Experts have warned there is no “one size fits all” response to the growth of ketamine use
09:13, 14 Mar 2026Updated 09:13, 14 Mar 2026
Users in Liverpool are as young as 14(Image: Getty Images)
The first time people in Liverpool use ketamine is often between the ages of 14 and 16 with fears there could be more young users in the city than is being reported to schools. Families also report uncertainty about how to spot warning signs and where to find support, as experts have warned there is no “one size fits all” as to how the drug can impact users.
This new information has prompted the city council to launch an action plan with partners from Merseyside Police, the city’s university and drug and alcohol treatment services, to address the “emerging and complex issue.”
Nationally, ketamine availability and use have been reported as growing concerns, with increasing treatment presentations and health complications in several areas. While the frequency of use remains lower than for some other substances, ketamine can cause serious and fast-developing harms, particularly among younger people.
Professor Harry Sumnall, Professor of Substance Use at Liverpool John Moores University, said studies conducted in the city’s schools may not be painting the full picture on how young people are accessing the drug.
He said: “In terms of national patterns of use, we’ve seen a sharp increase in ketamine use and harms from about 10 years ago. Increasingly we found, in particular cities and Liverpool’s not unique, but it’s a city that’s perhaps focussed on this more of a concern because there’s been lots of community concerns.
“Liverpool is not necessarily experiencing a greater level of harm than other cities but saying that we have seen a real increase in the number of treatment presentations. That’s in both adults and younger age groups.
“Most of the harms do tend to be focussed and perhaps those in the early to mid 20s, but that’s in keeping with other drugs. In Liverpool, there have been some school surveys and that suggests that maybe less than 1% of under 18s have used ketamine.
“Now, I think that’s a big underestimate simply because of levels of availability, affordability, and some of the national data as well but it kind of highlights, we don’t have an indication of the true picture of ketamine related harm across the population.
“There’s lots of different reasons why people use drugs. They are consumer goods to a certain extent, but they’re quite unique consumer goods, like other consumer goods, people are affected by price and availability.”
Although overall treatment numbers remain lower than for some other substances, the severity of harms associated with ketamine, particularly bladder and urinary damage, has highlighted the need to shift towards prevention and early intervention.
Unlike other substances where established pathways already exist, ketamine presents further challenges including patterns of use, rapid escalation, and serious physical harms which are different to other drugs.
Liverpool’s action plan sets out a framework for awareness campaigns, school engagement, peer-led support, strengthened treatment pathways, safeguarding work, and coordinated monitoring to track the impact of ketamine use and improve outcomes for people caught up in ketamine addiction.
Liverpool’s Director of Public Health Matt Ashton
Professor Matt Ashton is Liverpool’s director of public health. He said: “We’re very used to dealing with numbers and statistics, but actually, it is so important to remember that you’re talking about real people and people’s lives and harm that they are experiencing, poor physical health, poor mental health that sits underneath each and every one of those statistics.
“These are kids. These are like really young people who are experimenting and trying with stuff that can have significant harm on them.
“People try stuff, everyone tries things when they’re younger and experiments and all that kind of stuff, but the trouble is ketamine can cause significant harm. If you think about people starting at the age of 17 and think about at least a quarter and up to over half of regular users experienced bladder issues, they are ruining their bladders by taking this drug.
“When you hear the real life stories, they’re quite shocking and people in significant pain, not really knowing how to deal with the pain, sometimes needing medical interventions like bladder removal, struggling to mix with their friends, to socialise, to do the things that they were doing previously, to do stuff that helps you in your in your life because they’re embarrassed.
“They feel stigmatised, they are worried that people are judging them but they’re also worried about going out when they’ve got physical issues that they need to deal with.”
One of the partner organisations teaming up with the city council is RIVER, Liverpool’s drug and alcohol support service.
Ketamine in powder form(Image: Merseyside Police)
Zac McMasters, head of services for the North West, said: “Not one organisation can really tackle this on their own. We can do our bit, but we need a team approach.”
James Mahwinney is the ketamine lead for RIVER. He said up to 60% of users experience frequent bladder problems as a result and more use could lead to “devastating” impacts. He said: “We’ve got to make sure that we send the right message to people because what we’ve got to recognise is that the majority of people who use ketamine do so on an infrequent basis.
“Obviously we’ve got to promote messages around health, but we’ve got to be careful about how we do that because it runs a risk of scaring people who are not maybe as impacted thinking ‘I don’t get those severe bladder problems, so I’m all right, and I don’t need help.’
“We’ve also got to send another message to say for those who are using less frequently, when you maybe start to experience some of the physical health impacts that ketamine can bring that you’re accessing care and support and treatment earlier on, not when it’s too late, which is what we’ve seen a pattern of is these people are coming into us in crisis when they’ve got significant health problems.”
Zac said: “I think what’s pretty unique about ketamine is how quickly the damage can be done in comparison to other substances and the level you can reach more permanent damage.” James added how there can be other physical issues emerging as a result of ketamine use, including weight loss, nasal problems as well as damage to the kidneys and liver.
He said: “There’s no one size fits all with it. We can’t say the length of time someone’s using, for example, that’s got to then result in these health problems because we’ve seen people who’d been using for a long period of time and they’ve experienced health problems later and we’ve seen people who’ve been using for short periods of time and claiming something really quickly.”