What you need to know about the growing drug problem in the UK

There is growing awareness of the problems caused by the use of a fast-acting drug called ketamine. Ketamine is often referred to as K or Ket and was declared a Class B drug in the UK in 2014. Buying and selling the drug is illegal. Possession of the drug can result in a maximum prison sentence of five years, and trafficking can result in up to 14 years.

Ketamine is an effective anesthetic and plays an important role in war and emergency medicine. It is used to manage pain in end-of-life care and may treat some forms of depression. However, it is its non-medical use that raises concerns among some doctors and specialist drug therapists.

On the illegal market, ketamine is cheaper than cocaine and MDMA (ecstasy), costing around £20 per gram. Police report large seizures of the drug, but global production rates are high and the wholesale price of a kilogram of ketamine is said to have fallen from £8,000 to £5,000. This makes it an attractive drug for young people and those on low incomes.

Ketamine usually takes about 15 minutes to take effect and produces euphoria, relaxation and a slight sense of detachment. However, at higher doses it can also cause dissociation. This can be confusing and cause panic attacks and memory loss. It can increase blood pressure and affect breathing and heart function.

The effects can also be fatal. Friends actor Matthew Perry died in 2023 from the effects of drug use.

Some urologists have also raised concerns about an increase in bladder problems (so-called “ketamine bladder”) as a result of prolonged and heavy use of the drug. Although no national data is available on the number of people with ketamine bladder, there are other sources on ketamine use.

Ketamine first became popular as a recreational drug in the early 1990s. Use among 16- to 24-year-olds in England and Wales rose from 0.9% in 2006-07 to 3.8% in 2022-23 – that's about 220,000 people.

The number of young people attending specialist treatment services for problems related to ketamine use has increased: 512 in 2021-22, rising to 719 in 2022-23.

The increase is concerning because there are few services and interventions available that specifically address ketamine use. The increase in people seeking treatment has not been helped by historic cuts in drug treatment funding, which are only now being addressed, and the lack of meaningful drug education and early intervention measures.

This increase in the number of young people seeking treatment is also seen in adults, rising from 1,551 in 2021-22 to 2,211 in 2022-23. Since 2014, the number of treatments sought by adults has increased fivefold.

Self-medication

Experts believe the rise in ketamine use is partly due to the fact that some people with mental health problems are unable to access treatment due to long waiting lists.

Rather than waiting for treatment from a specialist, some people turn to medications such as ketamine, which offer some relief from their symptoms. Ketamine can induce a sense of detachment in users, a desirable state for those seeking to escape invasive mental health symptoms such as troubling thoughts and feelings.

In fact, they find their own solutions by self-medicating with the drug. Given that ketamine is readily available, relatively cheap, and fast-acting, it's easy to see why this drug is attractive, especially since there are no long waiting lists or invasive investigations.

Ketamine does not cause the same hangover as alcohol and other drugs, making it attractive to those who have to be at work the day after consumption. It is also attractive to those on zero-hours contracts who have to work at short notice.

However, many people use other substances in addition to ketamine – usually alcohol. The combination of alcohol and ketamine can cause significant harm, ranging from slowed breathing to coma and even fatal overdose.

Paradoxically, ketamine is being investigated as a treatment for alcohol addicts, including those for whom more traditional forms of therapy have failed.

As with the promise that other drugs, such as psychedelics, could help treat mental health problems, current evidence suggests that these drugs are only effective when used alongside therapy.

It is not clear whether ketamine use has peaked in the UK. Most drugs come in and out of fashion. It is clear that the original ban on the drug in 2005 and tougher penalties in 2014 did not stop its rising popularity. What could have helped was investment in prevention, education and harm reduction, but that has not happened and we are now seeing some of the consequences.

Only by preventing ketamine use can we ensure it does not cause harm. However, if we accept that young people and adults continue to use it, we should try to reduce the potential for harm. Useful resources already exist, but reducing drug-related harm requires a more active response – one that does not rely on people visiting websites or reading leaflets.

We should invest effort and resources in disseminating health information that reaches those most at risk of ketamine harm. At the same time, investing in timely psychological support would reduce the need for those who self-medicate with the drug.

With a new government in power with a significant majority in Parliament, could the Labour government in the UK make a policy change that could reduce suffering and save lives?