The dark reality of ketamine addiction

Dahlia, 28, will never forget the first time she tried ketamine. She was 15 years old, at Reading Festival with her friends, and had already tried “a lot of other drugs”, including MDMA, ecstasy pills and cocaine. “As soon as I tried ketamine, I fell in love with it, sadly,” Dahlia tells Dazed. “It gave me a different kind of high that I had never felt before. It seemed that it took away all my problems and felt like it wrapped me up in a warm, cosy blanket.”

Now, 13 years later, Dahlia takes ketamine every day, sometimes consuming up to 3.5 grams in a single evening (a common dose of ketamine is about 30 to 75 milligrams). “If I don’t have it, I’ll be itching and waiting until the next time I can use it,” she says. “Maybe trying to scrape any residue off of anything I’ve done a line on just to get some crumbs together so I can feel like I’ve had somewhat of a line.”

Last month, a BBC article warned of a sharp rise in young people presenting with ketamine-related bladder issues. Ketamine use is currently at its highest since records began in 2006, and the most recent government figures estimate that use has doubled since 2016. While the number of people seeking treatment for ketamine addiction makes up a tiny proportion of the number of people who use ketamine recreationally, the latest ONS figures show that there has been a rise in adults entering treatment with ketamine problems.

“Young people aren’t really educated about ketamine addiction […] Maybe if they knew they would treat it differently” – Josh Torrance, drug researcher

She would take around 1.75 grams a day, sometimes up to 3.5 grams, particularly in lockdown. “I had a lot of people around me who loved ketamine too, so we would take it together, but I’d also do it alone,” she recalls. “It felt like it was an escape from reality. I don’t think I wanted to face the fact I was depressed. I felt like I needed it all the time.”

According to Torrance, the majority of people who become dependent on ketamine are likely self-medicating due to trauma or poor mental health, just like Amber and Dahlia. “A large number of people that are using ketamine at least three times a week are often subconsciously self-medicating for something or other, or seeking relief from their daily existence,” he says. Considering that more than a quarter of a million under 18s are on a waiting list for mental health support, he says, it’s hardly surprising that some are seeking out other means of coping.

This chimes with Dahlia. “I suffer from many mental illnesses and have done for years,” she says. “Ketamine seems to be the only thing that can make me feel better, but it also makes me feel worse at the same time.” 

As Torrance says, although ketamine dependency is technically a psychological dependency, insofar as it does not cause physical withdrawal symptoms, the “psychological can manifest in the physical”. As Dahlia explains, when she is experiencing ketamine cravings, she finds it impossible to sit still. “The cravings feel like you have someone else in your brain controlling everything you do and there’s nothing you can do about it,” she says. People who use ketamine often may also experience what is known as ‘K cramps’, severely painful and debilitating abdominal cramps, and, in Dahlia’s case, projectile vomiting. “It physically feels like your organs are shutting down and you’re going to die,” she says. I have spent maybe eight or more hours in a hot shower to try and relieve the pain and nothing works. I will end up passing out on my bathroom floor due to exhaustion after an episode.”

Annual deaths related to ketamine have increased more tenfold since 2005. In 2022, some 37 people who died of drug poisoning in England and Wales had consumed ketamine. As Torrance explains, ketamine is not a very lethal drug: the dose required to overdose is around 2.7 grams, which is difficult for somebody who is snorting ketamine – the most common form of consumption – to take in one go. However, large amounts of ketamine may lead to someone falling unconscious, which may lead to death through constricted airways or choking on vomit. That said, the majority of ketamine-related deaths involve poly-drug use, meaning ketamine has been mixed with another substance, and the number of deaths in relation to the number of people who use ketamine is extremely low.

The main concern with ketamine dependency, then, is the long-term physical effects – namely bladder issues, known colloquially as ‘ket bladder’, which can leave some users either incontinent or in need of surgery. Amber first started experiencing bladder problems around six years after she first tried ketamine, when her addiction was at its height. “I started passing blood and jelly-like lumps out of my urethra, which was absolutely excruciating,” she says. Not knowing what was causing the issues, she continued to take ketamine, which she says was “the only thing that would mask the pain, meaning I was able to function without being in agony, even though it was making it worse.”

Despite being more than eight months clean, Amber is still experiencing bladder issues, and says her bladder is just one eighth of the size it should be. “I have to wear incontinence pads, I have an incontinence sheet on my bed. I can’t work because of the physical pain and I have to take a bath every day to help soothe the pain for a minimum of three hours,” she says. “I’ve been in the bath for more than 12 hours in the past, I just couldn’t move because of the pain.”

Amber is currently undergoing treatment with the NHS and is awaiting a biopsy. “I’m on morphine, amitriptyline and a bladder tablet to help relax my bladder muscles,” she says. “I didn’t know that ketamine did this to you, otherwise I would have never touched the stuff.” Dahlia has also experienced seizures and has even had a nose job to repair a collapsed septum due to snorting so much ketamine.

“I didn’t know that ketamine did this to you, otherwise I would have never touched the stuff” – Amber

In order to tackle rising ketamine addiction, Torrance says that treatment services desperately need to cater to the needs of those using the drug. “People who use ketamine generally don’t engage with treatment, which is why the figures for those accessing treatment are so low compared to the number of people who use ketamine.”

Dahlia has attempted to seek help for her addiction and is part of a rehabilitation programme which consists of meetings about how she’s been feeling – but it isn’t working for her. “No matter what anyone says or suggests it doesn’t work, it’s almost laughable,” she says. “When you have these cravings and someone suggests ‘having a bath or reading a book’ it’s clear they’ve never dealt with the cravings themselves.” Amber, meanwhile, was initially too scared to seek help for fear of losing custody of her child. But after getting support from her family and friends, she has been able to stay clean for eight months. “It’s been a very long and horrible road but I’ve finally got to the place where I’m so happy mentally besides the pain,” she says. “I’m not far off being a year sober from it and I’m very proud of myself.”

Most drug and alcohol treatment services are geared towards people who use crack cocaine and heroin. However, Torrance says, “more work needs to be done in this area, because it’s only by getting these people engaged in treatment as early as possible that we can prevent long-term future dependencies that are much harder to solve.” As with many substances, not everybody who uses ketamine recreationally will become dependent; using the drug moderately to enhance experiences, rather than to self-medicate or cope with poor mental health, is unlikely to cause lasting damage. But, as Torrance says, the more people that are aware of the potential life-changing effects of ketamine, the better. As Amber says: “It’s gonna be a long journey for me to get to a point where I’m able to live a semi-normal life, and I just want to spread awareness about the reality of ketamine – I hope that, if people are going to take it, they just take it in moderation, because it can change your life forever.”

If you’re worried about your ketamine use make an appointment with your GP or head here to access information, advice and support.

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  • Source of information and images “dazeddigital

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