The growing dangers posed by long-term ketamine use

Peredur Owen Griffiths MS

Having held many meetings of the Cross Party Group on Substance Use and Addiction, I am well used to hearing shocking testimonies.

I established this group with the drugs charity Kaleidoscope to create a space for people to give their honest views without judgement or criticism and to bring people together as well as influence government policy. This mission statement has made for frank and raw sessions over the years.

The topics we have covered have been wide ranging. We have heard about the success of drug consumption rooms in reducing fatalities in some countries, how alcohol has ruined lives, the prevalence of bogus and counterfeit produce in the steroid market, how women are often treated more severely by the criminal justice system for drug offences, as well as how heroin has taken some people to the brink of death and how Naloxone has brought them back again.

It has provided a lively forum for discussing problematic substance use and provided some potential solutions.

Problem

The most harrowing Cross Party Group meeting in my view happened earlier this year and this was dedicated to the emerging problem of long-term ketamine use. This drug has been around for decades and is often used in hospital settings as a short-acting general anaesthetic.

This drug is prevalent on the black market and has become popular among young people because it is easy to access, very cheap at £10 a gram in some places and is often used to self-medicate anxiety due to the disassociated state it triggers.

There is also a perception – a misguided one at that – that the drug is not as harmful as other illicit drugs because of the lack of a hangover the following day.

Its low price and availability possibly explains why WEDINOS (Welsh Emerging Drugs and Identification of Substances) part of Welsh Public Health is finding significant quantities of ketamine when they are testing samples of drugs such as benzodiazepine.

Despite its popularity, ketamine did not receive a single mention in the Public Health Wales document ‘Annual profile for Substance Misuse 2022-23 which provided the latest data on drug use in Wales, when this particular CPG was held a few months ago.

Worrying

If some public health policy makers and authorities are not thinking about mitigating against the use of ketamine, this is worrying because a major public health crisis could be on its way without fast action.

At the afore mentioned CPG, we heard harrowing details from two professionals who work at a ketamine treatment clinic. They outlined the stark realities and dreadful health consequences for the people coming through their door, who are typically around two or three years into their frequent use of the drug.

The fact that these young – once healthy people – have to be aided to get through the doors of the clinic after a relatively short time shows just how quickly ketamine can ruin lives and cause irreversible damage. In short, regular use of the drug destroys the bladder.

This in turn causes extreme pain, which leaves the person using more ketamine in a downward spiral that leads to serious liver and bowel damage once the bladder has been damaged.

The accounts we heard at the CPG of young people in detox, screaming in pain trying to urinate, were not for the faint of heart.

Illicit

Clinics can help patients to manage the pain and quit ketamine after years of regular use, but often the long term effects remain. There are young people in our communities who will have a colostomy bag for the rest of their lives as a result of ketamine use and there are many more who are on the path to this outcome unless they make urgent changes to their lifestyle.

As a Professor of Addiction Psychopharmacology remarked during an interview with a member of my team: “It causes problems way faster than any other illicit drug.”

The use of ketamine is high among young people and given the damage it can cause, urgent action is required. The Labour Government in Westminster is making moves to reclassify ketamine as a class A drug after the policing minister declared earlier this year that they would be seeking advice from the Advisory Council on the Misuse of Drugs about reclassification.

That decision is yet to be made but if history has taught us anything when it comes to drug policy, it is that that stricter reclassification does not impact on use or availability.

It merely punishes the vulnerable users more who are suffering enough from the health consequences of frequent use as it is.

In my view – and that of many of the people in the frontline of drug treatment – effort and resources would be better concentrated on a major public information campaign from Labour Governments in both Wales and Westminster.

Ignorance

This campaign needs to educate people about the dangers of its frequent use. Without that education, many people will continue to take ketamine in blissful ignorance about the problems they are causing their bladder and other internal organs.

I would also like to see more money pumped into treatment services so that many more people can get help when they need it rather than waiting until irreparable damage is caused.

GPs should also be part of enhanced training to recognise the potential for ketamine use in patients – particularly young patients – if they are presenting with bladder damage.

Apart from securing a better outcome for the patient, early intervention will also save the NHS money in the long run and will ease the pressure on urology departments. There also needs to be consideration of how pain is managed in people who are on the waiting list for urology appointments or operations.

Heavy ketamine users who have quit the drug have been known to relapse whilst waiting for treatment because they are trying to manage the extreme pain they are experiencing.

These are just a few things that could be done quite quickly to counter the burgeoning issue of ketamine use.

They are not meant to be the catch-all solution to the problem. One thing is certain, doing nothing is not an option if we are to avert what could be a major public health crisis.

I call on the Labour Governments in both Wales and Westminster to act swiftly on this.