At urging of Minneapolis police, EMS workers subdued dozens with ketamine | Hacker News Reader

At urging of Minneapolis police, EMS workers subdued dozens with ketamine

startribune.com

34 pointstomohawk64 comments

I am an EMS provider with experience sedating patients (generally using Versed, but I have used Ketamine on occasion as well). In every instance it has been done out of concern for safety (my own, my crew's, or the patient's).

Taking the article at face value, it seems likely this procedure was being abused (and I would not be surprised if that was proven to be the case).

However... Many of the circumstances described do not necessarily mean it was inappropriate to sedate the patient. Just because someone is handcuffed does not mean they are not a danger to me. Just because someone is secured to the stretcher does not mean they are not a danger (I've been kicked in the head by someone who continued to fight after being secured to the stretcher and eventually worked his leg free).

Just because someone has not committed a crime does not mean they cannot be taken to the hospital involuntarily (generally after expressing an intent to harm themselves). I think the moral answer to "should we prevent someone who wants to hurt themselves from doing that" is worth some discussion, but the legal answer is quite clear... I am required to transport that patient to a hospital.

In many cases is it safer for the patient to use chemical rather than physical restraints.

Again, I am not defending every instance of sedation in Minneapolis. I am simply providing some examples of how this isn't always a cut and dry decision.

You appear to be downplaying the article.

You write "just because someone has not committed a crime does not mean they cannot be taken to the hospital involuntarily". The article certainly doesn't disagree with that statement. It states: "Hennepin Healthcare staff are authorized to use ketamine when a patient is “profoundly agitated,” unable to be restrained and a danger to themselves or others, according to their policy."

Instead it is pointing out times where there does not appear to be a justifiable reason, and for situations where there seemingly should be a cut and dry decision. The morality point you brought up, while true, does not appear relevant to the topic at hand.

As an example of downplaying, the article talks about being handcuffed and secured to the stretcher. You turned that into two distinct cases, and gave an example of where each one separately has come up in your work. But how often have ended up in danger from people who were both handcuffed and secured to the stretcher?

The other use of "handcuffed" was from someone maced while intoxicated, who suffered an asthma attack as a result. The woman, who "was not actively resisting police, asked for an asthma pump. Instead they handcuffed her to a stretcher and gave her ketamine, the report said. ... It is also important to note that it appears no crime was committed, no threat to the safety of officer or paramedics was evident, ...".

Again, your abstract question of the morality of taking someone to the hospital involuntarily under any circumstance does not seem to be relevant.

You write "In many cases is it safer for the patient to use chemical rather than physical restraints." Certainly. Again, I don't think anyone disagrees. However, the article points out examples where both chemical and physical restraints were used. For example, a man secured to a chair, then "[w]hen the man began to regain consciousness .. [t]hey injected him with another dose of ketamine", causing him to stop breathing.

I interpret your true but abstract observations as a way to blur the concrete examples of problems highlighted in this piece.

I am not downlaying the article at all. I made it quite clear I believed it was likely the procedure was being abused. The anecdote of the asthmatic woman is particularly concerning.

> But how often have ended up in danger from people who were both handcuffed and secured to the stretcher?

Multiple times (I don't have a specific number). A stretcher is not intended to be used as an anchor for restraints. It's very difficult to keep someone restrained to a stretcher if they are continuing to fight. There is also a significant risk they will injure themselves. Finally, in some cases it is necessary to sedate a patient to provide treatment.

The point of my comment is that it would be very easy for the article to omit details to make situations seem far less appropriate than they actually may have been (or that the abuse was more widespread than it actually was).

EDIT: As your comment is starting to gray out, I think it's important to say that while I disagree with you, I think your comment is thoughtful and contributes meaningfully to the conversation (and certainly shouldn't be downvoted)

Thank you for your support. I tried to highlight the specific reasons why it felt like downplaying.

Another way to phrase my view would be, if someone did want to downplay the report, how would it come across?

