The Changing Landscape of Ketamine Use in the UKIn addition to its medical uses, ketamine produces dose-dependent psychoactive effects. Often categorised as a hallucinogen and/or psychedelic, ketamine’s effects are quite distinct from classic psychedelics like LSD, Psilocybin and DMT.

Before the early 2000s, recreational ketamine use in the UK was relatively niche, mostly confined to specific psychedelic and rave scene subcultures. However, in the past two decades, the drug has seen a significant shift into mainstream UK drug culture, particularly among young people and in party/nightlife environments.

Several factors may have contributed to the growing popularity of ketamine:

criminalisation. The ACMD have, more than once, recommended non-criminal sanctions for all drug possession offences.

Criminalising consensual adult risk behaviours is unethical and counterproductive. Increasing the harshness of criminalisation only makes it more so. While ketamine’s rising harms warrant serious attention, reclassifying it as a Class A drug risks repeating past mistakes by prioritising punitive posturing over effective health interventions.

Better ways forward?

The UK should pursue a public health-led strategy grounded in early intervention, targeted prevention, harm reduction education, and access to tailored treatment and social support. These are approaches that, unlike increased criminalisation, are supported by expert opinion, research evidence and international best practice.

ACMD classification reviews have always made important and welcome recommendations for improvements to public health responses to drugs, alongside any recommendations on classification. Somewhat counterintuitively, such harm reduction recommendations have been made even where the increased criminalisation that inevitably accompanies upward reclassifications (which the reviews usually recommend) will itself increase health and social harms.

Key elements of a public health approach, in the short term, must include:

• Development, implementation and funding for improved ketamine treatment modalities and training for relevant service providers – with specific focus on urinary tract/bladder issues and dependency.