LIVERPOOL — Alder Hey Hospital in Liverpool opened a dedicated NHS clinic for ketamine-induced uropathy in May 2025. An analysis of the first 60 patients seen at the clinic was published in the Archives of Disease in Childhood.

The data reveals that 43 of the first 60 patients analyzed were girls. The average age of the group was 14, with an age range of 13 to 15. Approximately two-thirds of the first 60 patients lived in the most deprived areas. Sixteen of the first 60 patients had autism or ADHD, or both. One in five of the first 60 patients had experience of the care system. Additionally, 72% of the first 60 patients had experienced emotional trauma during childhood.

Symptoms of ketamine-induced uropathy include urgent and frequent need to urinate, pain, and blood-stained urine. Ketamine-induced uropathy can cause the shedding of the bladder's protective lining. Some patients describe the pain of urination as feeling like 'weeing over broken glass'. Some patients describe shedding the bladder's protective lining as 'peeing a jellyfish'.

Some users experience abdominal pain and spasms known as 'K cramps'. Prolonged ketamine damage can lead to incontinence, uncontrolled urination, and kidney failure. In severe cases, ketamine-induced damage may require surgical repair or removal of the bladder, or dialysis. Harriet Corbett, Consultant Paediatric Urologist, stated: "The damage caused by ketamine can be devastating. It can affect the bladder wall, causing ulceration and fibrosis, and the effects can be irreversible."

Prof Rachel Isba explained the mechanism behind the injury. "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," Isba said. Isba described the daily impact on patients. "Sometimes they don't always make it. They might have accidents..and a lot of them report pain in their bladder," she said.

Isba also noted: "They describe this feeling of weeing over broken glass. It's very painful." On average, the teens had been using ketamine for one to two years before referral. Half of the first 60 patients reported concomitant use of other drugs, 27% reported alcohol use, and 48% reported vape use. Ketamine is a general anaesthetic that reduces or blunts sensations in the body. The drug is sold at 'pocket-money level' prices.

The clinic has received over 100 referrals since opening. The clinic receives about one referral every week from GPs or emergency departments in Cheshire, Merseyside, and other nearby regions. Doctors at Alder Hey saw one young patient with ketamine-related issues in 2023, nine in 2024, and experienced a rapid escalation in 2025. According to official government statistics, ketamine usage in under-25s has more than tripled (surging by over 200%) since 2016.

About three out of every 10 people who frequently use ketamine develop bladder issues, according to reports of Urological Surgeons. In the UK, 8.4% of individuals in treatment now report ketamine use.

Isba said gaps exist in the current healthcare infrastructure for minors. "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 said.

What's New

Additionally, 8.4% of individuals in treatment in the UK now report ketamine use.

Corbett stated: "This problem is preventable. Understanding more about the young people who are presenting to us is an important step towards preventing further harm." Prof Rachel Isba stated: "One of the most important things about this work is that we are trying to understand the wider picture. Ketamine use does not happen in isolation, and our analysis is helping us explore the different factors that may be associated with young people developing serious health problems."

Why It Matters

The rapid escalation in cases at Alder Hey Hospital mirrors a national trend, with official government statistics showing that ketamine usage in under-25s has more than tripled since 2016. The demographic profile of the patients, predominantly teenage girls from deprived backgrounds with histories of trauma or neurodiversity, suggests that ketamine use is often linked to broader social and mental health vulnerabilities rather than occurring in isolation.

The clinical consequences are severe, with potential outcomes including irreversible bladder damage, kidney failure, and the need for major surgery or dialysis. Despite these risks, Professor Rachel Isba noted that children under 16 lack access to inpatient detox facilities available to adults, creating a disparity in care for those ready to stop using the drug. The publication of this analysis aims to inform preventive measures by identifying the specific risk factors associated with these serious health problems.