The ACMD has advised the government ketamine should remain a class B controlled substance, but that police forces and health care professionals must receive greater support to better identify, prevent and respond to ketamine‑related harms.
In January 2025, the government asked the ACMD to review the prevalence and harms of the misuse of ketamine. After examining the latest evidence, engaging with people with lived or living experience with the substance, consulting stakeholders, and reviewing academic research, the ACMD concluded ketamine should not be reclassified and should remain in class B.
Findings and decisions
In reaching its decision, the ACMD noted that the acute harms of ketamine – such as toxicity and deaths – align with its current class B status.
The ACMD also expressed concern about the growing use of high‑dose ketamine – described in some cases as “chronic”- and the long‑term harms associated with it.
However, as these harms were established in the 2013 ketamine assessment, the group focused its discussions on identifying new and emerging risks.
The ACMD report highlighted that many acute harms experienced by ketamine users are likely to be significantly influenced by using other drugs at the same time, and that reclassifying ketamine in isolation would unlikely reduce prevalence or misuse.
Individuals with personal experience of ketamine use and harms who contributed to the review said they did not believe upgrading ketamine to class A would reduce its use. Health and social care professionals similarly, largely, voiced opposition to reclassification.
Ultimately, the ACMD concluded that a public health‑centred approach is essential for reducing ketamine-related harms. This approach requires co-ordinated action across public bodies, health services, and community organisations.
The ACMD Chair Professor David Wood said in relation to the report
The ACMD report highlights the need for a ‘whole system approach’ through its recommendations to tackle issues related to ketamine use, as no single recommendation is sufficient to do this alone.
Recommendations
The ACMD’s recommendations are outlined in full in their report. This includes recommendations on classification, improving treatment of ketamine-related harms, international control, intelligence gathering, education and training, harm reduction and research.
