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In the summer of 2019, 23-year-old Elijah McClain was stopped by Aurora, Colorado police on his way home after someone called 911 and said he looked suspicious.
The incident quickly turned violent when three police officers pounded the 140-pound McClain and twice put him in a stranglehold that has since been banned. After vomiting, passing out, and being asked for breath, paramedics came and injected McClain with an excessive dose of ketamine, a strong sedative.
He immediately went limp and suffered cardiac arrest on the way to the hospital, from which he died a few days later.
The three police officers and two paramedics have since been charged with negligent homicide, and the family of McClain – who was a black man – was recently awarded $ 15 million in a civil lawsuit against the city of Aurora, the second largest of its kind, right behind the one that was bestowed on the family of George Floyd.
McClain’s death added to the American reckoning with racism and police brutality, but it also sparked a nationwide debate over the use of ketamine – a medical anesthetic, a popular club drug, and psychotherapy tool – in law enforcement situations, resulting in its state being banned Colorado and possibly across the country.
“We’re talking about arming medicine here,” says Mari Newman, the attorney who represents McClain’s family. “It might as well be a taser or a gun.”
Newman says McClain exhibited none of the signs of “aroused delirium syndrome” – a controversial diagnosis that legally justifies a ketamine injection – and that police officers mistakenly “used code words like” he had superhuman powers “” which she says are was an attempt to influence the paramedic to give the injection (and to justify one’s excessive use of force).
The police are not legally allowed to administer ketamine. Paramedics can, but only if a patient shows symptoms of “aroused delirium”. The controversy surrounding this diagnosis – characterized by aggressive behavior, superhuman strength, and hyperthermia – stems in part from its emergence during the drug war in the 1980s and finds disproportionate use in the autopsy of blacks killed by police. The condition is not recognized by the Diagnostic Statistical Manual of Mental Health Disorders or the American Medical Association.
A report on public radio station KUNC found that doctors from Colorado injected 902 people for aroused delirium over the past 2.5 years, resulting in serious complications 17% of the time. The American Society of Anesthesiologists recently stated that it “strongly opposes the use of ketamine or other sedative / hypnotics to chemically incapacitate individuals for law enforcement purposes and not for legitimate medical reasons.”
A Minnesota medic filed a whistleblower lawsuit last year claiming police pressured him to inject someone with ketamine during an arrest, from 2015 to 2017).
Following McClain’s death – and a similar incident with the Aurora police force – the state of Colorado passed law last June banning the use of ketamine in agitated delirium and making it clear that police should never influence medical professionals to use it . “EMS is responsible for patient care, not law enforcement,” said Governor Jared Polis in a signing statement. “Ketamine should not be used for law enforcement purposes.”
A similar bill was tabled shortly thereafter and is being considered by Congress.
Emergency Medical Services Association of Colorado president Scott Sholes says ketamine, when used as directed, is the safest alternative to violence or other sedatives available to paramedics.
“I can tell you horror stories about physically tying people up for hours,” says Sholes. “For the first ten years of my career I strapped people to backboards, sometimes turned the board and sat on it to control people, and eventually we got drugs that we could use.”
From the early 1990s, Shole says, health professionals could use antipsychotics like Haldol and later benzodiazepines like Valium or opioids like fentanyl to suppress those who pose a threat to themselves or others. But these drugs could often take 30 minutes to work, and sometimes they gave the opposite effect.
“By comparison, ketamine lasts three to four minutes, is easy to dose, has the safest profile, and has been remarkably successful at sedating,” says Sholes. “With everything we’ve seen about ketamine in the media, nobody looks at the data.”
Sholes points to a study published last summer that showed that of the 11,291 cases of patients injected with ketamine by paramedics, “patient mortality was rare. Ketamine could not be ruled out as a contributing factor in 8 deaths, which is 0.07% of those who received ketamine. “
Sholes emphasizes some sort of church-state separation between paramedics and law enforcement, and that paramedics should never work with the police in the performance of their duties. However, he admits that there have been cases where that line has been blurred in violation of the EMS protocol.
And in the case of Elijah McClain, he says the Aurora paramedics did not follow basic practices when administering ketamine.
“I’ve been a paramedic for 40 years and this video [of McClain’s death]if you think it’s bad from a layperson’s point of view, it amazes me, ”says Sholes. “This is not how ketamine is normally used … In this video I see paramedics who have not examined the patient. He didn’t move when they gave him the injection, certainly not fighting. He was more indulged [ketamine] required as a protocol. ”
Ketamine was first approved as an anesthetic by the FDA in 1970 and has been a popular medical drug for pain relief and sedation in humans and animals for decades.
In the 1980s and 1990s, the illicit use of ketamine (or “Special K”) became popular among the New York club kids’ rave scene, who loved it for its euphoric, hallucinogenic properties. In recent years it has shown remarkably promising results in the treatment of mental disorders and has spawned an industry of “ketamine clinics” in the United States.
“The effects of ketamine work on a spectrum,” says Desmond Wallington, a psychologist and director of mental health in Colorado at Klarisana, a ketamine clinic. “At the end of the low dose, it’s a psycholytic; this is how time, space and reality briefly dissolve around you. And then there is a psychedelic experience where that effect lasts for about an hour and there is a numb at the other end [unconscious] Experience. We are active in the first two areas. “
Wallington says he “winced” at the idea of ketamine being used in a law enforcement context, particularly because of its growing association with police brutality against young blacks.
“You should give someone with schizophrenia or schizoaffective disorder ketamine – you could send them into a delusional headspace and leave them worse than you found them,” he says. “If you’re already on a stimulant, you risk a stroke.”
McClain’s family attorney Mari Newman says she believes law enforcement officials are using ketamine injections to silence a recalcitrant suspect.
“If someone disagrees with an officer, what better way to silence them than knock them out straight away?” She says.
