Policy > General > Ketamine consultation briefing

The ACMD report on Ketamine can be read here (pdf)

The Home Office consultation document can be read here (pdf)

Transform Drug Policy Foundation submission to the Home Office ketamine consultation 2005  

Summary.

The aim of drug policy should be to reduce the harm caused by drugs, both to users and to wider society. Transform do not accept that bringing ketamine within the Misuse of Drugs Act, 1971 (MDA) will achieve this. Prohibiting ketamine (under any classification) will maximise the risks associated with use, simultaneously create a full-blown criminal market that currently does not exist and make criminals of otherwise law-abiding citizens. There is no evidence that there will be any deterrent effect from such a prohibition that would have any meaningful impact on use or misuse. Significant criminal justice costs would be incurred with no apparent benefits.

Transform recommend that models for better regulation of ketamine for recreational use is considered. Given that ketamine is already effectively legal this need not encourage use. Money spent on futile and counterproductive enforcement efforts would be better directed to educating vulnerable populations about potential risks of ketamine use.

Health issues

Transform believe that no drug is made safer by abdicating control of its production and supply to criminals. Criminalising ketamine will make it more dangerous and maximise risks for users:

• Demand for ketamine will continue at some level in the future but post-prohibition this demand will have to be met through illegal channels (quasi-legal channels already in existence will doubtless smooth this transition). The effect of this will be a short term increase in price (although unlikely to be significant enough to deter use) and a long term decrease in purity and increased likelihood of contaminants, poisonings, and problems stemming from unknown dosages.
  
• The recent rise in ketamine use amongst clubbers may have followed from uncertainties about the purity / quality of much illicit cocaine and ecstasy, and it is important to take account of how shifting prevalence of different drugs are interrelated. Increasing the health harms of a drug (such as ketamine or magic mushrooms) through criminalisation is not an ethical way to deter use, especially when consumers have moved away from more risky drugs due to health concerns.
  
• Given that ketamine is currently legal we can assume that a properly regulated market for ketamine would not encourage increased use. It would however allow controls to be put in place over price and availability (specifically age controls), reducing exposure and harm to the underage vulnerable groups. Such controls are not enforceable under the current system nor will they be under the completely illegal market that will result from bringing ketamine within the MDA.

Prevalence

The ACMD consideration of ketamine is an understandable response to reports that use of ketamine has risen sharply in recent years (although this rise seems to have levelled off more recently).

The underlying assumption is presumably that prohibition and criminalisation of ketamine will provide a deterrent sufficient to reduce prevalence of use/misuse, or at least arrest any future increase. However, all the evidence suggests that this assumption is false, and that drug policy and law are - at best - a marginal factor in drug taking decisions, particularly for the target group of young clubbers. Research on the supposed deterrent effects of prohibition is effectively non-existent (Transform is aware of none produced by the UK Government) despite the principle being at the heart of UK and global drug control efforts.

The recent rise in use of the cocaine amongst a similar young population has taken place against a backdrop of strict prohibition with harsh penalties for possession (7 years imprisonment) and supply (life imprisonment). Similarly, ecstasy use exploded from nowhere in the1990s, despite its being Class A. Some have suggested that the publicity around the crackdown on ecstasy contributed to the rise in its use.

In reality it is other variables that are the key determinates of prevalence of drug use. For young people on the club scene patterns of drug use are largely related to fashions in music and club culture. Other factors in drug taking decisions such as price and availability are largely determined by a demand-led and completely unregulated illegal market – beyond the influence of Government.

Concerns about health effects of drugs are another important factor – but the role of using the criminal justice system to send out public health messages must be questioned both ethically and because of its historical lack of success.

As the ACMD report notes, the experience of ketamine intoxication is intense and far from being to everyone's taste, even amongst experimental, hedonistic and poly-drug using clubbers. The report notes that “87% of those surveyed who had tried ketamine said they would never use it again,” and that; “only 4% of those who had tried ketamine were intending to use it again which contrasts with 53% for ecstasy.” This suggests that ketamine is never likely to achieve the popularity of cocaine or ecstasy and that its use is unlikely to increase much beyond current levels which have apparently been stable for the past 3 or 4 years, despite its legal status. Ketamine use is not consistently pleasurable enough or practical enough in a party environment for it to ever experience mass youth market penetration.

