Ketamine Isn't Just a Party Drug: What Professionals Need to Know About Young People and Ketamine

Ketamine Isn't Just a Party Drug: What Professionals Need to Know About Young People and Ketamine

Ketamine is often talked about as a recreational or "party" drug. For some young people, that may be how their first experience with it begins.

But the picture is becoming much more complicated.

Across the UK, there is growing concern about ketamine use among young people, the physical harms associated with regular use, and the way substance use can overlap with trauma, mental health difficulties, exploitation and other safeguarding concerns.

The issue is particularly relevant for professionals working with children and young people because ketamine use may be only one part of a much bigger picture.

A young person using ketamine may also be experiencing anxiety, trauma, family difficulties, exploitation, peer pressure, homelessness, criminal exploitation or difficulties accessing appropriate support.

That means the professional response cannot simply be: "You need to stop taking drugs."

The more useful question is often:

"What is happening in this young person's life, and what role is ketamine playing in it?"

Why is ketamine becoming a concern among young people?

There is now clear evidence that ketamine use is becoming a more significant issue.

The latest English children's substance misuse treatment statistics show that the number of children reporting problems with ketamine increased from 512 in 2021/22 to 1,465 in 2024/25.

In 2024/25, ketamine was reported as a problem substance by 9% of children receiving drug and alcohol treatment. For the first time, more children in treatment reported problems with ketamine than with ecstasy.

The wider picture is also concerning.

In January 2026, the Advisory Council on the Misuse of Drugs (ACMD) published an updated review of ketamine use and harms. The review concluded that ketamine should remain a Class B controlled drug but highlighted the continuing increase in illicit use and the need for stronger prevention, identification and responses to harm.

And this isn't simply an issue attracting attention because of treatment statistics.

In August 2026, the Home Office reported that Border Force had seized 1,298kg of ketamine during the first three months of 2026 - the highest quarterly seizure total for 15 years. The Home Office linked this to increasing concern about ketamine-related harms, particularly among young people.

So why does this matter to professionals?

Because increasing availability and normalisation can make it easier for a young person to see ketamine as relatively harmless.

It isn't.

Ketamine is a legitimate medicine but that doesn't make recreational use safe

It is important to avoid oversimplifying ketamine.

Ketamine has legitimate medical uses, including as an anaesthetic, and ketamine-related medicines have also been used in specific clinical contexts.

The concern is non-medical use and misuse.

The ACMD's 2026 review examined both the legitimate uses of ketamine and the harms associated with misuse. It identified a range of physical and psychological harms, including emerging concerns around liver and biliary problems as well as the better-established damage associated with regular use.

This distinction matters when professionals are talking to young people.

If we describe ketamine simply as an inherently dangerous drug with no legitimate medical role, we risk losing credibility.

Young people may know that ketamine is used medically.

The more useful conversation is about dose, frequency, context, vulnerability and risk.

The physical harms professionals should understand

One of the most serious concerns associated with repeated ketamine use is damage to the urinary system.

Regular use can cause significant bladder and urinary tract problems, sometimes referred to as ketamine-induced uropathy or "ketamine bladder".

Symptoms can include:

• needing to urinate frequently
• pain when urinating
• urgency
• abdominal or pelvic pain
• blood in the urine
• bladder problems that can become severe

In serious cases, damage can be permanent.

The ACMD's 2026 review also highlights emerging evidence concerning other physical harms, including hepatobiliary toxicity.

This is particularly important when working with adolescents because a young person may not recognise urinary symptoms as something connected to their drug use or may feel too embarrassed to disclose them.

A professional who understands the potential connection may therefore be in a position to identify a health problem much earlier.

But the physical harm is only part of the picture

Focusing exclusively on bladder damage can also miss something important.

Why is the young person using ketamine in the first place?

For some young people, experimentation may be driven by curiosity or peer influence.

For others, substance use can become connected to:

• emotional distress
• anxiety
• trauma
• social isolation
• difficulties at home
• relationship problems
• low self-esteem
• mental health difficulties
• peer pressure
• exploitation
• a desire to escape or numb difficult feelings

The latest English treatment data shows just how closely substance use and wider vulnerability can overlap.

Almost half of children starting treatment in 2024/25 reported a mental health treatment need. The same data also records vulnerabilities including sexual exploitation and criminal exploitation.

This is why professionals need to resist the temptation to treat ketamine use as an isolated behaviour.

It may be a signal of something else.

What does trauma have to do with ketamine use?

Trauma and substance use can become closely connected.