An outright rejection doesn't work. It's too easily dismissed.

For example - and I make this comparison only to provide a well-known example - if you look at the anti-vaxxers, they don't outright reject vaccination. Instead, they argue that it should be examined more closely, there are uncertainties, and it's best to be cautious.

No one can argue with those general statements. It's when you come down to specific things like "should all 6 month old babies (excepting medical reasons) be vaccinated for X" where the opposition comes into play. The opposition strategy is to take it back to the more abstract level, or bring up specific examples where vaccination might have caused a problem.

I felt like your comment followed a similar pattern of switching to abstract principles that no one disagrees with. Someone who wanted to downplay the report would do that, to establish credential as being a reasonable person, and then use that credential to argue that things are more grey and nuanced than it appears.

A third way to phrase my view would be as a complaint about switching to abstractions, which seems to minimize the concrete abuses of the actual people described.

I think where my comment differs from an anti-vaxxer's position is that I am an (admittedly self-described) content area expert. I am not attempting to discredit established science, I am providing more context that a layperson reading this article would otherwise lack.

My concern with the article is that uses the same sort of vague and general statements that you're concerned with to argue against the use of sedation. For instance:

"The police encounters that led to EMS using ketamine ranged from cases of obstruction of justice to jaywalking, according to the report. One man was dosed with ketamine while strapped to a stretcher and wearing a spit hood."

To someone without the context of what these sorts of scenarios often look like, that sounds awful. As someone with a decade+ of EMS experience, I can think of a dozen calls that could be simplified into that paragraph. In every one of those cases in my personal experience I feel I acted in the best interest of the patient, while protecting my own safety and the safety of my crew. These are not decisions that are undertaken lightly, and even in cases where I'm 100% sure I made the right call, these are still the decisions I dwell on for the next couple days.

You are absolutely right that my point is to argue that things are more grey and nuanced. Because they _are_. When I read this article, I think about all the time I've sedated someone, and the ways in which those scenarios could be simplified and twisted into a case where I "obviously" did the wrong thing.

I'm not sure how you expect me to discuss this without using abstractions. I don't have specific knowledge of the cases involved, and it would be inappropriate for me to share all but the broadest details of the situations where I have personal experience.

I bring up anti-vaxxers as a clear example. There are any number of other examples I could bring up, including from content area experts. For examples, the current medical experiment ethics are in place because of a history of experts more interested in the research results than in people. Eugenics, infamously, was part of established science, but more recently we have found many cases where there have been innumerable wrong convictions based the false science of bite marks, flame patterns, etc., all made by content area experts.

There are also innumerable cases where people - domain experts - react to protect their institution over protecting people. Just look at the reaction of the forensics field to those who have identified major structural problems in forensics. Or look at how universities protect researchers over the many students who have filed sexual harassment claims. Or look to how co-workers often shun whistle blowers who highlight real problems.

As an historical example, a century ago more than 30 Brooklyn physicians opposed the Bureau of Child Health because "If we’re going to save the lives of all the women and children at public expense, what incentive will there be for a young man to go into medicine?” - http://www.harvardsquarelibrary.org/biographies/sara-josephi... .

So I don't mean specifically that this argument style is only used to discredit established science, but rather to give an example of how downplaying might look.

As for how to discuss this without using abstractions, that isn't quite my point. Abstractions are fine. What I didn't like was how your abstractions moved the topic away from the concrete details of what appears to be horrible treatment, and into a region where there is no real controversy - abstractions which the article itself used as the baseline for judging what might be unacceptable.

Personally speaking, and here I switch to an abstraction, after reading the many articles where police justify a shooting because they were worried about being attacked - at rates far higher than elsewhere in the world, and with department policies which seem to be biased towards an aggressive style - and stories of police using forced medical exams, and the stories of supposed 'content area experts' in forensics using false science for decades to reinforce police power, my presumption has become more that there is a systemic bias towards the use of power to enforce a level of compliance which is inhumane.

