FocusOn: Confronting the Growing Threat of Ketamine Misuse

Dr Mohammed Belal –  British Association of Urological Surgeons 2024

Background

Ketamine was developed in the early 1960s as an anaesthetic and has become increasingly misused as a recreational drug in the UK. The Home Office is currently considering re-classifying ketamine to a Class B substance highlighting the seriousness with which the government is treating its rising misuse. Its dissociative effects, which include hallucinations and feelings of detachment, have contributed to its popularity among young adults. However, ketamine misuse comes with serious physical, psychological and social risks, raising concerns amongst health professionals and policymakers

Rising Trends in Use

Ketamine was once primarily associated with raves and club culture, but its misuse has become a more widespread issue, particularly among young people. This is largely due to its relative affordability and increased availability compared to other illicit substances.

Recent figures from the Home Office show a significant increase in drug seizures, with the highest number of ketamine seizures on record in the year ending March 2024 – a 51% increase on the previous year. This rise in availability is mirrored by a surge in demand, with a Home Office study using wastewater analysis revealing an estimated 85% increase in ketamine consumption between early 2023 and early 2024.

This trend is particularly prevalent among young people, with ketamine use among those under the age of 25 having tripled. This troubling trend highlights the urgent need for targeted intervention and awareness campaigns to combat the growing public health crisis.

Health and Social Impacts

Ketamine misuse is having a significant impact on individuals and placing a heavy strain on healthcare services:

• Urological Damage: One of the most severe consequences is ketamine-induced cystitis, a condition known as “ketamine bladder.” Chronic use can cause severe bladder pain, ulcers and a permanent reduction in bladder capacity. In severe cases, surgical removal of the bladder is required. The devastating consequences of ketamine abuse have seen the emergence of specialist clinics, such as the UK’s first NHS ketamine clinic for children and young people at Liverpool’s Alder Hey children’s hospital.

• Mental Health Issues: Due to its dissociative effects, many individuals turn to ketamine to self-medicate for pre-existing mental health problems. This can create a dangerous cycle, as the drug’s short-term effects can mask underlying issues, while long-term use contributes to the development of psychosis and severe depression. This also further exacerbates existing mental health conditions and feelings of isolation and detachment that can persist long after use.
• Cognitive Impairment: Long-term ketamine use can lead to significant cognitive impairment, including memory loss, difficulty concentrating and impaired executive function. This can have a devastating impact on education, employment and personal relationships.
• Addiction and Dependence: Whilst once thought to be a low-addiction substance, chronic and frequent use can lead to both physical and psychological dependence. Users may experience intense cravings and a need for increasingly high doses to achieve the desired effect, or to anaesthetise themselves from the pain caused by ‘K-cramps’ – abdominal pain caused by prolonged ketamine use. 

The Need for a Coordinated Response

A comprehensive and coordinated response is essential to mitigate the risks associated with ketamine use. This requires collaboration across health services, law enforcement, schools, and community organisations to provide a seamless and integrated approach.

• Enhanced Monitoring and Surveillance: Robust surveillance systems are needed to track the prevalence and patterns of ketamine use, identifying at-risk communities and adopting strategies to meet evolving trends.
• Targeted Prevention Campaigns: Education for young people and adults is needed to highlight the risks of ketamine use and to directly challenge the perception of it as being a “safe” or “harmless” party drug.
• Early Intervention and Treatment: Accessible services are essential to address ketamine dependence and related health problems, ensuring timely support before irreversible physical and psychological damage occurs.
• Training and Education: Early intervention and signposting to specialist services are crucial for effective treatment and preventing long-term harm. Raising awareness of this issue amongst GPs and healthcare workers will help them recognise the early signs of ketamine abuse to minimise delays for specialist support caused by misdiagnosis

How ILLY Can Help

The growing misuse of ketamine and its complex health and social consequences require a data-driven approach to treatment and intervention. At ILLY, our mission is to make a meaningful impact across our communities through technology, and supporting services in this area is one way we can help.

LINKS CarePath is a versatile tool that can be adapted to help services record and track data related to ketamine use, including:

• Prevalence: Recording instances of ketamine use and related harms at both an individual and local authority level.
• Interventions: Tracking the delivery of harm reduction advice and treatment interventions for ketamine dependence.
• Outcomes: Measuring the effectiveness of treatment pathways and identifying successful strategies for recovery.

By leveraging and further evolving our systems to capture, share and analyse data across multiple teams and districts, we can help services identify ‘at risk’ cohorts, tailor their interventions and ultimately drive positive outcomes for those impacted by ketamine use. 

We are actively working with our community to further develop our tools to support services in this vital area. We hold an annual National User Group and Commissioner’s Forum to discuss the sector’s challenges and how we can tackle them. 

If you would like to discuss this topic further, or have any feedback or ideas you’d like to share, please contact us