Someone experiencing overwhelming emotions, intrusive memories, anxiety or a persistent sense of threat may discover that a substance temporarily changes how they feel.

That doesn't mean every young person who uses ketamine has experienced trauma.

It does mean that professionals should be curious about what the substance is doing for the young person.

Are they using it to fit in?

To feel confident?

To escape?

To sleep?

To feel different?

To manage difficult emotions?

To belong to a particular social group?

To cope with something they don't feel able to talk about?

Our existing article, Trauma and Substance Use: Understanding the Link and Building Better Support, explores this relationship in greater depth.

A trauma-informed approach does not excuse harmful behaviour.

It helps us understand it.

And understanding creates better opportunities to intervene.

Ketamine and exploitation

This is particularly important for safeguarding professionals.

Substance use can sometimes increase vulnerability to exploitation.

A young person may be introduced to drugs through peers or exploiters. Drugs may then become part of a wider pattern of control, dependency, debt, intimidation or coercion.

Alternatively, an existing vulnerability to substance use may be exploited by someone who offers access to drugs, accommodation, money, protection or social status.

The relationship is not always obvious.

A young person may appear to be willingly participating in drug activity while actually experiencing grooming or coercion.

This is a familiar issue within county lines and criminal exploitation.

Our article, County Lines, CSE and Criminal Exploitation in the UK, explores how grooming, coercive control and exploitation can operate beneath apparently voluntary behaviour.

Similarly, Criminal Exploitation in the UK: Why Victims Are Often Criminalised looks at the danger of interpreting exploited behaviour simply as offending.

The same principle matters when professionals encounter young people using ketamine.

The question shouldn't only be:

"What are they doing?"

It should also be:

"Who else is involved, and what might be happening around them?"

Signs professionals might notice

There is no single sign that proves a young person is misusing ketamine.

Equally, professionals should not expect a young person to openly disclose their drug use.

Possible indicators might include:

• changes in behaviour or mood
• increased secrecy
• changes in friendship groups
• unexplained spending or possessions
• missing school or appointments
• changes in attendance or engagement
• unexplained physical symptoms
• frequent trips to the toilet
• urinary pain or other urinary problems
• deterioration in mental wellbeing
• increased anxiety or distress
• changes in sleep
• unexplained periods away from home
• multiple phones or unexplained contact with adults
• associations with older individuals
• involvement in criminal activity
• sudden access to drugs or money

But context matters.

A single sign tells us very little.

A pattern of changes may tell us much more.

Don't assume the young person will describe themselves as having a drug problem

This is an important distinction.

A professional may look at a situation and think:

"This young person is using ketamine regularly."

The young person may think:

"Everyone I know uses it."

Or:

"It's not really a drug problem."

Or:

"I can stop whenever I want."

Or even:

"It's the only thing that helps."

These different perspectives matter.

If the professional immediately labels the young person as an "addict", the conversation may end before it has properly started.

A better approach is to explore.

What do they like about it?

What don't they like about it?

When do they use it?

Who are they with?

What happens before they use it?

What happens afterwards?

Have they noticed any changes in their physical or emotional health?

These questions can provide much more useful information than a simple yes/no question about drug use.

A trauma-informed response does not mean ignoring risk

There can sometimes be confusion about what trauma-informed practice means.

It does not mean being permissive.

It does not mean avoiding difficult conversations.

It does not mean accepting behaviour that places a young person or other people at risk.

And it certainly does not mean failing to act when safeguarding thresholds are met.

Trauma-informed practice means understanding that how we respond can affect whether someone feels safe enough to engage with us.

A young person who expects judgement may hide their drug use.

A young person who expects punishment may disappear from services.

A young person who has already experienced adults breaking their trust may be reluctant to disclose exploitation.

The professional challenge is therefore to hold two things at once:

Risk matters.

Relationship matters.

Good safeguarding practice requires both.

What should professionals do when they are concerned?

There is no single response that will work for every young person.

However, several principles are useful.

1. Stay curious rather than immediately judgemental

Ask open questions.

Try to understand the circumstances surrounding the drug use.

Avoid assuming that the young person has made a simple, freely informed choice.

2. Explore the wider context

Consider:

• family relationships
• education
• friendships
• mental health
• trauma
• exploitation
• missing episodes
• housing
• criminal justice involvement
• sexual exploitation
• other substance use

The substance may be only one part of the risk picture.

3. Consider physical health

Urinary symptoms should not be dismissed or treated as unrelated.

A young person experiencing pain, blood in their urine, urinary frequency or other concerning symptoms may need medical assessment.

4. Consider exploitation

Ask who supplies the drugs.