For perhaps the starkest contrast in prison treatment, https://www.youtube.com/watch?v=HfEsz812Q1I . (Haldane is likely the most extreme example of a humane prison, and not typical of European prisons, so this isn't quite fair.)

Do you have an idea of what people in your position do in other countries, like those in Western Europe? We rarely hear about British police throwing flash grenades by accident into a baby's occupied crib. On the same lines, do you think your European counterparts would be doing the same things you do?

> On the same lines, do you think your European counterparts would be doing the same things you do?

Chemical sedation of agitated patients is used in the prehospital setting in Europe, yes.

Yes, I have no doubt of that.

My question wasn't of a general nature - of which there is little disagreement - but of all of the situations which you described where you think it would sound awful to someone who doesn't have the same context as you have.

Would others in Europe, who deal with agitated patients in a prehospital setting, have a roughly comparable response in how to balance between the best interest of the patient's safety and that of the staff's?

I think we can agree that in the police context, that balance is quite different between the US and much of Western Europe. I think the perceived risk is lower in Europe, which affects that balance.

You mean would an EMS provider in Europe, facing identical circumstances, make the same decisions I have made? I believe in most cases they would.

Yes. Thanks for the reassurance.

I felt like he was trying to say "Let's not throw the baby out with the bathwater."

It is really common for people to say "X is being abused. Proposed solution: Do away with X altogether." In this case, EMS sedation in certain situations where safety of the patient and/or others is at stake.

I don't see anyone proposing that solution, so just how common is it?

It's possible you aren't seeing it in this discussion because of the comment we are discussing.

HN is less histrionic than most forums, but it isn't really as calm, cool and collected as it likes to imagine. Or, perhaps a little more charitably, the degree to which it manages to remain a sane discussion space hinges in part on the willingness of actual subject matter experts to inject such comments and then put up with being raked over the coals for it as if they are "apologists" for whatever nefarious behavior is under discussion.

"Please respond to the strongest plausible interpretation of what someone says, not a weaker one that's easier to criticize. Assume good faith."

https://news.ycombinator.com/newsguidelines.html

I believe I did that.

Regarding that guideline, are commenters supposed to follow a similar guideline in how to interpret the source material, or are they free to make a weaker interpretation that is easier to criticize?

Because one of my objections was how the article said that sedation was used on someone both handcuffed and strapped down, while the OP gave examples where someone handcuffed was sedated, and someone strapped down was sedated, but not both. That seems criticizing a weaker topic than what the article described.

Similarly the article presented a case where someone was both physically restrained and chemically sedated, while the OP described chemical sedation as an alternative to physical restraint. That too feels like criticizing a weaker topic than what the article described.

JshWright, to whom I replied, in another branch of this thread kindly commented "I think your comment is thoughtful and contributes meaningfully to the conversation."

> while the OP gave examples where someone handcuffed was sedated, and someone strapped down was sedated, but not both

Ah, I think that's a case where my existing context led to a lack of clarity... If someone is "strapped" to the stretcher (i.e. not just the usual seatbelts), then their wrists are restrained (either in handcuffs, or using "soft restraints" to the side rails of the stretcher). The reality is, a stretcher is not designed to serve as an anchor for restraints, and someone who continues to fight over the course of a 20-30 minute transport will eventually work themselves free (at least enough to start kicking).

Similarly, chemical restraint is always preceded by physical restraint. It's only when physical restraint isn't working (i.e. someone is fighting hard enough that there's a risk of injury) that chemical restraint is employed. It's in those cases that chemical restraint is safer (obviously continuing to wrestle with someone is more dangerous for everyone involved).

Thank you for the additional clarifications.

Then why are these EMTs administering such high doses that the patient can no longer breathe? Are these people not trained properly? Seems like there are other ways to restrain someone that doesn't put their life or the EMTs life in danger. Obviously police don't give a fuck if a suspect dies or not but shouldn't the EMTs care? Not least of all because it's literally their entire job to care for and save lives?

