Ketamine has gained a reputation over the past decade as being a cheap, clean drug with few lasting consequences. But the evidence and data starting to emerge tell a completely different story.
The drug has started to move from the fringes of club culture to something closer to the mainstream and the harms that follow this change are now starting to become clear. People are arriving at specialist clinics with life-changing damage, and they're a lot younger than most would expect.
This guide examines what UK government data reveals about ketamine's rise, who's using it, the damage it's causing and why people are still continuing to take it.
How much has ketamine use actually risen?
To answer this question, we’ve first got to turn our attention to the start of the 2010s. In 2012/13, fewer than one in a hundred young adults in England and Wales said they had used ketamine in the previous year. Fast forward to 2022/23, and that figure reached 3.8%, which is close to one in twenty-five.
To put that into an actual number, that’s roughly 222,000 people aged 16 to 24, which was the highest level ever recorded. Then, by 2024/25, use among the same group had fallen back to around 2%.
The most defensible reading of the recent data is that ketamine use has levelled off at a historically high level, rather than continuing its climb. Perhaps a flash in the pan, designer drug story we’re all used to (remember MKAT’s short touch with fame?).
But, as anyone in this field will know, prevalence is only one way of measuring a drug, and the other measures disagree.
Police and Border Force made a record 3,382 ketamine seizures in the year ending March 2025, taking 1.3 tonnes of the substance off the streets, a 55% increase in a single year.
Wastewater analysis, which estimates consumption by testing what ends up in the sewage system shows a 229% rise in ketamine across England between 2021 and 2025. Worryingly, this was the largest increase of any drug tested.
Now, we’re left with a survey that says one thing and sewage wastewater that says something completely different.
Problems with ketamine misuse data sourcing
Some of this discrepancy is explained by how the figures are gathered. The Crime Survey relies on people telling an interviewer what they've taken, which almost certainly understates the real situation. Trying to get a 17-year-old to confess to the drugs they've experimented with friends is never going to give solid results.
In the middle of these results also sits the pandemic, which made it very difficult to collect data and made comparisons across those years a lot less reliable.
Of course, none of this means the plateau of ketamine use is an illusion. Instead, it could mean there's a plateau on how many actual users of ketamine there are, rather than the amount being taken.
Who is using ketamine?
Ketamine use in the UK is concentrated among the young age group, and it’s getting younger. The peak age band sits between 20 and 24, but the figures that concern clinicians most sit well below that.
Typical first drug use, of any kind, happens around the age of 14 and among children and young people entering drug treatment, 80% report starting to use substances before they turned 15.
In some parts of the country the concentration is stark. In Greater Manchester, 64% of people in treatment for ketamine were under 18, and 42% were aged between 13 and 16.
Use skew male, though the clinical cohorts being treated for bladder damage include a substantial number of women. Rates are also higher among people of mixed or multiple ethnicity, and among those who identify as gay, lesbian or bisexual.
Ketamine is often seen first as a party drug in clubs, festivals and other nightlife settings, where many recreational users encounter recreational ketamine outside any clinical setting. One setting where ketamine appears is chemsex, the use of drugs to facilitate or enhance sex, most commonly among men who have sex with men. Research into chemsex identified ketamine among the substances involved, alongside mephedrone, GHB and crystal meth. Ketamine’s dissociative effects appear to lower inhibition even as they dull the physical experience, which is part of why it features.
Chemsex accounts for only a portion of ketamine use, and it doesn’t explain the wider demographic patterns on its own. But it’s one of the settings where the drug has taken hold, and it carries its own risks. Our guide to chemsex covers those in more detail.
Why has ketamine become so popular?
It's cheap, and nothing else comes close
Price is certainly the single biggest factor here, and other reasons aren't even close. A gram of street ketamine typically costs between £10 and £20, and less again if bought in bulk. Now, compare that with roughly £50-100 for a gram of cocaine.
Seeing as ketamine is favoured by the younger age bracket, it makes sense why they would choose it. For a young person during a cost-of-living squeeze, a shared gram of ketamine can work out cheaper than a round of drinks in the pub.
Supply has industrialised
Supply has industrialised alongside the demand. Organised crime groups reportedly exploit legitimate pharmaceutical supply chains. They import bulk ketamine, largely from countries like India and China, for supposed medical use, then divert it to the illicit market after it arrives in Europe.
At the other end of that chain, buying has never been easier. The Advisory Council on the Misuse of Drugs, the government's expert advisory body, found that easy access through messaging apps and home delivery was among the reasons users gave for choosing ketamine.
