Israel Says Prison Time Possible for Possessing Unprescribed Ketamine, Fentanyl

Knesset health committee approved Health Ministry’s request to criminalize possession of substances associated with drug overdose deaths without a prescription

A bag of 4-fluoro isobutyryl fentanyl seized in a drug raid is displayed at the Drug Enforcement Administration research laboratory in Sterling, Va, August 9, 2016.
Cliff Owen / AP

The Knesset Labor, Welfare and Health Committee approved a request by the Health Ministry on Monday to add five dangerous substances to the Dangerous Drugs Ordinance, among them ketamine and fentanyl, which are both used for medical purposes.

From now on, anyone possessing these substances without a prescription could be imprisoned. The decision was made against the backdrop of these substances entering the recreational drug market on the streets and in nightclubs.

The Health Ministry sees the move as a preventative step in the wake of increasing substance abuse in countries like the United States, Canada, Britain and Germany. According to Dr. Ronny Berkowitz, director of the Health Ministry’s Division of Enforcement and Inspection, there has been a sharp rise in the popularity and illicit use of these substances in recent years, causing thousands of cases of poisoning and death.

“The phenomenon isn’t yet palpable in Israel, but we are trying to prevent it before it’s too late,” he said. “These are the strongest of substances, which can kill with a dose of a few micrograms. The use of them in illicit drug labs in many countries has recently led to many overdose deaths.”

Ketamine’s legal use is for anesthesia in humans and animals. It has also been used in Israel and abroad for treatment-resistant depression. It has also become a popular recreational drug. Inspection officials at the Health Ministry say its use has increased in recent years as a party drug but also as a date rape drug. Ketamine is usually colorless and odorless. It has powerful side effects such as abnormal heart rhythms, spasms, muscle tremors and hallucinations.

Fentanyl is a powerful painkilling opioid. It is considered 100 times more powerful than morphine because of its ability to penetrate the central nervous system and cling to pain receptors. The substance is used in operating rooms for sedation and anesthetization, but it is also given as a transdermal patch to patients suffering from severe chronic pain after surgery or due to digestive problems or renal dysfunction. Fentanyl is known as a particularly addictive drug – as well as its consumption by patients with a legal prescription. It is one of the drugs most closely identified with the growing opioid epidemic in the United States and increasing opioid use in Israel in recent years.

“It is a substance that began seeping into the street in some countries, and it is especially fatal because a tiny dose is sufficient to cause death,” says Berkowitz. “Its use by illicit drug labs has made it even more dangerous.”

The Health Ministry says that the United States registered 400 cases of fentanyl poisoning in the first three months of 2017. According to the Center for Disease Control, there were 42,000 opioid-related deaths in the United States in 2016, 19,000 of them involving fentanyl and fentanyl-like drugs.

Carfentanil, an analog of fentanyl, will also be included in the Dangerous Drugs Ordinance. The substance serves as a heroin substitute and has been tied to over 50 cases of death in the United States and Canada. The ordinance will also include AL-LAD, a psychedelic drug that is an analog of LSD, whose use can lead to anorexia, suicidal thoughts and hallucinations, according to the Health Ministry. The other drug to be included in the ordinance is U-47700, a synthetic opioid that recently arrived in Israel. It is known as a painkiller and relaxant that gives the user a sense of euphoria, but it is liable to destroy living tissue.