Possible change in ketamine classification

Re: POSSIBLE CHANGE IN KETAMINE CLASSIFICATION

bob lehner — Thu, 12 Dec 2013 17:21:17 GMT

[quote user="Malcolm Ness"]

[quote user="Laurence Webb"]advised by a previous PSS inspector [/quote]

SOME PSS inspectors have an exaggerated opinion of their power, importance and understanding.

[/quote]

Indeed - you should have seen all us old codgers at our last inspectors' meeting - strutting about, 'Sieg Heiling' madly and singing the Horst Wessel song.

It's always the same - give a man a nice shiny badge and a fancy job title and he immediately changes from a rational human being to a raving tyrant.

Re: POSSIBLE CHANGE IN KETAMINE CLASSIFICATION

Bob Russell — Thu, 12 Dec 2013 14:53:19 GMT

Not tried it but how difficult would it be to remove the remaining amounts from bottles (at 28 days after broaching) and replace it with water for injection? Books will still balance and the guilty individuals can party!

Measuring the amounts left in the bottle is pointless in the face of a determined (or even slightly determined) individual.

Re: POSSIBLE CHANGE IN KETAMINE CLASSIFICATION

Martin Atkinson — Thu, 12 Dec 2013 13:21:09 GMT

[quote user="Malcolm Ness"]SOME PSS inspectors have an exaggerated opinion of their power, importance and understanding.[/quote]Sounds like a number of us on this forum and in the profession generally then Malcolm!

Re: POSSIBLE CHANGE IN KETAMINE CLASSIFICATION

Michael Woodhouse — Thu, 12 Dec 2013 12:39:22 GMT

[quote user="Martin Atkinson"] I just wonder how the change in legislation would affect this.[/quote]

In no way whatsoever. We keep the phenobarb in the safe, but the owner takes it home and keeps it on the kitchen work top. My gran was on morphine tablets - she kept them with the biscuits barrel near the kettle as she made a cup of tea to take them.

Once prescribed no requirement for any different storage.

Re: POSSIBLE CHANGE IN KETAMINE CLASSIFICATION

Laurence Webb — Thu, 12 Dec 2013 10:57:50 GMT

There is a difference between the legal requirement and the requirement to be a member of the PSS. A ketamine register isn't a legal requirement but does need to be kept if you want to be a PSS practice.

Re: POSSIBLE CHANGE IN KETAMINE CLASSIFICATION

Malcolm Ness — Thu, 12 Dec 2013 10:47:55 GMT

[quote user="Laurence Webb"]advised by a previous PSS inspector [/quote]

SOME PSS inspectors have an exaggerated opinion of their power, importance and understanding.

Re: POSSIBLE CHANGE IN KETAMINE CLASSIFICATION

Martin Atkinson — Thu, 12 Dec 2013 10:38:35 GMT

I can't see how it makes any difference to our usage, Ketamine is kept in the dangerous drugs cabinet and use recorded, we still have to fax a controlled drug order to NVS to get it. At our recent VMD visit the inspector was quite excited about the use of Ketamine and even though there is no legal requirement to record use still insisted that we should record what was left in the bottle after the 28 days expiry - presumably I would have to withdraw and measure what was left with a syringe.

At present I supply a client with ketamine and medetomidine/atipamazole for use on wildlife and exotics, latest batch was for a leopard he had to capture. He signs a document to say that he has been instructed in its handling and safety precautions and that he has facilities to store it safely. Because he could be called out at any time to anything from an otter to an elephant he needs to have the stuff on hand and cannot always tell me beforehand on what case he is going to use it, albeit most times it would be under the direction of zoo vet. The VMD inspector hadn't come across this situation before and wasn't aware of what legislation covered it, he was going to come back to me on this but over a month later I've still not heard. I just wonder how the change in legislation would affect this.