It doesn't feel like a hard drug
When the ACMD asked users why they chose ketamine, they recorded other answers that weren’t only price based. They described:
- A perception of pharmaceutical quality
- A growing social acceptability
- A lack of stigma
- Quick recovery (i.e no hangovers)
- A belief that ketamine holds mental health benefits.
That last point is something that certainly deserves attention, as ketamine is a dissociative anaesthetic with a genuine therapeutic use, including as an established anesthetic and analgesic in clinical settings and in veterinary medicine. Ketamine is licensed for treatment-resistant depression and, under medical supervision, may also be used for some mental health conditions; in 2025, it was recommended by the Royal College of Psychiatrists for patients who haven’t responded to other forms of treatment.
It would be reasonable to suggest that this legitimate medical use has softened public perception of the drug. Of course, a supervised clinical dose, which may involve sub anaesthetic doses when used for depression, is nowhere near the same as buying an adulterated gram from a stranger, but the association is still easy to see.
Tougher laws haven't reduced use
Ketamine became a Class C drug in 2006 and was upgraded to Class B in June 2014, but recreational use still rose after both of these changes. Under UK law, it is a controlled substance. Possession can lead to five years in prison, while supplying it can result in up to fourteen years. Some debate has also focused on whether it should be treated more like a Class A drug.
This shows the assumption that reclassification controls use is something that doesn’t quite work for every drug out there. It’s also a point that the government’s own advisers returned to when they reviewed the drug’s status in 2026.
The harm Ketamine is causing
Even though use has plateaued, ketamine is still causing serious harm to those who are still using it.
Treatment data
Treatment data captures problem use, rather than casual use, which makes it a good indicator of how many people are experiencing ketamine problems with the drug. In 2024/25, 5,365 adults started substance misuse treatment and cited ketamine as the drug causing them the most issues. When you compare this to ten years earlier, in 2014/15, that number was just 426, showing a twelvefold rise.
The most concerning aspect here is the rise in children seeking treatment for ketamine related problems. The proportion of under-18s in treatment citing ketamine rose from 1.3% in 2016/17 to 9% in 2024/25. The number of young people seeking treatment for ketamine rose from 512 in 2021 to 1,465 in 2024, underlining the growing pressure on drug treatment services.
Deaths
Sadly, deaths related to ketamine use have risen too. Ketamine was mentioned on 60 death certificates in England and Wales in 2024, compared to 18 in 2014. That works out to roughly one ketamine-related death a week in the UK. A mention on a death certificate isn’t the same as a death caused by ketamine, and the distinction matters here.
Most ketamine-related deaths are classed as polydrug deaths, meaning the greatest danger comes with mixing it with other drugs or other substances, especially depressants like alcohol or opioids. When combined, these drugs can suppress breathing, which is where the main health risks lie.
Ketamine bladder
The signature harm of heavy ketamine use is damage to the bladder, known as ketamine bladder or ketamine bladder syndrome.
Ketamine and its metabolites are excreted in urine, where they are directly toxic to the bladder lining. This causes inflammation and scarring, which can eventually lead to a reduced and painful bladder. In severe cases, the damage can extend beyond the bladder to the urinary tract and wider urinary system. Symptoms of ketamine bladder include:
- Needing to urinate constantly
- Urgency to urinate
- Pain
- Incontinence
- Blood in the urine
You would initially think that this is one of those horrific drug side effects that doesn’t affect many, but the data says otherwise. One UK survey found that 26.6% of recent ketamine users reported urinary symptoms, with frequency and abdominal pain being the most common. These types of symptoms were linked to both the amount of ketamine used and the frequency of use. In severe cases, bladder capacity can shrink to as low as 10-150 mL.
In severe cases, the damage spreads to the kidneys, causing bladder shrinkage, and some people require bladder removal.
Other physical harms
Chronic ketamine use is also linked to damage to the liver and bile ducts, which presents as abdominal pain and abnormal liver function. Chronic use is also associated with cognitive impairments and memory problems, and repeated heavy use may contribute to cognitive decline as part of the longer-term health harms.
Severe abdominal cramping, which many have nicknamed “K-cramps”, affects between a quarter and more than half of problem users, according to recent data.
Is ketamine addictive?
So far, a lot of the issues we’ve spoken about would suggest that ketamine is addictive. Tolerance builds with repeated use, and a minority of users, estimated to be around 5-8%, develop problematic ketamine use.
There’s also the idea that ketamine can be psychologically addictive, too. A 2025 study found that those with ketamine use disorder reported that cravings and ketamine dependency affected 71% of participants when they tried to stop. Low mood sat at 62%, anxiety at 59% and irritability at 45%.
