Don't Take Ketamine Again Until You've Read This
Written by Simon Doherty
Ketamine, rave culture’s favourite dissociative, is thundering through the European party scene like a wobbly, trippy, floaty, freight train. If you partake (no shame in that) and want to know how to reduce the potential harms as much as possible, THIS ARTICLE IS FOR YOU. If you’re struggling with dependency or addiction to ketamine (definitely no shame in that) THIS ARTICLE IS ALSO FOR YOU.
The latest research from scientists who test millions of people’s toilet water for byproducts of various substances, estimated that in the UK ketamine consumption has increased by 85 percent. And deaths related to ketamine in England, Wales and Northern Ireland have increased twenty-fold in the past decade. An estimated 264,000 people aged 16 to 59 in England and Wales enjoy using it to get either a tad floaty, marginally discombobulated, or so fractured from reality that it feels like their brain has turned into dust and is about to blow away in the wind.
Most people who use ketamine use it in moderate amounts and don’t run into any major issues, but the minority struggling with addiction and seeking treatment for it has increased twelve-fold from 2015 to 2025. On top of all that, it’s cheaper than it’s been in 20 years, at both a wholesale and retail level. Whatever way you slice it (or snort it), I’m sure you will agree that, all in all, that’s a pretty ketty picture.
Why’s It So Popular Right Now?
Why is it more popular now? After all, this substance has been making people on the rave scene feel like a ball of cotton wool since the 1990s. Well, in my opinion, that’s because of changes in the way that people take it. For a couple of decades it was strictly an afterparty drug, people would typically pile into someone’s house after going out raving. They’d maroon themselves on a sofa and flop around like a balloon animal escaped from the clutches of a small child. But at some point people started using it at the rave too, which at some parties led to a decrease of energy on the dancefloor (“ket killed the dancefloor” some people complain).
This coincided with government austerity measures, which stripped our public services to the bone, including our mental health services. That’s when many people who were suffering from mental disorders, such as anxiety or depression, had no mental health support on our National Health Service – but they could get a baggie of ketamine for £10.
People started self-medicating with street ketamine to treat these mental disorders which is probably quite effective in the short-term – after all, if you nosedive into a k hole, it’s easy to forget your problems. Therapy costs money, ketamine is cheap. We’re in a cost of living crisis. But this can be a treacherous path, reader, because if you’re using a drug to numb some kind of emotional or physical pain, a small to medium-sized drug habit can easily turn into a small to medium-sized drug problem. It doesn’t happen quickly, it can creep up on you like a thief in the night. More on what to do if you’re worried about your k use down below. But first let’s look at ways to reduce the potential harms if you like using it.
Harm Reduction
Firstly, let’s get one thing out of the way: All drugs have the ability to be dangerous (especially when mixed). If you want no risk at all, then don’t take drugs at all. But I’m guessing if you’re reading this, that’s not you. So, if you're going to take ketamine anyway, then arm yourself with the knowledge to reduce potential harms as much as possible. This is harm reduction. Let’s go…
🐴 Firstly, avoid mixing it with other downers. This includes alcohol, G (GHB/GBL), benzos (Valium and Xanax), and opiates. Because if you do it will increase the chances of being so fucked that you develop the balance of a toddler and topple over, potentially injuring yourself. Mixing it, especially with booze, also increases the risk of bladder issues.
🐴 Test your drugs: Harm reduction advice only works if you know what you’re actually taking. You can use an EZ TEST kit to find out if your ketamine is even the real deal. Substances that are sometimes mis-sold as ket, like Methoxetamine (MXE) for example, can hit you much harder and catch you off guard.
🐴 If you’re going to get wobbly as fuck don’t do it somewhere dangerous – like on a balcony, near a lake, on a motorway bridge, or whatever. Soft furnishings are your friends. When I was at uni, one particularly ketty student house had what they would call “The K Helmet”, a boxing headguard that would be placed on someone’s head if they’d overdone it. That’s probably over the top, but I like their thinking.
🐴 Pace yourself and know your limits: For the same reason as the point above, if you’re not used to taking it, start low and go slow. Like cooking, you can always add more but you can never take any away once you’ve railed it.
🐴 Don’t share equipment to snort drugs, like keys or notes or straws or those tiny spoons people wear on a chain around their neck at Shamballa festival. Using your own snorting equipment reduces the chance of infections being transmitted.
