Ketamine-related bladder problems reported among young teenagers

Non-prescribed ketamine use may start at the age of 13, suggest data from a UK clinic dedicated to the treatment of bladder problems associated with misuse of the drug and published in a clinical letter in the Archives of Disease in Childhood.

Clinic attendees were also more likely to live in the most deprived neighbourhoods and have experience of the care system.

The KIU (ketamine induced uropathy) clinic at Alder Hey Children's NHS Foundation Trust, Liverpool, was set up in May 2025 amid a rapid rise in referrals among under 16s for KIU-a progressive urinary tract condition associated with sustained use of the drug.

Symptoms include pain and burning when going to the toilet (dysuria), urinary frequency/urgency, and incontinence.

Analysis of the profile of the first 60 patients referred to the clinic showed that their average age was 14, ranging from 13 to 15, and that, for some patients, non-prescribed ketamine use had started when they were 13. 

Around two thirds (43) of the referrals were girls, and a similar number lived in the most deprived neighbourhoods (IMD quintile 1). Sixteen of those referred had autism or ADHD, or both.

Nearly three quarters (72%) had experienced some form of emotional trauma during their childhood, and 1 in 5 had had experience of the care system.

On average, the teens had been using for 1 to 2 years before referral and frequently reported concomitant use of other drugs (50%), alcohol (27%), and vapes (48%).

"These findings need to be considered when co-designing services for under-16s who use non-prescribed ketamine to ensure access improves inequalities and care is delivered in a trauma-informed and accessible way," write the authors.

Heavy ketamine use is not confined to Liverpool and surrounding areas, they point out. "Non-prescribed ketamine use and associated adverse effects are rising in the UK, including among under-18s, with 8.4% in treatment now reporting ketamine use."