Re: POSSIBLE CHANGE IN KETAMINE CLASSIFICATION

Laurence Webb — Thu, 12 Dec 2013 08:44:13 GMT

[quote user="Michael Woodhouse"]So the staff can take CDs as long as only small amounts in moderation.[/quote] Brilliant!

Re: POSSIBLE CHANGE IN KETAMINE CLASSIFICATION

Michael Woodhouse — Wed, 11 Dec 2013 23:30:00 GMT

If lay staff book work under a vet the person logged in is shown in brackets - so it's traceable who booked the work. The only way they could 'pretend' to be a VS would be if they knew our passwords.

We are not PSS. When we had our VMD inspection she asked to see the informal register. We told her there wasn't one and pointed out that it was not a regulation and simply a recommendation by the RCVS. She was going away to find me the legislation and then I agreed to starting to keep a record. I heard nothing since.

I have enough paperwork to keep by law to start keeping records I don't legally need to. The bloody Comfortan bottle constantly is missing a few ml and there is a statement to that respect on the VMD site - it's 'normal'. So the staff can take CDs as long as only small amounts in moderation.

Writing it in a book gains nothing.

Re: POSSIBLE CHANGE IN KETAMINE CLASSIFICATION

Laurence Webb — Wed, 11 Dec 2013 23:08:39 GMT

[quote user="Michael Woodhouse"]we use PMS to record usage as no legal requirement to have a written register. Small practice so we'd know if there was abuse going on[/quote]We were advised by a previous PSS inspector that this was not adequate unless it were impossible for anyone other than a MRCVS to enter ketamine use onto the PMS.

As ketamine use does not legally need to be reported this is probably more of an opinion that anything but the recommendation was made on the basis that, if good informal registers were kept, it would help to prevent the imposition of formal registers.

Re: POSSIBLE CHANGE IN KETAMINE CLASSIFICATION

Michael Woodhouse — Wed, 11 Dec 2013 20:09:05 GMT

I can see no issues either way. Won't change my usage, but would add extra hassle.

(we use PMS to record usage as no legal requirement to have a written register. Small practice so we'd know if there was abuse going on)

Re: POSSIBLE CHANGE IN KETAMINE CLASSIFICATION

bob lehner — Wed, 11 Dec 2013 19:50:23 GMT

The proposal is to re-classify ketamine from Class C to Class B. ( Illegal drugs used by people are classified from A-C with A being the most dangerous). Penalties for possessing or dealing are obviously much greater for Class A than B and then C).

The Controlled Drugs that we use as vets are classified Schedule 1 (not used by vets), Sch 2 (Morphine, pethidine,. methadone, fentanyl etc.) which have to be kept locked up and properly recorded in a CD Register, then Sch 3 and 4.

Ketamine is currently a Sch 4 CD - and as such does not legally have to be recorded, but because it is a drug of abuse the RCVS has advised that we should keep it under lock and key and record it in an 'informal' register, to the same level that we record Sch 2 CDs (except the VS doesn't have to sign the register each time).

I believe there have been moves recently to get ketamine re-scheduled as a Sch 2 CD. This would make no difference to actual day-to-day veterinary use - it would just mean that we would be legally required to keep it in a locked cabinet and record it properly.

As far as I know this is still only a proposal.

Re: POSSIBLE CHANGE IN KETAMINE CLASSIFICATION

Bob Russell — Wed, 11 Dec 2013 17:22:24 GMT

As we are legally able to possess, administer and prescribe a number of class A drugs I doubt the change will affect us beyond the need to formalise the paperwork rather than use an informal register.

About time. Ketamine is a really potent and dangerous drug if abused.

Re: POSSIBLE CHANGE IN KETAMINE CLASSIFICATION

Thomas Johnson — Wed, 11 Dec 2013 17:14:43 GMT

[quote user="Hannah Wynne Richards"]

Are others as worried as I am about the consequences, especially for equine practice if we are no longer allowed to use ketamine in the field? If so, what can we do about it?

[/quote]

Why would changing ketamine from class c to class b stop vets using it in the field?