The recent increase in ketamine use among young people, highlighted in The Guardian by Owen Bowden-Jones, has ignited concerns across the UK. While some experts, including Bowden-Jones, have described this as a “national problem,” the data reveals a more nuanced picture. Are we facing a full-blown crisis or a more moderate uptick in usage? And, crucially, how much do we really know about the true impact of ketamine, given the inconsistencies in data reporting, especially regarding related health conditions like bladder damage?
The Data: A Mixed Picture
Looking at the figures available from multiple sources, it’s clear that ketamine use has risen, but it’s not entirely an explosion. The most recent figures show that in 2021, only 0.6% of pupils aged 11-15 reported using ketamine in the last year, down from 1% in 2018, which was the highest level recorded . This fall seems to contradict the notion of an escalating ketamine epidemic among younger teens, but we can’t afford to ignore the possibility of data underreporting or emerging trends that may not be fully captured yet.
On the other hand, the use of ketamine among 16-24-year-olds has increased to 3.8% in 2022/23, up from the previous record of 3.2% in 2019/20 . This steady rise, particularly among young adults, underscores that ketamine is becoming more accessible and attractive within this age group. With 719 young people (5.8%) in treatment during 2022/23 citing ketamine as one of the substances they have a problem with, the drug is clearly presenting a growing challenge in substance misuse services . This is a marked increase from the 512 young people (4.5%) seeking treatment for ketamine-related issues the previous year, signalling a rising trend.
Among adults, the increase is even more pronounced, with those entering treatment for ketamine problems rising from 1,551 in 2021/22 to 2,211 in 2022/23 . These figures reflect a trend that has seen ketamine treatment cases increase fivefold since 2014/15. The numbers demonstrate that ketamine is not just a concern for younger people but is affecting a broad demographic.
The “Bladder Explosion”: A Real But Elusive Problem
One of the most alarming aspects of ketamine misuse is the damage it causes to the bladder and urinary tract, a condition colloquially referred to as “ketamine bladder.” According to the Guardian article, there has been an “explosion” in bladder problems related to ketamine use since 2019, described by a consultant urologist working in NHS services. However, as with the neurological problems tied to nitrous oxide use, NHS hospitals have so far been unable to provide clear, quantitative data to support this claim. What does this “explosion” actually look like? And how many cases are being treated annually?
The lack of precise NHS data on ketamine-induced harm is worrying. In a healthcare system that’s typically data-driven, the absence of figures to quantify this “explosion” prevents us from assessing the scale of the problem.
The Rise in Treatment Cases: A Warning Signal?
Despite the patchy data, the rise in people seeking treatment for ketamine misuse is undeniable. The increase in young people and adults entering treatment, along with a fivefold rise in cases since 2014/15 , should be seen as a warning signal. However, interpreting these figures requires nuance. While the rise in treatment cases could indicate a worsening ketamine problem, it may also reflect improved awareness and access to treatment services. With ketamine being increasingly discussed in the media and within drug policy circles, it’s possible that more people are recognising their addiction and seeking help.
However, the growing numbers also suggest that ketamine is becoming more socially acceptable, particularly among younger generations. With its reputation as a party drug and dissociative substance, ketamine’s rise may mirror patterns seen with other substances like MDMA and nitrous oxide. The accessibility of ketamine, its relatively low cost, and its potent dissociative effects make it particularly appealing to younger people who may not fully understand its risks, particularly when it comes to long-term health issues like bladder damage.
The Absence of Ketamine in Drug-Related Death Data
Interestingly, ketamine is not prominently listed in drug-related death statistics, which may contribute to a perception that it is a relatively “safe” drug. According to research published in The Journal of Psychopharmacology, approximately 30 deaths per year are linked to ketamine, usually in combination with other substances . These fatalities are often overshadowed by the larger numbers associated with opioids and other more lethal drugs, but they represent a hidden toll of ketamine misuse.
A Call for High-Quality Drugs Education and Harm Reduction
While the rise in ketamine use among young people is concerning, framing it as a potential major drug crisis would be an overstatement. The data shows an increase, but it doesn’t indicate an imminent explosion of ketamine misuse. What this trend highlights, however, is the urgent need for robust, high-quality drugs education and harm reduction strategies, particularly for younger people.
The increase in ketamine use among 16-24-year-olds and the rise in treatment cases clearly point to a lack of awareness around the risks of ketamine. Many young people may view it as a safer alternative to other substances due to its dissociative effects and its absence from overdose statistics. This perception needs to be addressed with comprehensive education in schools and universities, focusing on the physical and mental health risks of ketamine use, including bladder damage and dependency.
This is where harm reduction strategies come into play. By providing clear, accessible information on the risks of ketamine and offering safer-use guidelines, we can mitigate some of the harm associated with the drug. While no drug use is entirely safe, educating young people on dose control, frequency, and the importance of staying hydrated can reduce the likelihood of serious harm.
The Way Forward: A Harm Reduction Approach
Given the rising popularity of ketamine and the health risks associated with its misuse, it is crucial that policymakers and educators adopt a harm reduction approach. Instead of focusing on punitive measures or framing ketamine as a looming crisis, the emphasis should be on educating young people about the risks and empowering them to make safer choices.
Schools, colleges, and universities must be equipped with up-to-date, evidence-based drugs education resources that tackle the realities of ketamine use head-on. In addition to education, harm reduction services must be expanded to provide young people with the support they need to minimise risks. This includes offering advice on safer consumption practices, access to mental health support, and readily available treatment options for those seeking help for ketamine-related issues.
Furthermore, collaboration between health professionals, substance misuse services, and educational institutions will be key in addressing the rise in ketamine use. By working together, these stakeholders can ensure that young people are not only informed about the risks of ketamine but also supported in reducing harm and accessing treatment where necessary.
Conclusion: Education and Harm Reduction Are Key
While the data shows a steady increase in ketamine use, particularly among young adults, it does not indicate a looming national crisis. However, the rise in ketamine-related treatment cases and reports of bladder damage highlight a pressing need for improved drugs education and harm reduction services.
The most effective way to address this issue is through comprehensive, high-quality education in schools, universities, and beyond. By equipping young people with the knowledge they need to make safer choices and implementing harm reduction strategies, we can minimise the risks associated with ketamine use and prevent long-term health problems.
A harm reduction approach—grounded in education, support, and accessible treatment—is the best path forward in addressing ketamine misuse among young people in the UK. Instead of focusing on the possibility of a major crisis, we must concentrate on proactive, informed interventions that reduce harm and promote safer behaviours.