most oppressive, with mandatory minimum sentencing laws. Drug possession carries a sentence of up to 10 years in prison and a fine up to $20,000.

Without a doubt, the nation has recently doubled down on ketamine. Why is this, and are there major risks to using the drug? Do medical benefits outweigh these detriments? Upon close inspection, it appears that the drug can have a net positive impact on society, despite the potential for abuse.

Why Ketamine?

Of all drugs to have a harsh policy towards, what made the government crack down on ketamine over others? After all, some other dangerous drugs, such as alcohol and tobacco, are completely legal. Is ketamine any more dangerous than these drugs and other illegal ones? A CPC comparison of drug dangers sheds some light on the subject.

Harm comparison by drug
Harm comparison of drugs, to users and to others

The above graph looks at the harm to others and the harm to the drug user him or herself. It suggests that ketamine poses a very low risk to anyone but the user, which shows that most of the risks are personal. Therefore, there is no reason to ban it on the grounds of protecting other people. Alcohol, after all, has a risk to others more than 20 times that of ketamine, but it is fully legal. Even tobacco’s risks to others are significantly higher.

Looking at the risk to the individual, there is not anything that stands out as a reason to ban ketamine, either. Once more, it has harm levels noticeably lower than tobacco and alcohol, both of which are legal. Based on this graph, there is no logical reason to ban ketamine, especially in a society that celebrates alcohol use and even, in some settings, alcoholism. But a further point against the ban comes in ketamine’s clear medical benefits, many of which scientists are just beginning to discover.

Medical Ketamine

As stated previously, the medical community already has used ketamine extensively as an anesthetic. But this only scratches the surface of its immense potential to heal. Most notably, researchers are beginning to see its success as a treatment for opioid addiction and chronic depression.

opioid deaths 2002-2017
Opioid deaths in the United States, 2002-2017

In 2017, nearly 50,000 people died from misuse of opioids. This figure has exponentially increased since the beginning of the 21st Century and shows no sign of stopping. Recently, though, researchers have conducted a number of studies that suggest ketamine may be an effective way to combat addiction.

One 2016 case study looked at how the drug may be useful in treating opioid addiction. The psychiatrists noted that there is an addictive potential to it. However, they confirmed that ketamine shows promise as a drug to manage opioid withdrawal.

A Treatment for Chronic Depression

In the United States this year, over 13 million people will experience major depression. However, up to 40% will not see symptoms improve using common antidepressants. As a result, these people will face the many medical risks of chronic depression, which include increased suicide and drug addiction rates. Ketamine, however, is offering promise as a solution in many of these cases.

Doctors have used it in emergency rooms to temporarily curb suicidal thoughts. As a result, the drug has saved a number of lives. Psychiatrist Kyle Lapidus, M.D., Ph.D. of Stony Brook University says that many studies have confirmed its positive effects on chronic depression. However, he also acknowledged that the sample size for these has been fairly small

“The benefits I’ve seen are impressive, and the data are pretty strong” -Kyle Lapidus

After much delay, even the FDA is beginning to recognize ketamine’s success to treat these cases. Last week, they approved a new nasal spray that contains the drug, which adults can use as an antidepressant. Developing company Janssen Pharmaceuticals, Inc. is calling it esketamine and plans to market the treatment under the name Spravato. However, costs for the drug are often out-of-pocket, and the FDA has not generally approved ketamine yet as an antidepressant.

Depressed Citizens in Danger

As stated above, depression carries a number of major risks, and ketamine offers a solution to many of them. But many countries are not allowing their people to take advantage of it and recover. Two distinct categories of limiting access to drugs exist: banning them and regulating them. Both of these seriously cause harm to those who need help.

The most blatant risk to citizens comes in countries like Canada, which have criminalized it entirely. Obviously, when a country disallows a drug, citizens cannot legally obtain it. This means that if they want something that shows promise in treating depression, they risk an extended prison sentence.

Such a policy creates two terrible alternatives for many Canadians with chronic depression; they can live with increased risks for suicide and drug addiction or have to fear an arrest and a term in prison. It goes without saying that this very concept is detrimental to citizens who desperately need medical attention.

The Risks of Regulation

Unfortunately, though, the regulation of drugs also carries its own harms. The general concept is as follows: regulation stifles competition, which increases prices. As a result, many people cannot afford the drug.

When the government tightly regulates a drug, they prevent competitors from selling it. This occurs through the often-bureaucratic actions of the FDA. In order to approve a drug, companies must put it through extensive research and testing. Simply put, the expenses for these are often too high for a smaller company to manage. As a result, large pharmaceutical companies gain control over the industry. When a smaller company can afford the testing, they need to cover these costs by increasing drug prices. Still more companies simply cannot afford the costs period, removing themselves from the market and restricting competition.

Congress has also started a program that benefits larger corporations. Their “Priority Review Vouchers” allow companies to bypass some FDA bureaucracy, often taking years off of the process to approve a new drug. The catch: these vouchers are incredibly scarce and expensive, generally going to the richest companies. Once these companies alone have certifications for the drug, they can choke the market and charge exorbitant prices for the product.

Around the Corner, Just Beyond Reach

Each this time occurs, another patient suffers without relief from Prozac. Someone sits and waits for their condition to improve, often not realizing that a potential cure is right around the corner. But governments are holding it back. For those that know the truth and take action, they run the risk of hefty fines or worse, imprisonment. Though proponents of drug criminalization and regulation may have noble intentions, so paved is the road to hell.

Ketamine is just one example of the dangers of the drug war. With these bans, people are suffering. Over five million people in the United States alone have a condition that no approved medicine will treat. Don’t think that aid isn’t out there. The drug has risks, as do all, but they are considerably lower than those of many legal drugs with little to no medical benefit.

Science defends the notion that ketamine has a number of beneficial medical purposes, including opioid withdrawal. It is also indubitably true that opioids make the pharmaceutical industry $24 billion a year. Ketamine offers a potential solution to opioid death, but pharmaceutical companies have poured billions of dollars into lobbying politicians to further drug prohibition. Regardless of whether or not there is a relationship between these actions: one thing is clear: bans on ketamine across the world are leading to preventable deaths, but those in power are taking no action to prevent them from happening.

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