‘Peeing a jellyfish’: Children’s ketamine injuries revealed

The devastating and often irreversible damage inflicted by ketamine abuse on children is coming to light, with a specialist clinic reporting a "rapid escalation" in young patients suffering from severe urinary tract problems. The drug, commonly known as "Special K," is a general anaesthetic that profoundly alters sensory perception, inducing dream-like detachment, calmness, and relaxation. However, this recreational escape comes at a terrifying cost, leading to excruciating pain and significant physiological harm, particularly to the bladders of young users.

Professor Rachel Isba, who heads a dedicated clinic for these affected children, described the harrowing reality to the BBC. Many of the young individuals she has treated have developed alarming urinary symptoms, including frequent bedwetting, an urgent and uncontrollable need to urinate, and often, the inability to reach a toilet in time. "Sometimes they don’t always make it. They might have accidents… and a lot of them report pain in their bladder," Professor Isba explained, painting a grim picture of their suffering.

The pain is so severe that children often describe it as "peeing over broken glass," a visceral testament to the internal damage. Tragically, this intense discomfort can trigger a dangerous cycle: the very drug causing the pain becomes the means of seeking relief. "Ketamine is a very good pain reliever. It’s an anaesthetic, and so they get into a vicious cycle or ‘K loop,’ which makes their bladder worse," Professor Isba elaborated. This self-perpetuating mechanism underscores the insidious nature of ketamine addiction, trapping vulnerable young people in a downward spiral.

A significant factor contributing to the rise in ketamine abuse among children is its accessibility and affordability. Professor Isba highlighted that ketamine is "pocket-money level," making it an easy purchase for young people. Furthermore, only a small amount is needed to achieve the desired psychoactive effects, further lowering the barrier to entry. This cheapness, coupled with the drug’s potent effects, makes it an attractive, albeit destructive, choice for those seeking an escape or social belonging.

The social dynamics surrounding drug use also play a crucial role. Professor Isba noted that many children find it incredibly difficult to quit if their peers continue to use the drug. "There’s use going on at school. That’s really difficult," she stated, emphasizing the pervasive influence of peer pressure in educational settings. This environment makes it challenging for young individuals to break free, leading to a disturbing trend where "unfortunately for many of these children they are not able to attend education for various reasons." This disruption to schooling can have long-term consequences, hindering their academic and personal development.

The vulnerability of these young users is often compounded by pre-existing conditions or difficult life circumstances. Some children presenting with ketamine-related injuries have had underlying conditions such as ADHD, while others have experienced the instability of being in and out of the care system. These factors can make them more susceptible to seeking solace or escapism in drugs, further complicating their journey towards recovery.

The alarming rise in ketamine abuse among children and young people in the UK is statistically evident. Doctors at Alder Hey Children’s Hospital, renowned for their work in pediatric health, witnessed a stark increase in cases. They treated one young patient in 2023, nine in 2024, and then experienced "a rapid escalation" in 2025, prompting them to establish a specialized clinic in May of that year. The clinic now receives approximately one referral per week from general practitioners and emergency departments across Cheshire, Merseyside, and surrounding regions, indicating a widespread problem.

Of the initial 60 patients seen at the clinic, a significant majority, 43, were girls, challenging traditional assumptions about drug use demographics. The term "ketamine bladder" is a misnomer, as the damage caused by the drug can extend to the entire urinary tract, including the kidneys and ureters. The symptoms are not limited to frequent urination; they encompass an urgent and intense need to go, often accompanied by severe pain and even blood in the urine. While abstaining from ketamine can sometimes lead to improvement, the damage can be so profound that surgical intervention, including the removal of the bladder, may become necessary.

Beyond urinary issues, ketamine users frequently experience debilitating abdominal pain and spasms, colloquially known as "K cramps." Furthermore, there are emerging concerns about liver damage in heavy users, though isolating ketamine’s impact from the effects of other substances, such as alcohol and other street drugs, presents a diagnostic challenge. Professor Isba acknowledged that while cannabis and alcohol remain more prevalent, ketamine has "probably up into third place" in terms of drug use among this demographic. Many children attending the clinic report a history of poly-drug use, including cannabis, alcohol, and vaping, highlighting the complex substance use patterns prevalent among young people.

The British Association of Urological Surgeons estimates that approximately three out of every 10 individuals who frequently use ketamine develop bladder issues. While some of these problems can be reversible with cessation of drug use, the potential for permanent damage is a serious concern. Despite the escalating risks, calls to reclassify ketamine as a Class A drug, placing it in the same category as heroin and cocaine, have been met with caution. The Advisory Council on the Misuse of Drugs has recommended maintaining its Class B status, alongside substances like amphetamines and cannabis, a decision that critics argue may not adequately reflect the severity of harm, particularly to young users.

Professor Isba also highlighted a critical gap in provision for young people struggling with addiction. She pointed out that children under 16 who would be eligible for inpatient detoxification services if they were 18 are currently being denied access due to a lack of such facilities in the UK. "There are definitely some children out there who are under the age of 16 who if they were 18 would be offered an inpatient detox stay. But because we don’t have those facilities in the UK, they are not able to access that and that feels unfair. Particularly for the ones who are ready to stop," she stated, emphasizing the inequity and the missed opportunities for crucial interventions. This disparity in access to care leaves vulnerable young individuals without the necessary support to break free from the devastating grip of ketamine addiction, risking their long-term health and well-being.