Ketamine is a very safe drug. My guess is in many of these cases the patient was also on some other drugs (prescribed or otherwise), which a) likely contributed to the need for sedation in the first place, and b) contributed to the respiratory arrests. That is, however, only a guess, I obviously have no specific information about these cases (I can speak from personal experience that the vast majority of people I end up sedating have been using drugs or alcohol (off the top of my head I can't actually think of a single exception to that)).

A very minor pedantic point... "EMT" generally refers to providers with a few months of training, and a very narrow scope of practice. The providers administering sedatives would be paramedics, who have a couple years of training (the report cited by the article does use the term "EMT" though).

As more and a wider variety of stories emerge about police malfeasance around the U.S., it should become increasingly difficult to credibly say it's just a few bad apples here and there responsible for isolated incidents. It is ubiquitous? I don't know. But empirically it does seem to be pervasive.

The biggest refutation of the few-bad-apples theory in my mind is that for each bad apple there are a dozen other officers that either did nothing or actively covered for them, plus the policeman's union which will zealously assert that basically no policeman is ever to blame for anything.

It would be a whole different story if the police rooted out bad actors within their ranks on their own, but it seems like it takes a lot of kicking and screaming and, most importantly, public scrutiny, to get anything done.

Their theory seems to be that if i don't back him, then him or his cohort will throw me to the wolfs at a bad moment.

Sadly this line of thinking just reinforce the mentality that the police is at war with the public, in that the only people they can "trust" (in a tit for tat sense) are fellow officers.

>difficult to credibly say it's just a few bad apples here and there responsible for isolated incidents

the point of the metaphor is that a few rotten apples spoil the entire bunch, so this isn't really an excuse to begin with.

It's funny you should bring that up because, come to think of it, I've never actually seen a bunch of apples spoiled by a bad one. They seem to rot from the outside in, maybe on account of their relatively thick skins. Softer skinned fruits like berries and those which tend to mold on the outside (like citrus) do tend to spoil the whole bunch, though.

I think it's in many ways about precaution. We're pretty damn cautious when it comes to signs of decay in food for good reasons, even if many apples are still edible. It's just not worth ruining your stomach with a rotten one.

And I think that mindset ought to apply to civil servants as well. It's not just enough for them to be just okay at their jobs, they have the right to exercise deadly force so we can demand that they are more dutiful and more restrained than the people they protect. The 'servant' is in the name for a reason.

When it looks more like a group of people on a power trip then something has gone very wrong.

It is inevitable that malfeasance will spread, for the simple reason that as the police are required, in big ways and small, to violate the rights of the people they are supposed to protect, those who do not wish to do so will leave the force, leaving behind those who do.

Even the metaphor used is wrong. A few bad apples in a barrel will make the whole thing rot. A cop that covers for another is equally rotten so I simply do not believe there are any non-rotten cops. They might not commit the torture, rape, and murder of unarmed people themselves, but they'll do anything to defend those cops that do. That's somehow ethical in the mind of many and thus they applied the phrase "a few bad apples" about as well as they apply their ethical principles: terribly. So "a few bad apples it is": aka all police are rotten scum. Their logic, not mine.

Interesting and encouraging use of bodycams:

"To evaluate how the sedative was being used, the Office of Police Conduct Review investigators looked for mentions of the word in police reports, and then reviewed body camera footage from those cases."

It seems to me that this article is concentrating on the wrong thing. The biggest problem in the incidents in question is not misbehavior by police; it is misbehavior by EMS workers.

Consider: a police officer and an EMS worker are dealing with someone who is difficult to subdue. The police officer -- who does not have the expertise to know whether it is a good idea -- requests that the person be injected with ketamine. The EMS worker -- who does have the expertise -- does so, knowing that it is a bad idea.

What most needs to change here is the EMS system.

