Treat ketamine use as public health threat, say Government advisers
Government advisors have called for more support for healthcare professionals in tackling ketamine-related harms, and a national alert on its public health impact.
In an updated review of the evidence, the Advisory Council on the Misuse of Drugs (ACMD) concluded that ketamine should remain a class B controlled substance.
But the committee expressed concern about the growing use of high-dose ketamine and the long-term harms associated with the drug, particularly for chronic users.
Classification would be unlikely to reduce its use, the ACMD said, echoing opposition from health and social care professionals to such a move.
However, a stronger public health-based approach is needed to tackle the harms associated with ketamine, the committee concluded.
Ketamine was reclassified in 2013, but illicit use has continued to rise, the updated ACMD report says.
Data from the Office for National Statistics shows that the number of people aged 16 to 59 in England and Wales who reported using ketamine in the last year increased from 160,000 in 2014/15 to 299,000 in 2022/23.
There has also been a 12-fold increase in the past decade in the number of people seeking help for ketamine-use disorder.
Long-term use of the drug is associated with several adverse effects ‘which can be debilitating and life-changing’, the ACMD report said, with the risks often not appreciated by the user until the damage is done.
This includes damage to the bladder with a quarter of regular users experiencing at least one urinary symptom.
A study published last year found that many people addicted to ketamine may not seek help from their GP despite high levels of physical and psychological problems associated with their use of the drug.
Government should consider issuing a National Patient Safety Alert on ketamine cascaded to NHS staff about the ‘public health threat caused by increasing ketamine use’, the ACMD recommended.
In addition, community drug services, primary care providers, education and social care providers, mental health services and hospitals ‘should work collaboratively to deliver holistic support’.
Services should offer drug treatment alongside specialist urology, pain management, hepatology and gastroenterology services.
These services must involve professionals with expertise in ketamine use disorders, ‘be adequately funded, clearly publicised, and supported by streamlined referral pathways to enable timely and coordinated care’.
The recommendations added: ‘Services for young people under 18 should have similar arrangements, with clear provisions for transition into adult care when needed.’
Research is also needed into improving management of problematic ketamine use, including ketamine uropathy and ketamine dependency, the report said.
ACMD chair Professor David Wood said: ‘The ACMD report highlights the need for a ‘whole system approach’ through its recommendations to tackle issues related to ketamine use, as no single recommendation is sufficient to do this alone.’
Visit Pulse Reference for details on 140 symptoms, including easily searchable symptoms and categories, offering you a free platform to check symptoms and receive potential diagnoses during consultations.
