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PSYCHOLOGICAL IMPACT Many professionals fear that the full psychological impact has yet to be seen, however, and is likely to escalate in both severity and complexity. Concerns already raised include disrupted education and its impact on life prospects, difficulties in forming intimate relationships, challenges around family planning, and the psychological burden of emerging research – such as whether ketamine misuse may eventually be linked to diseases such as bladder or kidney cancer. This raises troubling questions – do such harms contribute to further ketamine use, or even extend to polysubstance misuse in those already struggling with its consequences?
The early warning signs of misuse are subtle as ketamine does not carry the visible aftereffects and lengthy intoxication associated with other substances.
So why are young people being caught in the ketamine trap? Put the pieces together and a coherent picture emerges. Teens and young adults are especially drawn toward social and sensory rewards, and ketamine delivers both. Within friendship groups, its use takes on a social dimension that normalises and encourages dose escalation, which is reinforced by the shared belief that nothing bad will happen. Supply chains are highly accessible, easy to navigate, and frequently promoted through social media channels that are already embedded in young people’ s daily lives. For those experiencing anxiety – a problem reported with increasing frequency among young people – ketamine can appear to offer an immediate, if deceptive, solution.
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The early warning signs of misuse are subtle as ketamine does not carry the visible aftereffects and lengthy intoxication associated with other substances, allowing young people to believe that their use will go unnoticed. As a result, schools, parents, and health services are often unaware of the problem until physical damage and psychological dependence have already advanced. This combination of developmental vulnerability, social reinforcement, easy supply, and delayed detection creates the ideal conditions for young people to become trapped in their ketamine use.
INFORMED PATHWAYS Drug and alcohol services are already adapting their approaches to support and treat people presenting with ketamine-related problems, recognising the distinct needs of this relatively new client group. More informed treatment pathways have begun to emerge, and health professionals now stress the importance of tailoring services so that young people can access the treatment they need with greater confidence. At this year’ s DDN conference, Acorn Recovery Projects and Delphi Medical highlighted their solutions and shared their successes( DDN, September, page 10). These organisations are not alone. Across the sector, significant work is underway in response to what many are now describing as an epidemic among young people.
What is becoming increasingly clear, however, is that these interventions come‘ after the fact’. Perhaps greater focus on targeting the setting, not just the substance, will help teens and young adults connect with the dangers of ketamine in ways they are more likely to engage with. At a recent ketamine unity day organised by Ketamine Education Services – an initiative founded by a former client of Acorn Recovery Projects – young peer educators suggested exactly this. They showed that young people respond best to plain English discussions about symptoms,
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MISLEADING PERCEPTIONS Ketamine is sometimes regarded as a safer party drug. Its psychotropic effects are relatively short-lived and often described as leaving no obvious after-effects, which contributes to the perception that it is less damaging.
This perception is misleading, which is increasingly evident among those now experiencing serious health consequences. Ketamine has been linked with deficits in memory and cognition, reduced concentration, and poorer executive functioning. Whilst there is some evidence that cognitive impairments may be reversible following cessation, both the extent of this recovery and the full range of ketamine’ s effects remain the subject of ongoing research.
In England and Wales, the Office for National Statistics has begun publishing dedicated tables on deaths where ketamine is mentioned on the certificate, with a marked increase over the past decade( DDN, October, page 4). This is still far fewer than deaths involving opioids or alcohol, but no longer a rarity in the statistics. This trend mirrors the serious urological harm that is increasingly being reported in both primary and secondary healthcare settings – medical practitioners are now seeing growing numbers of young adults with incapacitating bladder pain, with the young people themselves reporting that relief is found only through further ketamine use for its analgesic properties.
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The toxicity of ketamine to the urological system goes beyond physical pain. It’ s leaving a growing number of young adults with permanent bladder and kidney damage, in some cases requiring extreme interventions such as bladder removal and reconstruction. These procedures demand lifelong adaptation, with a profound impact on the individual. People affected by ketamine-related health problems often describe their condition as degrading, with symptoms such as incontinence and sexual dysfunction frequently reported.
combined with a clear message that stopping early can prevent considerable suffering.
Commitment from a wide range of services, whether in education, the arts, sport, or healthcare, could help build on this by involving peer educators to lead conversations in ways that reflect young people’ s social norms, and helping to shift attitudes without moralising.
Should this happen alongside initiatives that expand access to support that relieves youth anxiety and confronts the reality of ketamine retail, then safer environments could be created for young people – where open conversation and early intervention reduce risk before lasting damage occurs.
Dr Lisa Ogilvie is a psychologist at Acorn Recovery Projects
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