There’s a paradox in the medical world: some of the drugs that have dramatic medicinal and pain relieving qualities can also be the most dangerous if they are abused. This is well known for drugs like morphine and cocaine, which were openly sold across the counter before their adverse effects were widely recognised. Such drugs are now controlled globally by international agreements: these make it the supply and use of the products difficult – or impossible - when they’re needed for medical purposes, but they do achieve the goal of limiting the social damage that would be caused by unrestricted availability.

Ketamine: a unique anaesthetic agent

Recently, pressure has begun to be applied to have a new drug added to the list of globally restricted medicines: an anaesthetic agent called ketamine. Ketamine is currently easily available and widely used every day by vets and doctors across the world. It’s a safe anaesthetic which does not depress respiration or the circulation and can be used without oxygen, ventilators, electricity supply and the other support systems that are needed for most other anaesthetics. For these reasons, ketamine is the only anaesthetic suitable for medical and veterinary use in the developing world. It has a particular role in areas of natural disasters and conflict zones where infrastructure is limited. Ketamine is on the World Health Organisation’s list of minimum medicine needs for a basic health‐care system.