UK doctors warn of ketamine bladder damage in children as young as 13

At Alder Hey Hospital in Liverpool, doctors are treating children for a condition most people have never heard of—and most would not expect to see in teenagers. Since opening the UK's first dedicated NHS clinic for ketamine bladder damage last May, the team has received over 100 referrals. Some of the patients are 13 years old.

The damage ketamine does to the bladder and urinary tract is both specific and brutal. Children describe the sensation of urination as "peeing a jellyfish"—a reference to the protective lining of the bladder shedding—or compare it to "weeing over broken glass." The pain is severe enough that some patients wet the bed, need to urinate constantly and urgently, and sometimes cannot make it to the toilet in time. Blood appears in their urine. The condition can progress to incontinence, uncontrolled leaking, and in serious cases, kidney failure. Some patients require surgical repair of the bladder or, in the worst scenarios, bladder removal altogether.

Professor Rachel Isba, who runs the clinic, told the BBC that many of the children she sees have been using ketamine for a year or longer—meaning some started when they were 12 or younger. The drug is a general anaesthetic; it blunts sensation and creates a dream-like, detached feeling that users describe as calming. For children dealing with emotional trauma, it offers what some call a way to "shush" or quiet their brain. The cost is negligible. Ketamine sells for pocket-money prices, and only a small amount is needed to produce an effect.

What makes the situation particularly grim is the cycle it creates. Ketamine is an excellent pain reliever—it is, after all, an anaesthetic. So when the drug damages the bladder and causes excruciating pain, some children use more ketamine to manage that pain. Isba calls this the "K loop." The drug that caused the damage becomes the tool used to escape the damage, making the condition worse. Quitting is harder still when friends at school are still using, and when some of these children are already struggling to attend education for other reasons. Many have pre-existing conditions like ADHD or histories in the care system.

The scale of the problem is accelerating. The clinic saw one patient in 2023, nine in 2024, and then what doctors describe as a "rapid escalation" in 2025. They now receive about one referral per week from GPs and emergency departments across Cheshire, Merseyside, and nearby regions. Of the first 60 patients treated, 43 were girls. The British Association of Urological Surgeons estimates that about three in every ten people who use ketamine frequently develop bladder issues.

Ketamine remains a Class B controlled substance in the UK—the same classification as amphetamines and cannabis—despite calls from some quarters to reclassify it as Class A, like cocaine and heroin. The Advisory Council on the Misuse of Drugs has recommended it stay at Class B. Isba notes that cannabis and alcohol remain more popular among young people, but ketamine is "probably up into third place." Most children at the clinic have tried multiple drugs, alcohol, and vaping as well.

The damage is sometimes reversible if use stops early enough. But for many, it is not. And there is a gap in care that Isba finds troubling: children under 16 who are ready to stop using ketamine cannot access inpatient detoxification services that would be available to them if they were 18. The UK does not have those facilities for minors. Some of the most motivated young people to recover, she says, are locked out of the help that could save them from permanent harm.