BBCMegan Harmes was 14 when she first tried ketamine.
A decade later, rehab is helping her rebuild her life after bladder issues caused by the drug have left her needing to wear incontinence pads.
The drugs charity Kaleidoscope says it has seen a huge rise in referrals to its detox and rehabilitation facility over the last five years, with two people referred in 2021 compared to 112 so far this year. The majority of clients are aged 18 to 24.
Research is now underway by the University of South Wales into the specific needs of this group, as the harm caused by “chronic, escalating use” of ketamine is far more rapid, over a shorter space of time, than from alcohol or Class A drugs.
For 24-year-old Megan, from Flint in north Wales, drug use became more common among her peers during lockdown.
As an aeronautical engineering apprentice, she was suddenly working from home, on full pay, with access to a drug whose price had plummeted.
She said at its worst, she was on it “all day, every day”, as according to Megan it helped to suppress symptoms or feelings associated with ADHD and borderline personality disorder.
“I’m very hyperactive now that I’m sober. I haven’t been like that since I was 14, it suppressed pretty much everything,” she said.
Eventually her ketamine use meant she lost her apprenticeship, causing her to “spiral”.
Megan later found work elsewhere, but four years of night shifts further entrenched her use, as she would use ketamine to stay awake through the night even on days off.
For the last two years she has been in agony, unable to stand straight and needing to wear incontinence pads.
“For a 22-year-old wearing pads or nappies, it takes away all dignity,” she said.
“Back then I really didn’t care whether I lived or died – now I don’t want to die.
“I’ve been in rehab just over four weeks and I’m getting back to my old self.”
Megan said she wouldn’t know the extent of the damage to her bladder for some time, but she has put on weight and is physically feeling better than when she arrived.
Jo Moore runs the Birchwood rehabilitation facility for Kaleidoscope and said five years ago they had just one referral for inpatient detox from ketamine.
“Since January this year we’ve seen 112 people come through the door,” she said, adding that half their clients are currently being supported for ketamine use.
“It’s very, very cheap and very accessible – that’s what allows people to use it more frequently and at large amounts at the same time.”
The drug is prescribed in healthcare settings as a dissociative anaesthetic, and also used with animals, but was reclassified as a Class B drug in 2014. This means it is illegal to take, carry, make or sell.
Illicit ketamine use among those aged between 16 and 59 in the UK was estimated to be about 264,000 people in 2024-25, with those seeking treatment for ketamine use disorders increasing twelvefold over the course of a decade.
While younger people have driven the rise in its use, Moore said the last year had seen a rise in referrals for adults aged 25 to 34, particularly in Cardiff and south-east Wales.
Dr Darren Quelch, from the University of South Wales, said interviews with service users at Birchwood suggested use started from as young as 13.
He said the physical harm caused by persistent use ranged from memory problems and chronic pain to bladder damage and kidney failure, but that support services were having to rapidly adapt as the needs of users are more complex.
“Their bread and butter isn’t dealing with really complex medical presentations,” he said. “Even if they were, we actually don’t know what the right answer is yet.”
He is now conducting research alongside Kaleidoscope to establish what types of support work for this specific patient group.
“The population is inherently different to lots of other groups that might engage with drug and alcohol treatment services,” he said.
Mark said his health had deteriorated to such an extent that “at the age of 25 I probably had the body of an 80-year-old”.
“I was no longer functioning like a proper human being,” he said.
As a keen footballer growing up in Liverpool, he now looks on jealously at others his age, walking without pain.
“It stopped me being a father to the little girl that I’ve got – I stopped being the big brother, the responsible son,” he said.
Mark would regularly pass clots and experience pain during urination, but said the collapse of his nose from snorting drugs has had a huge impact.
“It completely destroys self-confidence – which leads to more drugs, because that just blanked out what I think of myself.”
It’s one of the reasons he has asked to remain anonymous.
“I started getting looks of disgust from my own family, which destroyed me. It was a very lonely time through my addiction,” he said.
Mark’s drug use started at 18, but by 21 he said he was using “copious amounts of cocaine and ketamine”.
He initially sought help from his GP in Liverpool, but was too ashamed to admit he was using ketamine for fear of being dismissed or judged.
“It’s a hard lesson learned,” he said.
It’s an issue reflected in Quelch’s research. He found young people struggled with A&E and GP surgeries, as their symptoms weren’t always linked with ketamine use, or the question wasn’t always asked.
“That’s not necessarily because people aren’t asking the right question, but we don’t actually know what works well at the moment,” he said.
“There’s very little provision for young people experiencing drug and alcohol-related harms, and that has almost left us starting right from the beginning.”
Moore said things were improving, with greater availability of early intervention in the community, reducing the need for detox.
“We’re seeing less people presenting to services with a new substance use of ketamine – so the education in schools, colleges and universities is actually working.
“But we are seeing an increase in people that have been using for a couple of years that we are going to continue to have to help and support.”
With trends in drug use evolving, Moore said the challenge for both the third sector and the NHS was to adapt around the needs of clients, but that the involvement of those with lived experience had made a difference.
“I can see improvements now, but there have been some really difficult times where it felt like we were shouting in the dark.”
Quelch said while research continued, the scale of the current ketamine problem was still unclear, as was the longer-term health implications.
“Anecdotally, relapse is a big problem in this group – we don’t know the recoverability of their bodies, but we have seen that when people resume using ketamine after a period of abstinence, those harms appear a lot quicker than the first time around,” he said.
However, Quelch added the work being done with peer support at Kaleidoscope was “really unique and impactful”.
“There was a lack of judgement or stigmatisation – the peer element was really important and is something to learn from the Birchwood environment.”
For Mark it has meant a focus on the future is possible. Like many we spoke to, he was adamant he wanted to give something back.
“I grew up thinking money was everything, but I get joy now from helping other people who are struggling. I was there once and I know how much it means to get someone to help you.”
