No.70 Ketamine

Contents

What is Ketamine?

Ketamine is an hallucinogenic dissociative and anaesthetic that is used in both humans and animals for medical purposes. It was developed in 1962 and today is most frequently used in veterinary medicine and as an anaesthetic in paediatric medicine.

Ketamine is a Class B drug, a classification based on the chronic harm associated with Ketamine use.

‘Street’ Ketamine, also known as Ket, K, Kit-Kat, Special K, Super K, Vitamin K, Donkey Dust, and Green is a grainy white or light brown powder.

‘Street’ Ketamine looks like salt, or flaky like tiny glass shards, similar to cocaine. But is a very different drug.

Why do young people use drugs?

There are many reasons why young people take drug, and it is different for every single person. Some of the most common reasons are that they:

  • Worry that they will ‘not fit in’ unless they do
  • Just want to experiment
  • Find that taking a particular drug, makes them feel more confident, better able to deal with things and may help them face difficult situations
  • May be stressed, unhappy, or lonely and find that they are turning to drugs or alcohol to help them forget their problems

It is important to remember that some pupils presenting with safeguarding concerns may be living in a home where there is adult/sibling substance misuse including e.g. Ketamine.

  • 231% increase in use among 16-24-year-olds since 2013 (ACMD 2025)
  • There have been record seizures and an 85% rise in wastewater detection (Home Office 2025)
  • A shift from nightlife use to casual settings (parks, homes)
  • Use among school children remains low but has doubled in the last decade, from 0.4%in 2014 to 0.9% in 2023
  • Health services are reporting increasing presentation of bladder related problems associated with ketamine use
  • Treatment for Ketamine rose from 1.3% in 2016 to 8.4% in 2024
  • 49% of young people in treatment report mental health needs

(Public Health Devon)

35% of secondary school aged pupils responding to SHEU 2024 said they would not know where to go if they wanted information or support around alcohol or drugs.

Ketamine effects

The most common way of use is by snorting, however ketamine can also be ingested (swallowed as a ‘bomb’), drinking (dissolving the powder in liquid), gumming, and injecting.

Its effects can last from 30 mins to an hour on average, dependant on dosage and route of administration. It makes the user feel happy, chilled, detached, in a dream like state and/or confused, anxious. After-effects can last between 1-3 hours after taking Ketamine.

Physical and mental health risks

Ketamine can

  • Increase heart rate and blood pressure
  • Cause confusion, agitation and delirium
  • Cause nausea
  • Damage short and long term memory
  • Leave the user vulnerable to being hurt by others or hurting themselves.
  • User may partake in risk taking behaviours, leading to potential injuries
  • Cause serious bladder problems as well as the urgent and frequent need to pee
  • Affect users urinary tract and lead to incontinence
  • Cause abdominal pain, known as ‘K’ cramps
  • Cause liver damage
  • Cause death through overdose – the risk is increased if used with other drugs or alcohol

Regular and long term use of Ketamine can lead to

  • Memory loss
  • Problems with concentration
  • Depression
  • Occasionally psychotic symptoms such as hallucinations
  • Existing mental health conditions worsening

K-hole

In large doses users may experience a “k-hole”. This is an intense out-of-body or near-death like experience with very realistic visuals, that can be perceived as profound or distressing.

Ketamine bladder syndrome

Repeated doses may lead to ‘ketamine bladder syndrome’ which is a painful condition.

Symptoms include difficulty holding in urine, incontinence and damage to the bladder epithelial layer which can cause ulceration and scarring reducing the bladders ability to expand.

This condition is often referred to by users as ‘blood and chunks’ in urine, ‘ket cramps’ as well as a frequent need to urinate.

