Eva was 16 when she first tried ketamine. She had moved to a new school in the sixth-form and wanted to fit in.
At parties it was handed around like sweets and students appeared to prefer the drug to alcohol; it seemed cheaper and easier than getting drunk.
‘Everything felt so pressurising,’ says Eva. ‘Schoolwork, friends, my appearance, university applications – it was just easier to be out of it. After I started taking ket, the boys at school would joke with me and then invite me to do it with them in a nearby park during lunch. I felt I had been accepted.’
She quickly began to use it every day. ‘I was taking it before class, in the toilets, the library – lots of us were doing it, so I thought it was normal. What I didn’t realise was when they got home to their bedrooms they stopped.’ But Eva didn’t.
After two years on ketamine, she found she needed to go to the bathroom constantly –and then the cramps began. ‘At first they were every few weeks, an excruciating pain in my stomach area,’ she says. ‘I would pretend to my parents that I had my period so the heat pads I used for pain relief weren’t so obvious.’
Eva’s parents are both management consultants living in London who sent their children to private school.
‘But I carried on using the drug,’ she tells me. ‘I thought that girls like me didn’t get addicted – until it was too late.’
Today, eight years on from the day she started taking it, Eva aged 24, is bladder incontinent and wears what she refers to as ‘nappies’. ‘No one tells you about that side-effect the first time they hand you ket,’ she warns as she tells me of the life-changing devastation the drug has wrought upon her.
Among 16 to 24-year-olds, ketamine use has increased by 231 per cent since March 2013 and is now at its highest level since 2006, when records began (posed by model)
Ketamine is used medically as an anaesthetic, its popularity with recreational users due to the feeling of euphoria it generates, as well as out-of-body experiences and hallucinations. It has become Generation Z’s drug of choice.
The Class B narcotic, sometimes administered in the NHS for pain management and depression, was developed in the 1960s and used as a battlefield anaesthetic in the Vietnam War and as an animal tranquilliser. It was in the 1970s that it first became widespread at parties.
But its use has now reached terrifying levels in the UK. So much so that the Government announced last month that it was considering reclassifying ketamine as a Class A drug alongside heroin.
Among 16 to 24-year-olds, use has increased by 231 per cent since March 2013 and is now at its highest level since 2006, when records began.
One in 20 of this age group said that they had tried it in 2023, according to data from the Office for National Statistics.
Known colloquially as ‘Ket’, ‘K’, ‘Special K’, ‘regretamine’ or ‘Calvin Klein (a cocktail of ketamine and cocaine), its popularity has soared due to its low price and easy availability. Ketamine made up more than a quarter of drugs confiscated at festivals in 2023 in the UK.
With one gram costing £10 to £30 – and around 30 to 75mg providing a single dose or ‘bump’ – users can get high for less than £2.
Usually consumed as a white powder, it is considerably cheaper than cocaine and MDMA, and less expensive even than vaping.
And it has long had a reputation among its users for being safe.
But the truth is that its use can lead to incontinence, kidney failure and bladder shrinkage – which can require major reconstructive surgery – plus memory loss, lack of muscle control, psychosis and depression.
In some cases, it can be lethal, particularly when mixed with alcohol and other drugs.
The death of Friends actor Matthew Perry at the age of 54 in 2023 from the ‘acute effects’ of ketamine, and the opioid buprenorphine, further raised awareness of its risks.
The drug is quickly becoming one of the biggest killers on British university campuses and was cited as the cause of death for seven students in 2021 alone.
The death of Friends actor Matthew Perry at the age of 54 in 2023 from the ‘acute effects’ of ketamine, and the opioid buprenorphine, further raised awareness of its risks
Mohammed Belal, a consultant urological surgeon at Birmingham’s Queen Elizabeth Hospital, who treats those suffering from ketamine addictions, tells me he is alarmed by the ‘explosion of users in the younger population’.
He says huge numbers of 16 to 24-year-olds – or ‘Generation Ket’ as they are dubbed – are being admitted to hospital.
The number of those aged 18 and over undergoing treatments for ketamine-related issues has more than doubled, increasing from 1,140 the year before the pandemic to 3,609 in 2023-24. It is the quickest jump in treatment figures for any named substance in England.
Equally concerning is the surge in under-18s being treated, from 1 per cent of ketamine patients in 2015 to 6 per cent last year.
Yet this is only the beginning, Mr Belal warns. ‘There’s always a delay. Many healthcare professionals and GPs don’t yet realise the full consequences or even that ket is the culprit in some instances. So I don’t think we’ve reached the peak.’
He adds: ‘Covid and lockdown probably exacerbated ketamine abuse. So now we’ve seen a big surge of patients with ‘ketamine bladders’, as we call them.’
This is the least-known, yet perhaps most horrifying physical side- effect of chronic ketamine usage: a urological condition where the lining of the bladder becomes so inflamed due to drug use that the organ contracts – in extreme cases to the size of a thimble – causing the patient to pass blood clots through the urethra and lose control over the ability to pass urine.
According to one user I spoke to, it feels like ‘peeing glass’.
The pain can become so unbearable that only another dose of the drug offers relief. But while being an effective analgesic, taking more ketamine further irritates the bladder in a merciless circle. What starts as ‘K cramps’ – debilitating pain spasms around the stomach and bladder – can quickly turn into full-blown incontinence.
Mr Belal is blunt: ‘This means they literally have to go to the toilet at least every half an hour, they are in such agony. They end up having a urinal bottle with them, because they have to go so often.’
And it only gets worse: ‘The tubing, which connects the kidneys to the bladder, can scar up and trigger potentially fatal kidney failure that would require major surgery.’
Years of ketamine abuse, he warns, can cause the kidney and liver functions ultimately to turn off, as the bladder shrinks.