A formal physical ketamine withdrawal syndrome is less clearly established than it is for substances like alcohol or opioids, but the psychological symptoms are well documented. If someone is taking the drug regularly and struggling to stop, ketamine detox can be arranged in a safe environment.
Why experts are worried about ketamine use in the UK
In 2025, Alder Hey Children’s Hospital in Liverpool opened the UK’s first NHS ketamine clinic for children. Consultant paediatric urologist Harriet Corbett stated that ketamine is “on everyone’s radar now because it’s snowballed; it’s gone a bit crazy.”
She explained that “when they get bad bladder pain, for some, the only pain relief they find that is helpful is ketamine. So, they get into a very nasty downward spiral.”
She has described children using incontinence pads and urinating into buckets at night.
Harriet states that her focus is on prevention at this moment in time, stating that if young people are encouraged to stop using the drug, it could spare them a life of medical intervention. Heavy use can also lead to wider social harms, not just serious physical damage.
The ACMD also directly warned that ketamine’s harms, including how addictive it can be and the possibility of irreversible bladder damage, may be underestimated by the people using it, which is a growing concern in cases of ketamine misuse. Rising incidents can also place more pressure on emergency services.
Ketamine in the UK: a timeline
- January 2006 – Ketamine is controlled as a Class C drug under the Misuse of Drugs Act 1971.
- 2013 – The ACMD reviews ketamine and recommends it be upgraded to Class B.
- June 2014 – Ketamine is reclassified as a Class B drug.
- 2022/23 – Use peaks at its highest recorded level, with 3.8% of 16 to 24 year olds reporting use in the previous year.
- January 2025 – The government asks the ACMD to review whether ketamine should be reclassified again, this time to Class A.
- 2025 – Alder Hey Children’s Hospital opens the UK’s first NHS ketamine clinic for children and young people.
- October 2025 – The government launches a public health campaign on the harms of ketamine.
- January 2026 – The ACMD publishes its review and recommends that ketamine remains Class B, alongside 14 public health recommendations.
- February 2026 – Home Office data reveals a record year of ketamine seizures, with 1.3 tonnes taken off the streets.
What's in store for ketamine moving forward?
In January 2025, the government asked the ACMD to review whether ketamine should be reclassified from Class B to Class A. In January 2026, the ACMD ruled that ketamine should remain Class B, drawing on national statistics alongside wider evidence.
The decision wasn’t unanimous, and was a majority recommendation from both the Council and its Ketamine Working Group. The reasoning was that the acute harms match the Class B status, and that while chronic high-dose harms are serious, the reclassification on its own would be unlikely to reduce use.
Instead, the ACMD made 15 recommendations centred around public health. This included:
- Better testing, including at the roadside and on arrest.
- Integrated services that bring urology, mental health and drug treatment together.
- Education and harm reduction recommendations.
Professor David Wood stated that this approach is a whole-system one, arguing that no single recommendation would be effective on its own.
So where does this leave the trajectory for ketamine?
The honest answer is that prevalence and harm are running on different clocks at the moment. As we saw, survey data suggests fewer people are picking ketamine up than at the peak, but the people arriving at clinics now didn’t recently start using the drug. They started years ago, during the years when use was climbing the fastest. Not all psychoactive substances produce the same effects, and ketamine’s dissociative profile differs from drugs like LSD or DMT.
This means that treatment demand and death figures could keep rising for some time yet, even if the plateau in ketamine use turns out to be real and lasting.
Essentially, the harm being counted now belongs to a period of use that has already happened.
It also means the landscape isn’t clear moving forward. For example, if prevalence holds steady and the harm figures eventually flatten behind it, the plateau is real. But, if use starts climbing again, everything clinicians are dealing with now continues.
What may change the direction, on the weight of expert opinion, is earlier intervention and education that bridges the gap between how safe ketamine is believed to be and what it actually does; a useful starting point is clear harm-reduction information for young people and families, especially around the long-term risks linked to taking ketamine regularly.
Where to find out more about ketamine and ketamine addiction recovery
Ketamine is one of the most misunderstood drugs in the UK right now, and much of the harm described in this article comes from people not knowing what they were getting into.
If you want to understand the drug itself in more detail, our guide to ketamine covers how it works and what it does, including the wider context around recreational ketamine use. The dangers of ketamine goes further into the risks, and there’s a dedicated piece on ketamine bladder for anyone worried about the urinary symptoms covered above.
For anyone reading this because of someone they know, or because of their own use, help exists and it works. You can read about ketamine addiction treatment success rates and what recovery actually involves whenever you’re ready to look.