Behavioural signs of drug use

  • Skipping classes; deteriorating work at school; suddenly starting to get into trouble at school
  • Unexplained need for money; missing money, valuables or possessions; stealing money
  • Engaging in secretive, or suspicious, behaviour
  • Acting uncharacteristically: such as appearing withdrawn, isolated, angry or depressed
  • Sudden changes of friends, hangouts and hobbies; loss of interests in old hobbies; lying about interests/friends
  • Demanding more privacy; locking doors; avoiding eye contact
  • Getting into trouble/fights/illegal activities

What should school do?

Key points highlighted in the non-statutory ‘DfE and ACPO drug advice for schools’ include schools

  • providing early access to school and other local service support for pupils affected by their own or others drug misuse
  • having a drugs policy to act as a central reference point for all school staff
  • having an identified senior member of staff responsible for the drugs policy ad for liaising with the local police and support services.

Schools can also ensure all staff have had appropriate training, that they are confident in spotting the signs and indicators of drug use and know how to report any concerns. Staff also need to have an awareness of those pupils with a potential increased vulnerability and play an active part in any early help support offered, both strategic and reactive.

Schools have a statutory responsibility to promote pupils wellbeing and have a clear part to play in preventing drug misuse as part of their pastoral responsibilities.

What can parents do?

If parents are aware their child may be using drugs school should work together with them to find the appropriate support for their child.  Advising parents on the following from Y-Smart is a good start:

  • Don’t attempt to punish, threaten or bribe. Make sure they know you love them and are proud of them. Praise them for what they do well, and encourage them to try new things
  • Avoid trying to be a martyr. Avoid emotional appeals that may only increase feelings of guilt and increase the likelihood of the child/young person using drugs or alcohol
  • Don’t cover up or make excuses for them. Don’t shield them from the negative consequences of their behaviour
  • Don’t argue with the person. If you suspect that they are under the influence of drugs or alcohol, let them know you are concerned about them, and are there if they need you
  • Don’t feel guilty or responsible for another’s behaviour. If your child is having problems, don’t be too hard on yourself or blame yourself

Early Intervention

Early identification of young people’s more vulnerable and providing preventative/strategic support can have very positive outcomes. 

  • Considering the ‘push/pull’ factors in a young person’s life, possible previous or current childhood trauma (ACEs) could help identify young people in a setting. 
  • Gathering individual and collective pupils voice is important.
  • Where do young people feel safe/unsafe in school and local neighbourhood?
  • Ensuring PHSE curriculum is suitable for needs of pupils.
  • Explore with students ‘how to be an upstander’.
  • Exploring the barriers to school attendance.

Resources

Y-SMART – Youth – substance misuse, Advice, Recovery, Treatment Y-Smart

The Loop – a charity providing resources and information on drugs, their uses, effects and dangers.  The Loop

Talk to Frank – on this site find street names for drugs, information on effects, help and advice Talk to Frank

Drugs and Me – expert drug information, anytime, anywhere Drugs and Me

BBC Teach video – Sam’s Experience of using ketamine, Modern Stories  Sam’s Experience

DCD Hub – DCDHub

Devon and Cornwall Police information site for professionals working with children and young people.

DCC Levels of need tool –

https://www.devonscp.org.uk/document/lon-indicators-of-need/

When to call the police guidance:  School incidents, NPCC

Police guidance on when to call covering Assault, Criminal Damage, Harassment, Cybercrime, Drugs, Hate Crime, Sexual Offences, Theft, and Weapons.

Searching, screening and confiscation in schools

Guidance for schools from the DfE

Dept for Education Advice for School 2012 DfE and ACPO drug advice for schools

Contacts

Devon Front Door (formerly known as the Multi-Agency Safeguarding Hub or MASH):

Consultation line – 01392 388 428          

Main telephone including emergencies or Early Help – 0345 155 1071

E-mail – mashsecure@devon.gov.uk

Request for Support Form – DCC – Request for support (outsystemsenterprise.com)

Children’s Social Care Emergency Duty Team (out of hours) – 0845 6000 388

Police (non-emergency) – 101

Please refer to your Local Authority Safeguarding Partnership for specific resources, threshold tools and assessment

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