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Ketamine, primarily used as a general anaesthetic, works by dulling or numbing sensations throughout the body. Users often report experiencing feelings of detachment, relaxation, and a dream-like state. However, despite these effects, ketamine misuse can lead to serious health problems. Professor Rachel Isba, who oversees a clinic specializing in this issue, has observed troubling symptoms among young patients, including increased urgency to urinate, bedwetting, and severe bladder pain. One child described the sensation as similar to “weeing over broken glass,” highlighting the intensity of the discomfort.
The pain caused by ketamine abuse sometimes drives users to take more of the drug in an attempt to relieve their symptoms. “Ketamine is a very good pain reliever. It’s an anaesthetic, and so they get into a vicious cycle or ‘K loop’, which makes their bladder worse,” Isba explained. She also noted the drug’s accessibility, mentioning it is inexpensive enough to be bought with pocket money, and only a small dose is needed to feel its effects. This accessibility, combined with peer pressure, makes it difficult for children to stop using ketamine, particularly when use is ongoing among their friends at school. Additionally, many of these children face challenges attending school due to their health and social circumstances, with some having pre-existing conditions like ADHD or being involved with the care system.
In the UK, ketamine abuse among young people has been increasing sharply. Data gathered by doctors at Alder Hey shows a marked rise in cases, with one patient seen in 2023, nine in 2024, and a rapid escalation in 2025 that prompted the establishment of a dedicated clinic in May. Currently, the clinic receives approximately one referral weekly from general practitioners or emergency departments in Cheshire, Merseyside, and nearby areas. Of the first 60 patients treated, the majority were girls, numbering 43. Although commonly referred to as “ketamine bladder,” the condition can impact the entire urinary system, including kidneys and ureters, and manifests as urgent and frequent urination, often accompanied by blood-stained urine and considerable pain.
The damage caused by ketamine can be so severe that, even if use is stopped, some patients require surgical intervention to repair or remove the bladder. Other symptoms include abdominal pain and muscle spasms known as “K cramps.” There are also indications that heavy ketamine users may suffer liver damage, though it’s challenging to isolate this from harm caused by concomitant use of alcohol, cannabis, and other substances. Isba pointed out that while cannabis and alcohol remain more popular, ketamine is likely the third most commonly used among young people. Many patients at her clinic report experimenting with various substances, including alcohol and vaping. The British Association of Urological Surgeons estimates that about 30% of frequent ketamine users develop bladder issues. Despite the serious risks, ketamine remains classified as a Class B drug, alongside amphetamines and cannabis, following recommendations from the Advisory Council on the Misuse of Drugs, even though some have advocated for its reclassification to Class A. Isba also highlighted the difficulties children face in accessing appropriate treatment, noting the lack of inpatient detox facilities for those under 16, which means many young people who want to quit are unable to do so in a supported setting
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