A panel of experts convened by the Colorado Department of Public Health released a report Wednesday that found the sedative ketamine “is a safe drug” if used in certain circumstances, but recommended several steps the state should take to reduce medical harm and racist outcomes.
The group, chaired by the state’s chief physician, which included seven other doctors, was the product of massive outrage over the death of Aurora’s Elijah McClain, who was brutally arrested by police and then injected with ketamine by paramedics prior to his death in 2019.
Among the many criticisms the city faced in the McClane case, an external investigation found that the Aurora Fire paramedics seemed to “accept (police) officers’ opinion that Mr. McClain was instigating delusion” – and thus ketamine use became a strong sedative was justified – “without confirmation of this impression by meaningful observation or diagnostic examination.”
The panel was asked not to evaluate McClane’s case in particular, but rather to find out if and how the drug could be safely used in future emergencies.
Recommendations in the panel’s 126-page report include:
- Avoiding “agitated delirium” as an acceptable pretext for giving ketamine to someone. The state already suspended this excuse in July during the prehospital phase, and therefore the recommendation, if accepted, would not change current policy.
- Creation of standard doses depending on the body structure – small, medium or large – of subjects. (Third-party researchers found that McClane, who had a small physique, was given a dose more suitable for someone 80 pounds heavier than he actually was.)
- Close monitoring of people taking ketamine. “All ambulances should have a checklist for proper dosing and monitoring,” the guidelines say.
- Standardize ketamine practice across all emergency care providers through new state oversight.
- Analyze whether there is disproportionate use of ketamine by “marginalized individuals and communities of color in Colorado”.
Summing up its findings, the panel wrote that “it agrees that ketamine is a safe medicine if it is used correctly and carefully monitored by properly trained and qualified paramedics.
“However, certain side effects appear to have arisen mainly from administering ketamine and other sedatives to people who may not have a medical need for these drugs and who could be treated with a less compelling alternative,” he continues. “In addition, other social and systemic factors involved may have allowed chemical restrictions to be disproportionately applied to marginalized populations and communities of color in Colorado and across the country.”
Earlier this year, the legislature passed new legislation restricting the use of ketamine in emergencies.
This law, HB21-1251, requires responders to prove a “medical emergency” before using ketamine to suppress anyone suspected of criminal behavior; Requires respondents to weigh the person prior to administering ketamine or, if this is not possible, to confirm the weight estimate by at least two trained experts; and prohibits police from prescribing or unduly influencing health workers to administer ketamine.
It is possible that the state law will be supplemented by a new policy proposed by the commission.
In a statement Wednesday, Jill Hunsaker Ryan, executive director of the Colorado Department of Health and Environment, said: “The Department will take seriously the committee’s recommendations to determine how best to protect the health and safety of Colorado’s residents.”