-------------------

EDIT. I guess I mean to say that the people involved here (as opposed to the article) are concentrating on the wrong thing. The police are the ones that have changed their policies. But it seems to be the EMS system that has the more serious problem.

That's assuming the premise "it is a bad idea" is true.

I also don't believe it is inappropriate for the police to suggest that physical restraint isn't working and that something else should be tried (as that is there area of expertise)

I don't think it's inappropriate either. But we should note that police do not have expertise regarding the administration of drugs.

Someone with no expertise in a field can suggest anything they want to. Those with expertise who are actually making the decisions need to be held to account for them.

I absolutely agree that the folks pushing the drugs are the ones responsible.

My point is that it is reasonable for police to say "we're getting our asses kicked, this isn't working, can you sedate this person?"

How do you infer that the article concentrates on the misbehavior of police more than misbehavior by EMS workers?

I have read it a few times now, and I don't get that interpretation.

If anything, the medical system comes off worse. For example, compare:

> Hennepin EMS Medical Director Jeffrey Ho and Minnesota Poison Control System Medical Director Jon Cole dismissed the findings of the report as a “reckless use of anecdotes and partial snapshots of interactions with police, and incomplete information and statistics to draw uninformed and incorrect conclusions.”

with

> Minneapolis Police Chief Medaria Arradondo would not comment on the specifics of the draft, but credited it for changing his department’s approach to interacting with EMS workers.

> How do you infer that the article concentrates on the misbehavior of police more than misbehavior by EMS workers?

Well, I guess it's not so much that the article concentrates on police misbehavior, but that the actual people involved did so. The article does not give us complete information, of course, but it appears that the police basically said, "We messed up, and we're fixing things," while the EMS people said, "There isn't any problem." And since the EMS people apparently are the problem, I find the response disturbing.

The article is based on "the findings of an investigation conducted by the Office of Police Conduct Review", so I think it's reasonable that it concentrates on the police conduct.

Is there an industry code of conduct for EMS personnel?

From what I've seen, it's 'do what the cops say or go to jail.'

https://nypost.com/2017/09/01/nurse-arrested-after-refusing-...

Whilst I suspect in general we agree about the systemic problems, in this particular case, the officer was fired and his supervisor demoted:

https://www.cbsnews.com/news/detective-jeff-payne-fired-nurs...

EMS providers operate under a set of protocols that define what they can and can't do. Deviation from those protocols requires permission from a doctor.

This doesn't answer your question, but in England all trusts who perform rapid tranquillisation (mostly mental health trusts) need to have a policy. You can see some of them here.

https://www.google.co.uk/search?source=hp&q=rapid+tranquilli...

These are bureaucratic documents aimed at NHS managers and external auditors so they're full of jargon but some things to note are:

1) They often talk about the impact on SUs of rapid tranquillisation

2) They talk of the need to reduce and prevent it where possible, and link to external auditors (CQC) or national guidance.

3) They mention NHSLA (NHS litigation authority, the organisation that funds malpractice lawsuits) because RT sometimes causes death or other long lasting harm.

The other sources of information are NICE and Royal College of Psychiatry.

https://www.rcpsych.ac.uk/pdf/RT%20Algorithym%20(2).pdf

https://www.nice.org.uk/guidance/ng10

https://www.nice.org.uk/guidance/qs154

https://www.nice.org.uk/guidance/qs14

In England regulation of individual healthcare professionals is the GMC for doctors, the NMC for nurses and midwives, and the HCPC for everyone else.

The HCPC standards of practice are here: https://www.hcpc-uk.org/aboutregistration/standards/standard...

On top of those all HCPs will be expected to know and follow law.

There are some worrying interactions between English police and health care professionals, mostly around misuse of "lack of capacity" (but without using the Mental Capacity Act) or misuse of the Mental Health Act (eg misusing S136).

Minneapolis police previously had no policy addressing the drug, and the department manual classifies it as a “date rape drug” for its powerful sedative impact and ability to erase or alter memory.

