Growing concern over ketamine use among children and young teenagers in the UK has prompted warnings to parents about physical, behavioural and psychological changes that could indicate substance use.

Recent evidence suggests ketamine use among younger people has become an increasing concern. A 2026 UK government review found evidence of a substantial increase in ketamine use over the past decade, particularly among younger people, alongside growing reports of regular high-dose use, dependence and related health problems.

The issue has also reached specialist children’s healthcare services. Alder Hey Children’s Hospital said on September 23 that its specialist clinic for children and young people with ketamine-related bladder problems had identified new insights after its first year of operation. The clinic was established in response to an increase in children presenting with ketamine-induced urinary complications.

Growing Concern Over Ketamine Among Young People

Ketamine is a dissociative anaesthetic and pain-relieving medicine that has legitimate medical uses. In the UK, however, it is a controlled substance and its non-medical use can cause serious health problems.

The government’s updated review says that although the peak age group for reported ketamine use is 20 to 24, use among younger people, including school-aged children, is well documented. It notes that the typical reported age of initiation in some evidence is around 14.

Among English school pupils aged approximately 11 to 15, 0.9% of respondents to the most recent available survey reported using ketamine in the previous year in 2023. The government review noted that this compared with estimates of between 0.4% and 0.5% in surveys conducted between 2010 and 2016.

Government treatment statistics also show an increase in children entering specialist substance-misuse treatment with ketamine identified as a problem. The number rose from 512 children in 2021–22 to 1,465 in 2024–25, representing an increase from 5% to 9% of children in treatment.

Why Ketamine Can Be Dangerous

Ketamine can produce a dissociative state, particularly at higher doses. People experiencing this effect may become detached from their surroundings and have difficulty responding normally.

Dr Hooper explained: ‘At higher doses and concentrations, it can produce what we call a dissociative state. This means people can appear almost trance-like, very disconnected from their environment and from what is happening around them.’

The drug affects several receptors and pathways in the brain and body, including NMDA receptors associated with memory and other neurological functions.

Ketamine can also cause hallucinations, confusion, blurred vision, headaches and a sensation of being separated from one’s surroundings or body.

Dr Hooper said: ‘It also increases activity in the sympathetic nervous system, which can raise heart rate and blood pressure.’

She added that the drug’s effects on the brain can cause ‘hallucinations, vivid or frightening dreams, headaches, blurred vision, confusion and a sense of being detached from your body or surroundings.’

The drug can also produce nausea, vomiting and abdominal pain.

Bladder Problems Are a Major Warning Sign

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

Doctors have reported cases involving severe bladder inflammation and other urinary complications among young users. Alder Hey’s specialist clinic was established specifically to address ketamine-induced uropathy, sometimes referred to as ‘ketamine bladder’.

Dr Hooper said: ‘It can also cause a type of cystitis, or inflammation of the bladder, which can lead to pain when passing urine, pain in the bladder or pelvis, blood in the urine, and needing to pass urine suddenly or much more frequently.’

She said around a quarter of ketamine users develop bladder-related symptoms according to clinical studies.

For parents, unusual changes in bathroom habits may therefore be worth paying attention to, particularly when they occur alongside other unexplained behavioural or physical changes.

The government review also warns that frequent or high-dose ketamine use can result in significant long-term health consequences.

Other Physical and Behavioural Changes

Parents may notice a combination of changes rather than one obvious symptom.

According to the advice outlined by Dr Hooper, warning signs can include a child suddenly needing to urinate more frequently, waking during the night to use the bathroom, experiencing bladder or pelvic pain, recurrent abdominal pain or vomiting.

Other possible signs include unexplained weight loss, changes in appetite, persistent tiredness, poor coordination and unsteadiness.

Dr Hooper said: ‘They can appear intoxicated without smelling of alcohol. And they can seem confused or experience hallucinations.’

Changes in spending habits can also provide another potential warning sign.

‘Look out for unexplained spending or asking for money more often than usual,’ she said.

Parents may also notice a child becoming increasingly secretive, withdrawing from established friendship groups or being less forthcoming about where they have been.

However, these behaviours do not automatically mean that a young person is taking ketamine.

Dr Hooper stressed: ‘None of these signs on their own proves that a young person is using ketamine. It’s the overall pattern, particularly if several changes are happening together, that should prompt a calm conversation and, if needed, medical or specialist support.’

Emotional Problems Can Be Connected to Drug Use

Health professionals have also reported that some young people using ketamine have experienced trauma or other difficulties.

The UK government’s review says there is increasing evidence of people using ketamine in an attempt to self-treat underlying problems such as pain, anxiety and depression. It also warns that ketamine use itself can contribute to psychological and physical problems, potentially creating a cycle of increasing use.

Treatment data for children reinforces the wider connection between substance misuse and other vulnerabilities. In 2024–25, 82% of children entering substance-misuse treatment reported that they had started using substances before the age of 15, while 48% reported a mental-health treatment need.

How Parents Should Approach a Child

Experts advise parents to avoid confronting a child while they are intoxicated.

Dr Hooper said: ‘These conversations are best held when the child is not intoxicated.’

She recommended explaining why there is concern and giving the child an opportunity to speak rather than immediately demanding information.

‘Teenagers sometimes find it easier to talk when they’re not looking directly at you. That can make the conversation feel less intense,’ she said.

She suggested that parents could begin the conversation during everyday activities such as driving, walking or preparing dinner.

‘Tell them what you’ve noticed — perhaps changes in their behaviour, mood, or other physical changes — and give them a chance to open up.’

If a child admits to using ketamine, Dr Hooper advises parents not to pressure them into revealing everything immediately.

‘Don’t pressure them to tell you absolutely everything in the next five minutes,’ she said.

Instead, parents should try to establish what substance has been taken, how frequently it has been used and whether other drugs have also been involved.

Particular attention should be paid to physical symptoms, especially urinary problems such as pain, frequent urination or blood in the urine.

When Medical Help Is Needed

Parents who suspect that their child is using ketamine can arrange an appointment with a GP, who can assess physical and psychological symptoms and provide access to appropriate specialist services.

Emergency medical assistance is required if the child is struggling to breathe, has become severely confused or is having difficulty remaining conscious.

Ketamine remains a medicine with legitimate clinical applications, but its misuse can result in serious health consequences. The emergence of specialist paediatric services dealing with ketamine-related bladder damage demonstrates the importance of recognising potential problems early.