🐴 Protect your nose: Crush the powder as finely as possible, a shard-y line increases your chances of causing cuts which can get infected. After each sesh, wash your nose out with saline solution, which you can buy from any pharmacy.
🐴 Protect your bladder: Try not to take it all the time. It’s no secret that ketamine is bad for your bladder. That’s why you want to take breaks in between getting on it as much as possible. Staying hydrated (drinking water before, during, and after the sesh) can help to reduce the chance of bladder damage. But don’t drink more than half to one pint of water an hour (roughly 250-500ml).
🐴 Watch out for bladder damage: If you experience any of these symptoms stop taking k and go to your GP: k cramps (abdominal pain), pain when you piss, blood in the toilet, or a need to piss all the time.
🐴 Know the signs of a ket-related emergency and look out for your friends. Put someone in the recovery position and get help if they’re disorientated, vomiting, or passed out. Also, try to avoid using it alone as much as possible, so someone can help you if needed.
“A Daily Ket User for Nine Years”
Six months ago, the UK’s National Health Service opened the first ever clinic for children (under the age of 16) who had damaged their bladders from smashing ketamine for too long. So I headed down to Alder Hey Children's Hospital Trust in Liverpool, where the service is based. They let me in for a chat with Professor Rachel Isba, who is involved in running the clinic. I asked what sort of patterns of use might result in bladder damage. “It’s different for different people,” she told EZ TEST. “The longer the exposure and the large amounts being used increase the chances of bladder issues, but it’s really variable.”
Why does this drug sometimes cause bladder problems? “When you take ketamine, your body breaks it down,” she says. “And one of the chemicals it gets broken down into irritates your bladder.” She added: “So people can get stuck in this cycle where their bladder is constantly getting irritated. It’s [the bladder] got a lining and the lining can eventually erode away. Then the chemical [the piss] is touching the bladder directly which can cause an ulcerative pattern which can be very painful and cause blood in the wee.”
For some, this can create a vicious spiral. “Then, unfortunately, some people will get in a cycle of self-medicating that pain with ketamine because it is an anesthetic. That makes it worse. Eventually the bladder can hold less pee and you have to go to the toilet a lot.” If this is you, you can get help through the drug and alcohol services. It starts with an appointment with your GP.
I did a Q and A with Professor Adam Winstock, founder of the Global Drugs Survey and student harm reduction outfit Staying Safer. Hundreds of people submitted questions, but one for me stood out: “As a daily ket user for nine years, what’s the potential extent of the damage?”
“It would depend on the dose and route [of administration],” he explained. “Long-term ketamine use can affect cognition and memory, verbal recall, and things like that. So, your performance.” He went on: “At much higher doses, people can start to develop things that could borderline on psychotic illnesses.”
He added: “Depending on the time of day and context of use, I’d be worried about it affecting their relationships and the way that they’re relating to other people. And then the really obvious one is bladder damage which we know is related to amount used, duration of use, and mixing it with alcohol.”
Bottom line: If you’re struggling, get help. There’s always help available and there’s no shame in using that. Your GP can refer you to your local drugs and alcohol services.
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If I was in charge of this country, I know how I would respond to many more people struggling with ketamine use. I’d ramp up access to mental health support, I’d start putting out harm reduction messaging in educational institutions, and I’d start treating drugs as a health issue, rather than a criminal or moral one.
But, alas, the British government is going in the opposite direction; they’ve said that they’re potentially going to address the situation by upgrading ketamine from a Class-B drug to a Class-A one under the Misuse of Drugs Act 1971. This would increase the criminal penalties for possessing it.
They hope that this will make the problem go away. But there’s no evidence to suggest that increasing the penalties for possessing a drug decreases or deters its use in any way. Quite the opposite in fact; ketamine used to be a Class-C drug with less penalties for possession than it currently has. It was upgraded to Class-B in 2014 and its use has skyrocketed ever since. So trying to upgrade it again to stop its use is about as useful as asking a friend to whack you on the head with a cricket bat because you have a headache. But it doesn’t surprise me, following UK politics is like driving past a car crash. People struggling with ket do not need to be prosecuted criminally, they need mental health support.
It’s called logic.
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