Ask whether anyone is expecting something in return.

Ask whether the young person owes money.

Ask whether they are being threatened.

Ask whether someone else controls where they go, who they see or what they do.

The answers may reveal a safeguarding concern that would otherwise remain hidden.

5. Follow safeguarding procedures

Where there are concerns about significant harm, exploitation or abuse, professionals should follow their organisation's safeguarding procedures and relevant statutory guidance.

The response should not depend solely on the young person's willingness to describe themselves as a victim.

What if the young person is involved in criminal activity?

This is where professional judgement becomes particularly important.

A young person can be involved in criminal activity and still be a victim of exploitation.

The two things are not mutually exclusive.

For example, a young person found carrying drugs may be viewed primarily through a criminal justice lens.

But professionals should also consider:

• Who gave them the drugs?
• Why were they carrying them?
• Were they threatened?
• Were they in debt?
• What would happen if they refused?
• Are they being groomed?
• Are they being moved between locations?
• Are they being sexually exploited?
• Are they being supplied with drugs themselves?
• Are they frightened of someone?

Our Criminal Justice and Exploitation in the UK article explores the intersection between exploitation, trauma, safeguarding and criminal justice in more detail.

Avoiding the "bad choices" narrative

It can be tempting to describe substance use in terms of poor choices.

Sometimes a young person has made choices that carry significant risk.

But describing the situation only in terms of choice can obscure the circumstances surrounding that choice.

Imagine a young person who:

• has experienced childhood trauma;
• has little trust in adults;
• is struggling with their mental health;
• has become isolated from protective relationships;
• is being groomed by older peers;
• is using ketamine to escape emotional distress;
• and is simultaneously being pressured to transport drugs.

Calling this simply a "drug problem" misses most of the story.

This is where the concept of complex needs becomes useful.

Our article What Are Complex Needs? Understanding Overlapping Trauma, Substance Use and Mental Health explores why multiple difficulties often need to be understood together rather than treated as separate problems.

Schools and education settings have an important role

Education professionals may be among the first people to notice changes.

Attendance can change.

Friendships can change.

Academic performance can deteriorate.

A previously engaged student may become withdrawn or increasingly dysregulated.

There may be unexplained absences, changes in peer groups or concerns about behaviour.

The latest English treatment data shows that education services were the most common referral route into children's drug and alcohol treatment in 2024/25, accounting for 33% of referrals. Social care accounted for a further 23%.

That highlights the important role schools and colleges can play in recognising concerns and connecting young people with appropriate support.

But education staff should not be expected to become substance misuse specialists.

They need to know what to notice, how to respond, when to seek advice and how to use safeguarding pathways effectively.

What professionals should remember

Perhaps the most important point is this:

Ketamine use is information.

It tells us something about what may be happening in a young person's life.

It doesn't tell us everything.

A young person using ketamine may be experimenting.

They may be developing problematic substance use.

They may be trying to cope with trauma.

They may be experiencing mental health difficulties.

They may be being exploited.

They may be experiencing several of these things at once.

Our job as professionals is not to decide which explanation fits fastest.

It is to stay curious enough to understand what is actually happening.

That means looking beyond the drug.

Beyond the behaviour.

And beyond the immediate incident.

A wider safeguarding picture

The increasing concern around ketamine sits within a wider pattern of overlapping risks affecting children and young people.

Substance use can intersect with:

• trauma
• domestic abuse
• sexual exploitation
• criminal exploitation
• homelessness
• mental health difficulties
• missing episodes
• peer violence
• poverty and social exclusion

This is why fragmented responses can struggle.

A substance misuse service may see the drug use.

A school may see the attendance problem.

Social care may see the safeguarding concern.

The police may see the offending.

Mental health services may see the anxiety.

The young person experiences all of it.

Effective practice requires professionals to connect those pieces together.

Final thoughts

Ketamine should not be reduced to a headline about a dangerous "party drug".

Nor should young people who use it be reduced to their substance use.

The latest evidence tells us that ketamine-related problems among children are increasing, while government and professional bodies are recognising the need for better prevention, identification and responses to harm.

For professionals, the challenge is therefore broader than recognising ketamine use.

It is about recognising what may sit underneath it.

A young person's substance use might be a health issue.

It might be a mental health issue.

It might be a trauma response.

It might be connected to exploitation.

It might be several of these things at once.

The most effective response is one that can hold that complexity without losing sight of safety.

Because sometimes the most important question isn't:

"Why are they taking ketamine?"

It's:

"What has happened to this young person and what do they need from us now?"