Short increases in levels of use have happened in the past, as ketamine has briefly become fashionable, before dropping off again as the notoriously fickle youth culture market has moved on to the ‘next big thing'. This has also been the experience in the US . It is likely that this pattern will continue as each new generation of youth culture discovers then grows out of ketamine or similar drugs at the margins of youth culture.

Use of ketamine amongst ‘psychonauts' (noted in the ACMD report) should not cause the same concern as use within youth club culture. These users are older, better informed, less reckless and will generally use the drug more responsibly and in a safer environment. This use is more controlled and unlikely to have significant health harms as use is more focused on ‘exploring consciousness' rather than hedonism or escapism. Deployment of significant criminal justice resources or any change in the law are unlikely to make any difference to drug using behaviours amongst this group, who are deeply opposed to drug prohibition on principle.

Social disorder

Ketamine use (intoxication) is not associated with any public order problems and, as things stand, is also associated with very little crime, certainly amongst users (although there are inevitably some criminal profits accruing from its diversion from legitimate medical sources).

Prohibiting ketamine therefore cannot be justified on public order grounds. In fact it is inevitable that bringing ketamine within the MDA would actively promote crime and create new criminal justice expenditure by instigating a full blown illegal market that currently does not exist, as well as criminalising a significant number of otherwise law abiding citizens.

The impact of a criminal record, even for a Class C drug offence, is still significant. It can mean restrictions on certain types of employment, travel (to the US for example), personal finance, and housing. Such criminalisation contributes to social exclusion and can significantly damage future prospects of young people, potentially increasing their likelyhood of involvement certain types of offending. The committee should consider if such punishment is proportionate, fair or effective, especially in light of the complete lack of evidence produced by the Home Office that such severe punishments have been any kind of deterrent to the use of any prohibited drug at any time since 1971.

Conclusions and recommendations

• Transform, whilst acknowledging the problems of an unregulated quasi-legal ketamine market, has no enthusiasm for bringing any new drugs within the remit of the MDA 1971. Given the relative lack of problems associated with ketamine, and the likely increase in health and social disorder that will follow its prohibition, Transform would not support this move. Transform urges the Council to reject it for this reason - in line with its remit in “preventing the misuse of such drugs or dealing with social problems connected with their misuse” and “ restricting the availability of such drugs or supervising arrangements for their supply”. Transform believes complete prohibition of ketamine will increase overall harm to users and wider society, and appropriate legal regulatory options would produce better outcomes on all health, crime and economic indicators.
  
• Health and social disorder problems associated with ketamine use at present appear to be marginal. In health terms the risks are largely restricted to irresponsible or ill informed patterns of use (ie mixing with other drugs), or for use amongst vulnerable groups who should not be taking recreational drugs anyway. Social order problems related to ketamine are almost entirely associated with the quasi legal market – a manifestation of its anomalous legal status and lack of market regulation.
  
• Transform recommends that in the short term ketamine remains legal to possess for adults and that in the longer term its supply for recreational use is legally regulated to a level appropriate to its risks. This will eliminate the criminal element within the existing market and ensure the quality of supplies. Transform explores the legal regulatory options is some detail in its recent report ‘After the War on Drugs – Options for Control' available for download as a pdf from www.tdpf.org.uk .
  
• Transform are disappointed that better legal regulation is not an option presented to the committee or other policy makers for consideration in the Regulatory Impact Assessment, as was the case with the magic mushroom section of the Drugs Bill 2005 RIA. Transform feel that the RIA is not satisfactory or complete as a result, and hope that this option will be considered by all interested parties and feature in the final RIA.
  
• Transform would like to see an urgent review of the entire classification system in line with recommendations from the Police Foundation (2000), Drugscope and The Home Affairs Select Committee (2002). The recent classification of fresh magic mushrooms (which have comparable or less, harm potential than ketamine) as class A highlights the urgent need for a review.