Ketamine: Understanding the risks to reduce harm

With use of the drug ketamine increasing, our understanding about the negative impacts on people’s health is also growing.

In this blog, Ruairi O'Brien, Senior Health Improvement Officer at Public Health Scotland (PHS), explains why raising awareness of ketamine-related harms matters and how informed conversations can help people access the support they need.

As Scotland's drugs early warning system, Rapid Action Drug Alerts and Response (RADAR) brings together information from a range of sources to identify and respond to emerging harms. Much of this work focuses on substances linked to an immediate risk of overdose and death. However, understanding drugs that can cause other significant health harm is equally important. Ketamine is one example.

Through our work with partners across Scotland, we are hearing growing concerns about ketamine use. While often perceived as a lower-risk drug, regular ketamine use can lead to serious health harms, some of which may not be immediately recognised or linked to use. To help address this, Public Health Scotland has developed a new information sheet for health and care professionals. It aims to raise awareness of the potential harms associated with ketamine, support early recognition of warning signs, and help professionals have informed, supportive conversations with people who may be using ketamine regularly.

What is ketamine?

Ketamine is a drug widely used in human and animal medicine as an anaesthetic. People take ketamine because it changes how they see and hear things, making them feel relaxed and disconnected from their body. Ketamine also has pain relieving effects. It’s mostly found as a white crystalline powder. It’s usually snorted but may also be swallowed or injected. Ketamine may be taken alone or alongside other substances to enhance their effects, for example cocaine or ecstasy. Using more than one drug at the same time, especially when alcohol is involved, can increase the risk of harm because the effects can be unpredictable, unpleasant and the chance of overdose is higher.

Why might more people be using ketamine?

There are a few possible reasons for the increase in non-prescribed use of ketamine. Ketamine is often perceived to be less harmful than other drugs. Ketamine is cheap and widely available and can sometimes be easier to access than alcohol. There have also been more reports of people taking ketamine to self-medicate for mental health problems in recent years. Self-medicating is risky, because there is a higher chance of experiencing serious physical and mental health harms in the future.

The harms are not always obvious

Harms can include:

• problems affecting the kidneys and urinary system
• serious bladder damage, sometimes referred to as ‘ketamine bladder’
• severe abdominal pain
• dependence on continued ketamine use
• mental health difficulties
• problems with memory, concentration and thinking
  
  

Many of these harms present with symptoms which also commonly occur in other conditions such as bladder infections, indigestion, anxiety or depression.

People who use ketamine, their family members and health professionals may not realise that their symptoms are connected to ketamine use. Asking about ketamine use is the first step in recognising the link and can help people access appropriate support earlier.

How to ask if someone is using ketamine

Talking is one of the most important and underrated ways to help someone who may have a problem with drugs or alcohol.

Before starting a conversation, it’s often a good idea to find out more about the substance, this is where our information sheet can be helpful. There are also other useful resources which we’ve linked to below.

Building our understanding of ketamine-related harm

The new ketamine information sheet is an important step in raising awareness of the potential long-term harms associated with use.

However, this is only one part of the wider picture. RADAR continues to work with partners across Scotland to improve awareness and strengthen the monitoring of ketamine-related harms. Better information will help us understand the scale of these harms and improve the health system response.

Ketamine-related harm is not always recognised, but it can have serious consequences for physical and mental health. By increasing awareness among health and care professionals, reducing stigma and ensuring people can access timely, compassionate support, we can help to identify harm earlier and improve outcomes for those affected.

Further information

Read and share the new ketamine information sheet for health and care professionals.

Read about how to have a conversation about someone’s drinking or drug use on changegrowlive.org.

Read about ketamine and harm reduction advice on crew.scot.

Find out more about the RADAR programme here.

Find local drug and alcohol services on drugandalcoholservices.scot.

Read general information on drug use on NHS inform.