Deaths linked to illicit ketamine use in the UK have risen sharply over the past decade, with a 20-fold increase since 2015.
But new research suggests that these deaths are rarely due to ketamine alone. Instead, they are increasingly tied to complex and dangerous patterns of polydrug use, raising doubts about whether reclassifying the drug will meaningfully reduce harm.
The new analysis, carried out by King’s College London alongside the University of Hertfordshire and Manchester Metropolitan University, examined coroners’ reports from England, Wales, and Northern Ireland between 1999 and 2024. Researchers identified 696 deaths involving illicit ketamine during that period, making this the most comprehensive study to date on ketamine-related fatalities in the region.
The findings were published in the Journal of Psychopharmacology.
Ketamine, a Class B drug in the UK, is best known as an anesthetic with hallucinogenic effects. It is far cheaper than cocaine—about £15–30 per gram compared to £80 for cocaine—making it an increasingly popular option.
In 2024, an estimated 299,000 people aged 16 to 59 reported using the drug. Ketamine has also been in the spotlight due to high-profile cases, including the death of Friends actor Matthew Perry and reports that billionaire Elon Musk uses it to manage his mood.
While deaths involving ketamine have risen dramatically, the study shows that the number of cases where ketamine alone was the primary cause has fallen.
Instead, deaths are increasingly linked to people mixing ketamine with other substances such as opioids, cocaine, benzodiazepines, and gabapentinoids.
The average number of drugs detected in each fatal case has grown, highlighting how risky combinations, rather than ketamine itself, are driving the crisis.
The study also revealed a shift in the profile of those dying from ketamine-related causes. Historically, ketamine was most associated with recreational use among younger people, often linked to bladder damage and dependence.
Today, deaths are more common among older, socioeconomically disadvantaged individuals with entrenched patterns of drug use. Between 2020 and 2024, 85% of the people who died were men. Of those with reported employment status, 42% were employed, 42% unemployed, and 11% students.
The majority of deaths were ruled accidental, with just under 6% determined as suicides.
Dr. Caroline Copeland, lead author of the study and director of the National Program on Substance Use Mortality, emphasized that the issue goes beyond ketamine itself.
“We are seeing more ketamine-related deaths, but these deaths rarely involve ketamine alone,” she said. “They are increasingly part of complex polydrug use patterns, often among people facing social disadvantage and entrenched drug dependence. This means single-drug policies, such as reclassification, are unlikely to tackle the real drivers of harm.”
The researchers argue that a more comprehensive public health response is needed. This would include better access to drug-checking services, overdose prevention programs, and improved treatment pathways for people who use ketamine. Education campaigns that address the dangers of mixing ketamine with other substances are also vital.
Medically, ketamine is still used as a sedative and in veterinary care. But when misused, it can cause serious long-term harm, especially to the bladder. When combined with depressants like opioids or benzodiazepines, the risks rise dramatically, as people may underestimate how much they’ve taken of each substance.
As Dr. Copeland explained, “Illicit ketamine use has moved beyond the recreational setting. To reduce deaths, we need harm reduction, treatment, and social support strategies that reflect the realities of polydrug use—not just legislative changes focused on one substance.”
The findings underscore the urgent need for a shift in policy and practice—away from focusing solely on classification and toward addressing the complex social and health factors fueling ketamine-related deaths.
Source: KSR.