That's funny, because the World Health Organization classifies it as an "essential medicine." I'm being somewhat disingenuous as I do understand it has potential for abuse, but "date rape drug"? I've never once heard of ketamine used for that. Meanwhile it's being looked at for treating depression and other things. This over-the-top drug war rhetoric is so frustrating.

I am surprised as your surprise. For example, the term "date rape" occurs twice on the Wikipedia page for ketamine:

> In December 2013, the government of India, in response to rising recreational use and the use of ketamine as a date rape drug, has added it to Schedule X of the Drug and Cosmetics Act requiring a special license for sale and maintenance of records of all sales for two years.

> Because of its ability to cause confusion and amnesia, ketamine can leave users vulnerable to date rape.

It's not hard to find things like:

> "Tests for “date rape” drugs, such as Rohypnol and ketamine, were conducted. Those tests came back negative." - https://chicago.suntimes.com/news/attorneys-for-kenneka-jenk...

> "Three teenagers are being praised for a straw they invented to detect the presence of date rape drugs in drinks. ... two common drugs used in assaults — GHB and Ketamine" - https://www.sfgate.com/business/article/straw-detect-date-ra...

> It’s called ketamine, a class III scheduled drug .... The drug is the most commonly used among veterinarians for anesthetic purposes, according to Medical News Today, but is often illegally used in clubs and as a date-rape drug. - http://www.miamiherald.com/article206350184.html

But did you actually know of it as a date rape drug before you googled "ketamine date rape?" Not one of those articles (including the two referenced in the Wikipedia quote) even attempts to substantiate any connection between ketamine and date rape. They just put the terms together, sometimes in the headline, to create an association without actually supporting it. One of them contains a statement from an Indian FDA official that "Its misuse is rampant. Its powdered form has been associated with sexual assault cases world over." Not exactly convincing.

You may deduce that I am a user of ketamine. I do think it has potential and it is clearly deemed safe by health professionals. Putting "KETAMINE DATE RAPE" in headlines/subtitles of articles that have nothing to do with someone being date raped is not useful.

Ketamine is used as a drug rape drug. Here's a government level organisation listing ketamine as a drug rape drug.

Ketamine has the advantage of being easy to get hold of; quick acting; and memory affecting.

https://www.nhs.uk/live-well/healthy-body/drink-spiking-and-...

Notice that drugs are not commonly used in sexual assault, and they're only talking about a few hundreds of spiked drinks. (In the UK about 90,000 people are raped each year. Many more are sexually assaulted.) If someone's drinking it's far easier to just give them more alcohol.

I get that you enjoy ketamine, but it's a bit worrying when drug users deny any possible harm that happens with their drug of choice. It means Public Health workers have to spend time debunking both sides of the discussion.

I did say in my first post that I understand it can be abused. I don't mean to claim that nobody has ever used ketamine for such purposes.

I do think that the original article and some of the other ones linked draw wholly unnecessary connections between ketamine and date rape. As you note, it is a very minor use case, and alcohol itself is far more often implicated in these situations, yet we don't read articles that casually mention "the date rape drug alcohol."

I don't think there is any special conspiracy against ketamine, but it's just part of the way major media outlets distort these things to play up shock/outrage/drama.

You said "I've never once heard of ketamine used for that." and asked me "But did you actually know of it as a date rape drug before you googled "ketamine date rape?""

Yes. I heard about that putative connection from one of the times when the "date rape drug detection straw" or something similar made the rounds. At this point I can no longer find the specific link. I think it was from last year. Two possibilities from the media I frequent are:

* HN 5 years ago at https://news.ycombinator.com/item?id=6122049 . (The link to the original article no longer exists.)

* Phyrangula from 6 years ago https://freethoughtblogs.com/pharyngula/2012/12/04/its-a-goo...