Serial abusers may have to rely on having catheters inserted and live in constant pain. ‘It’s a pretty miserable existence for a young person,’ Mr Belal says.
Billionaire Tesla founder Elon Musk insists ketamine has helped get him ‘out of a negative frame of mind’
This is what happened to Eva. ‘During lockdown it became evident to my parents very quickly that something was wrong,’ she tells me. ‘I needed to go to the toilet the whole time, they could see I was in agony. But when we consulted a doctor, he suggested it was just a really bad UTI and gave me repeated antibiotic courses.’
So, Eva kept taking ketamine. ‘It wasn’t until they found me sobbing on my floor after I had peed blood that my parents discovered I was addicted to ketamine. I was panicking, I thought I was going to die.
‘My parents were desperate to help, but until then they had never suspected it was drug addiction.’
This was four years into Eva’s ordeal with ketamine and, despite now being clean, she still has to use incontinence pads or ‘nappies’ – disposable absorbent pants. She has been informed her bladder – which shrank by about a third – will never recover to its original size.
‘The problem was everyone was doing it,’ she recalls. ‘But they could stop themselves, they’re fine now. I’m not. I’m in nappies. My life will never be the same.’
Scott Ardley, a senior treatment adviser from Rehabs UK sees children as young as 13 with ketamine addictions.
‘It’s everywhere,’ he says. ‘Teenagers don’t even need to know a dealer; they can be added to a Snapchat group and the next thing you know there is a bike on its way to deliver you the drugs.’
Teenagers and young people go to social media to seek out the distinctive unicorn or horse emoji used by ketamine dealers, a reference to its use as a horse tranquilliser. Pupils often buy ketamine because it helps them relax after they’ve been using ‘study drugs’, such as Ritalin, which heighten alertness and energy.
Mr Ardley explains that even £10-a-week pocket money could be enough to fuel a dangerous drug habit. ‘Everyone knows that drugs are illegal, but when you are young you think you are Superman, you don’t believe you could end up incontinent for life.’
Another problem is that ketamine is hard to detect in schools.
‘Cannabis you could smell in the air, alcohol, too – whereas ketamine you can’t,’ says Mr Ardley. ‘And kids can make money dealing it to each other. You have these young runners who will take and distribute a few bags for the older years and maybe get a bag in return.’
But the biggest issue with the drug is its addictive power.
‘The reason ketamine is a wicked drug,’ explains Mr Ardley, ‘is that it can be incredibly hard to come off it.’
Usually consumed as a white powder, ketamine is considerably cheaper than cocaine and MDMA, and less expensive even than vaping
Jack Curran, 29, from Bexleyheath in south-east London, became caught up in this nightmare. He first tried ketamine at 16, but it was only at 19 when he had an accident and injured himself that he began taking it in regular small doses to help with the pain. ‘It was a habit,’ he tells me.
‘But then somewhere along the journey I crossed the line and was hooked, which means I lost the power of choice.’
Within six months, he was using three to four grams a day, and at 19 was getting ‘K cramps’.
‘Any normal person, when they get these pains might be put off,’ he adds.’ But I’d be in agony, crying in bed, screaming for my mum, thinking I was going to die. And then an hour later, the cramps subsided, and I’d be using ket again to dull everything.’
Eventually, Jack would deliberately burn himself with the hot water bottle he would clutch to his stomach, ‘because the burning pain would distract me from the actual pain in my belly’.
His bladder issues became so bad, he says, that ‘I’d be at work (for an events company), and I’d be wearing four pairs of jogging bottoms, under my overalls, because I couldn’t keep going for a pee every ten minutes.
‘I was basically peeing myself continuously.’
By the age of 24 Jack was wearing ‘adult nappies’. He nearly suffered multiple organ failures and was on the opioids oxycontin and fentanyl for pain. By 27, he weighed just six-and-a-half stone: ‘I was constantly weeing every two minutes, I’d got a p*** bottle by my bed. Weeing blood. Imagine.
‘I didn’t dare eat or drink much. I couldn’t hold down a job. All I could do was wait for my next ket delivery. It’s ironic: the thing that helps with the pain is also causing it. I wasn’t scared of dying any more. I was scared of living,’ he says. ‘It’s been absolute hell.
‘Sometimes I used to think it would be easier to die than to deal with this physical pain. I was so scared of living with ketamine, but I was so scared of living without ketamine.’
Eventually, Jack received treatment to get clean. Now he works in the rehab clinic Step by Step Recovery in Southend, Essex.
‘I still haven’t slept over two hours without needing a wee because my bladder is so scarred and shrivelled, but at least I’m alive,’ he says.
The UK isn’t the only country battling the drug. In the US, doctors have been prescribing ‘micro-doses’ of ketamine for years for pain relief, often in the form of nasal sprays. Seizures of illicit ketamine grew there by 350 per cent between 2017 and 2022.
But many celebrities in the US have espoused the use of the drug recreationally. Billionaire Tesla founder Elon Musk insists it has helped get him ‘out of a negative frame of mind’.
He uses ‘a small amount once every other week’ and this has fuelled an interest in experimenting with the substance as a treatment for mental health.
Abigail Wilson, lead clinical pharmacist at the drug and alcohol charity WithYou, says some young users feeling anxious or depressed could turn to ketamine to manage their mental health.
‘If you’re using the drug to self-medicate, you may find it will initially relieve symptoms,’ she says. ‘But as the use escalates, it can become more out of control, and you need to use more in order to get the same effect – which can lead to dependence and physical health problems.’
Whether reclassifying the drug to Class A will bring an end to the epidemic is open to question.
Somehow Gen Z users need to understand the potentially devastating consequences of an addiction to this drug of the moment that they think is harmless.
They need to know they risk a life in nappies.
Eva’s name has been changed to protect her identity.
