Ketamine use is on the increase in the UK. The drug, which first became popular in the 1990s in the club and rave scene, is thought to be in regular use by 125,000 adults and teenagers in the UK, and that number is rising according to drugs and alcohol research groups. Ketamine, in its original form, is a powerful anaesthetic, used mostly in veterinary medicine, but it causes a loss of sensations in the body. Users report a detatched and “floaty” feeling, as if mind and body have been separated. The drug also has powerful hallucigenic properties. How someone on ketamine sees or hears things are completely different. Heavy ketamine users may experience not being able to move, or to having a near death experience, the so-called “k-hole”. While some users enjoy the “trip”, many people who regularly take ketamine also report confusion, agitation and panic attacks. Ketamine use is also heavily linked with depression and longer term panic disorder. Perhaps the most serious side effect of regular use is serious damage to the bladder. Users of ketamine first notice the urgent and frequent need to go the toilet. Urinating becomes painful and urine contains blood and tissue from the wall of the bladder. Sometimes the damage is so great that the bladder needs to be removed. Ketamine users will often increase their dosage as a means of controlling the pain. As use of ketamine becomes heavier, so the risk of damage to the liver increases. As with all drugs, a user’s tolerance increases, and therefore the doses become larger. If high doses are mixed with alcohol or other drugs, it can cause death. Many drugs experts believe that while most people are aware of the dangers of some of the Class A drugs – heroin or cocaine – many clubbers remain unaware of the powerful effects and dangers of ketamine. It is still often referred to as the “new ecstasy” by party-goers and it sells for as little as £20 a gram, making it relatively affordable for many young people. “Ketamine is one of the most dangerous drugs on the drugs scene,” says one addictions counsellor, working in London. “Most people start with a relatively low dose and report a mild-dissociative effect and mild hallucinations, lasting anything from twenty minutes to a couple of hours. But Ketamine is highly addictive. Users want more and their doses increase. The hallucinations become stronger and so do the physical risks.” Many ketamine users – because of its analgesic effect – are at high risk from accidents. There have been a number of cases of ketamine users drowning in the bath or shallow water. Larger amounts of ketamine produce anaesthetic type effects and people have died lying outside on a cold night. The numbness and weakness of the muscles, together with impaired vision and hearing can make users particularly vulnerable. Ketamine is used as a “date rape” drug, and is often used to commit serious assault. The drugs counsellor goes on to say: “In the UK, accidents and assaults where ketamine is involved, are rarely recorded. The number of patients with bladder and liver or kidney damage linked to ketamine use, also goes unrecorded. None of the health figures in the UK truly show the dreadful effects of this epidemic.” He maintains that, because usage and effects are under-reported, so too is clear information on how to get help for ketamine use. “Ketamine is highly addictive and many users, even if they start out as recreational users, will find it hard to stop. The drug produces both physical and psychological cravings and it may be hard to stop without support or treatment.” If you or a family member or friend is experiencing difficulties in stopping using ketamine, you should talk to your GP or to an experienced addictions therapist. It is important that he or she recognises that although there might not be a clinically significant withdrawal syndrome, a period of anxiety and depression plus increased craving to use, is very common. It is possible to stop the use of Ketamine altogether with out-patient support – usually a combination of psychotherapy and counselling sessions, group therapy and a 12-step support group, such as Narcotics Anonymous. For some users, however, a period of in-patient rehabilitation is the best way for them to stop their drug use altogether and to look at the reasons underpinning their addictions. The drugs counsellor says: “Many heavy Ketamine users add a cocktail of other drugs – MDMA, cocaine, plus alcohol or benzodiazepan to manage the come-downs. By the time someone is ready for either in-patient or out-patient help, there may be more than one addiction or dependency going on. It is important that the healthcare professional understands this and supports the user as he or she tries to break the cycle.” Most treatment centres offer a tailored programme of recovery. It may be that a ketamine user has no physical or emotional effects from their using. However, many people who use drugs addictively report a history of mild to moderate depression, relationship or work difficulties, all of which fuel the need for drugs and alcohol. Effective treatment offers a safe space, away from the temptations of everyday life, together with depth counselling or psychotherapy to address the underlying reasons for heavy use or addiction. Equally, recovery from any drug addiction, including ketamine use, can be successful with outpatient treatment, working with a specialist addictions counsellor or psychotherapist. “Outpatient treatment is perfectly possible for any drug addiction, once the medical withdrawal has been supervised,” says the addictions counsellor. “With ketamine, there tends not to be problems associated with physical withdrawal, but there will be psychological cravings. This is where the support of a trusted therapist and often a 12-step group will be beneficial.” “I hope that many more problem users will begin to come forward,” he says. “Ketamine mis-use is rife in Britain. I believe we are going to see many more deaths from this widely available drug. There are already thousands of young people struggling with bladder and kidney damage who are still using ketamine. We must ensure that treatment options are available and are sign-posted.”