Looking at the other media sites I read:

* Neatorama from 8 years ago https://www.neatorama.com/2010/06/30/10-weird-items-people-t... says "tests on the liquid found the animal tranquilizer ketamine, a hallucinogenic drug often used in date rape"

* a comment on BoingBoing last year is the comment "From horse tranq, to date rape drug, to therapy. Is there anything Special K can’t do?", at https://bbs.boingboing.net/t/dissociative-psychedelic-ketami... . A 12 year old BoingBoing article at https://boingboing.net/2006/09/20/willie-nelsons-myste.html references the commentary:

> For instance, one report called the disassociative hallucinogen Ketamine a “date rape drug.” There is, of course, no such thing as a date rape drug. There are drugs that were developed to be used – and are used – for other purposes that are, on rare occasions, used for date rape. And then there’s alcohol, which has been the more easily available and frequently used substance of choice for date rapists since time immemorial.

I completely agree that the association with ketamine as a "date rape drug" is hyped-up drug-war propaganda, and alcohol is a far more common date rape drug, and ketamine has has many therapeutic uses. (Look at how many people are allowed to carry explosives with them on a plane - nitroglycerin is a common heart medicine.)

But I think I have demonstrated enough examples which show why I don't think you should be surprised when someone makes that connection. Instead, I think you should be pushing back against the propaganda.

I’m very confused about the legal status of ketamine in the United States. It’s seemingly illegal (schedule 1?) but also there have been stories about ketamine therapy for depression symptoms and now this? I don’t understand US drug laws.

Schedule III. Of course, there are studies on cannabis/psilocybin, which are both schedule I.

It's still a terrible and terrifying drug for subduing people.

I’m not terribly familiar with ketamine. Thorazine is often used for this purpose, as an injection, a gas, or a pill. How does it compare in how it affects the target?

I’m emphatically not in favor of police using this except as an alternative to other types of violence, but sedation is useful in other contexts.

Thorazine is an antipsychotic, for schizophrenia, stimulant overdoses, and stuff like PCP.

Ketamine is more of a dissociative; it's a little like long-lasting injectable nitrous oxide. It causes hallucinations, but more like a loss of connection from reality than seeing things that aren't there.

> It's still a terrible and terrifying drug for subduing people.

It is commonly use for procedural sedation (i.e. sedating someone so you can reduce a joint dislocation).

Right, but when is using procedural sedation on unconsenting suspects acceptable?

When they pose a threat to themselves or others.

That’s fair. I just don’t trust police to be good judges of that. We can’t even get them to stop obstructing investigations by turning off their body cameras.

Sure, but that doesn't make it "terrible and terrifying". It is literally life saving in certain circumstances.

Ketamine is an anesthetic with broadly valid medical use. There are many similar substances which are scheduled and controlled.

This is correct, it's actually a very safe drug, it's on the WHO list of essential medicines, it's given to infants, obviously in a appropriate setting. Very questionable that some people had to be resuscitated because they were given Ketamine while handcuffed - already a strain on your breathing and heart, when it's a depressant.

Some years ago, I had a close friend who got drawn into ketamine (ab)use and spent an extended period seriously addicted to it. Having watched the devastation it wrought in her and her family's lives, and the struggle it took to break its hold, I find this highly disturbing.

Yes, ketamine has its uses, but it also carries real risks and should not be used without proper controls and medical oversight.

Yeah it’s quite addictive. But for example anyone who undergoes surgery gets given opiates which are also highly addictive. That doesn’t result in millions of people suddenly being addicted.

I've had ketamine infusions for depression. At the ketamine clinics, the drug is administered by an anesthesiologist, and insurance does not cover the cost since the drug is not FDA approved for depression.

Is the US a dictatorship yet

It has a inadequately trained police force, apparently with some cultural and management issues, probably under-staffed and wearing down under a high workload and too many encounters with the worst kind of people in some districts, where there is absolutely no time to take it slow.

It's not just the police force though, is it.

Please stop doing this.

https://news.ycombinator.com/newsguidelines.html

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