Over the past decade, ketamine has surged beyond its origins in raves and festival culture to become a widespread recreational drug across the UK. In England alone, an estimated 299,000 people aged 16–59 reported using ketamine during the year ending March 2023 – the highest number on record, driven largely by young adults.
Usage has more than doubled among schoolchildren: a 2023 NHS England survey of over 13,000 students in 185 schools revealed that 0.9% of 15‑year‑olds had used ketamine, up from 0.4% in 2013. Disturbingly, 11% had been offered ketamine at some point.
Experts including Dr Owen Bowden‑Jones describe ketamine misuse among young people as a national problem, with NHS treatment figures for ketamine addiction doubling from 1,140 in 2019 to over 2,200 in 2023. Today, nearly 6% of under‑25s in treatment services report ketamine problems, versus less than 1% in 2015.
What’s behind this trend? Ketamine’s low price and easy access make it appealing – sometimes cheaper and faster than drinking alcohol – and its dissociative, numbing effects attract users seeking escape from emotional distress or trauma.
Why people are using it recreationally
- Affordable and accessible: In places like Manchester and university settings, ketamine can cost as little as £3 per gram.
- Emotional self‑medication: Many young users cite mental health challenges – trauma, anxiety, depression – as motivations, using ketamine to “numb” the pain.
- Perceived as “safe” leisure drug: Marketed as a mild dissociative or “party drug,” ketamine is wrongly believed by many to be less harmful than harder substances.
The physical and psychological harms
Ketamine misuse is far from harmless. The most common and severe consequence is ‘ketamine bladder syndrome’ – a form of cystitis and uropathy caused by regular heavy use. Symptoms include pain, frequent and urgent urination, bleeding, bladder shrinkage (capacity as low as 10–150 mL), fibrosis, and ulceration. Long‑term damage may be irreversible, requiring bladder removal.
Additional harms include:
- Kidney and liver damage: Chronic use is linked to acute kidney injury, biliary colic, elevated liver enzymes, cachexia, and multiorgan dysfunction.
- Weight loss and malnutrition: Case studies report extreme weight loss that can mimic eating disorders.
- Neurological harm and cognitive decline: Brain scans of long‑term users show reductions in grey and white matter, cognitive impairments, dissociation, even delusions.
- Psychological dependence and withdrawal: Withdrawal can be severe and anxiety‑provoking – users describe overwhelming dread, and there is no substitute medication like methadone for heroin.
Journalists and families recount tragic stories: young users developing ulcerated bladders, crippled bodies, debt, and mental collapse. Several cases have resulted in early deaths or suicide.
Young people and children – a growing concern
While ketamine misuse has primarily affected late teens and young adults, under‑16s are increasingly at risk. NHS‑commissioned data shows rising referrals of under‑16s with ketamine bladder symptoms – mostly concentrated in Cheshire and Merseyside.
Alder Hey’s Ketamine Clinic: A first in the UK
In response, Alder Hey Children’s Hospital in Liverpool opened the UK’s first NHS clinic for under‑16s with ketamine‑induced uropathy (ketamine bladder) in July 2025. Led by Consultant Paediatric Urologist Harriet Corbett and Public Health specialist Professor Rachel Isba, it’s a multi‑disciplinary service offering:
- medical treatment for bladder damage
- mental health support and community drug service referrals
- non‑judgmental, personalised care plans.
The aim is to halt further damage and support cessation, and emphasise that this harm is entirely preventable.
What can be done?
The NHS recommends that young people suspected of ketamine use be directed to FRANK, the national drug info and support service. Where bladder symptoms persist, referrals to a urology consultant team – such as Alder Hey’s – should follow. Without bladder symptoms, community drug and alcohol services should be contacted.
Additionally, The BMJ urges better screening tools, a national registry, joined-up care between addiction, mental health and urology services, and a review of ketamine’s classification – potentially reclassifying it as Class A to deter use.
How individuals and families can help
- Education and awareness: Talk openly with young people about ketamine’s risks, especially the insidious physical harm such as bladder and kidney damage.
- Look for warning signs: Frequent urination, blood in urine, unexplained abdominal pain, weight loss, or emotional withdrawal could hint at ketamine misuse.
- Seek medical assessment: GPs and A&E clinicians should ask about drug use in cases of chronic urinary symptoms in youth – early detection matters.
- Direct to support services: Use Talk to FRANK, local community drug services, and addiction-focused NHS resources.
- Encourage therapy and mental health care: Many users are self-medicating emotional pain. Access to counselling, trauma-informed therapy, and psychiatric care is crucial.
- Support cessation holistically: Quitting often requires support across physical, psychological and social domains. Peer support groups, structured services, trusted healthcare professionals and family encouragement are vital.
Ketamine crisis in the UK
The escalation of ketamine use in the UK – especially among young people and children – is a pressing public health crisis. While its appeal lies in its affordability, dissociative effects, and supposed “harmlessness,” the real-world consequences include irreversible bladder damage, organ harm, neurological decline, dependence, and tragic outcomes.
The opening of the Alder Hey NHS ketamine clinic for under-16s is a hopeful step, but much more is needed: greater awareness, better integrated NHS support, early screening, and stronger preventive education. If you or someone you know is struggling, don’t wait – reach out to NHS drug support services or Talk to FRANK, speak to your GP, and know that help is available.
By combining education, medical vigilance, and compassion, we can stem this tide and protect young people from avoidable harm.
