Pubdate: Wed, 11 Mar 2015
Source: National Post (Canada)
Copyright: 2015 Canwest Publishing Inc.
Author: Jesse Kline
Page: A8


Ketamine is a vital anesthetic in the Third World. But now China wants
it banned for everyone because of its own recreational drug users

At the same time America was repealing its disastrous experiment with
alcohol prohibition, U.S. states were passing laws restricting the
growth and sale of marijuana. It's little wonder that many of the
problems experienced during prohibition - the growth of organized
crime, mass flouting of the law, the incarceration of
otherwise-law-abiding, non-violent offenders, higher-potency
substances, etc. - are now associated with the War on Drugs.

In the 1970s, the federal government stepped in and classified
cannabis as a Schedule I substance - a category for drugs such as
heroin that have no medical benefit and a "high potential for abuse."
For decades, this classification prevented researchers from studying
the plant's medicinal qualities and states from allowing doctors to
prescribe it to patients.

Even now, the states that have legalized medical or recreational
marijuana have done so in violation of federal law. But the fact that
23 states and the District of Columbia have legalized medical
marijuana, and numerous others have legalized or decriminalized the
substance, shows a growing willingness on the part of the American
public to experiment with alternatives to the drug war.

But at the same time many American states and various countries around
the world are liberalizing their drug laws, the United Nations is
still prosecuting former U.S. president Richard Nixon's War on Drugs.
As Tom Blackwell reported in Monday's National Post, the UN Commission
on Narcotic Drugs will meet in Vienna on Friday to discuss whether to
list ketamine as a Schedule IV substance under the 1971 Convention on
Psychotropic Substances.

Known as "Special K" on the street, ketamine is one of the most widely
used anesthetics in the developing world, due to the fact that it is
inexpensive, relatively safe, easy to get and, unlike anesthetic
gases, doesn't require special equipment to administer. Although the
World Health Organization (WHO) says that ketamine "use in the general
population appear to be very low," it has become a relatively popular
party drug in China and Hong Kong. And it is China that is pushing the
UN to classify the drug as a controlled substance.

The unintended, but easily foreseeable, consequence of such a move
would be to make it harder for developing countries to gain access to
the drug. "If the proposal passes, it will be a catastrophe for access
to ketamine and safe surgery in developing countries," wrote Jason W.
Nickerson and Amir Attaran of the University of Ottawa in the journal
The Lancet. "Access to controlled drugs in low-income countries is
deplorably poor; the Commission should not repeat its mistakes by
restricting access to yet another essential medicine."

Indeed, the UN previously listed morphine as a controlled substance,
which has meant that a majority of the world's population no longer
has access to a medical-grade painkiller. According to a 2012 WHO
report, "If ketamine is placed under international control, it can be
assumed that its availability and accessibility will fall into the
same level of other controlled medications, which would result [in a]
huge public crisis."

China is hoping that because ketamine is hard to synthesize - and
therefore the black-market product is generally diverted from
hospitals and veterinary clinics - making it more difficult to obtain
for legitimate purposes will help keep it out of the hands of
criminals. But China does not need to corral the UN in order to
control the substance within its borders. Indeed, it is illegal to use
ketamine for recreational purposes here in Canada. We apparently don't
need the UN in order to control it, either.

Unfortunately, the Canadian government has remained mum on this issue,
telling the Post that Health Canada is "taking into consideration the
implications for developing countries where ketamine is an essential
anesthetic." Given that we're talking about a policy that will have a
real negative impact on health care in the developing world, it should
be a no-brainer for the Canadian government to stand firmly against
this move.

And while this is a clear case of the UN trying to put up bureaucratic
impediments to countries that import drugs for medical purposes, which
will hurt people not involved in the recreational drug trade, it has
become abundantly clear that the drug-control regime we currently have
causes more harm than good. Yet one of the major stumbling blocks to
countries engaging in policy experiments to try to find a better way
to deal with the harms caused by illicit drug use is the arcane
drug-control regime run by the United Nations.

In a recent paper, for example, the UN's International Narcotics
Control Board (INCB) criticized the Supreme Court of Canada for
"permitting a 'drug injection room' to continue to operate in
Vancouver." In a perfect world, I would prefer if Vancouver's Insite
clinic wasn't publicly funded, but it is a novel attempt to reduce the
harms caused by drugs without resorting to traditional law enforcement
methods. And it has seen favourable results: A 2011 study found that
overdose deaths in the Downtown Eastside fell by 35% since the clinic
opened, compared to a 9% drop in the city as a whole.

It is also true that the highest court in the land ruled that not
granting the clinic an exemption to operate under the Controlled Drugs
and Substances Act would be a Charter violation - and the constitution
must supersede any UN mandate. Indeed, the UN drug-control treaties
specifically say that compliance is subject to "constitutional
limitations," but that has not stopped the INCB from lashing out
recently at Colorado and Washington state for approving marijuana
legalization through ballot measures and even the Netherlands, which
has taken a liberal approach to cannabis use since 1976.

Fortunately, the INCB has no real ability to do anything, beyond
spouting over-hyped rhetoric. But it raises the question: Why are we
letting a dysfunctional and ineffective body like the UN dictate
drug-control policies to sovereign countries?

In the same way that anti-marijuana laws were adopted on a
state-by-state basis, we are now seeing the opposite occur in the
United States. It is a fundamental recognition that the War on Drugs
has been an abysmal failure and needs to end. If international
drug-control treaties are hampering such efforts and going so far as
to prevent doctors living in the Third World from gaining access to
medicines needed to perform lifesaving surgeries, then it is high time
we took drug policy out of the hands of the United Nations.
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