Criminal Networks Are Raiding Europe’s Medicine Cabinet

A drug found in hospital operating theatres and veterinary clinics is quietly ending up in the hands of organised crime. The European Union Drugs Agency (EUDA) published a landmark report on 10 March 2026 confirming that ketamine diversion in Europe has reached a scale no legitimate medical need can explain.

The numbers tell a clear story. In 2024, European authorities seized at least 3.5 tonnes of ketamine. Back in 2016, that figure was just 200 kg. That is a 17-fold increase in under a decade. Hospital prescribing and clinical demand, meanwhile, stayed broadly flat across the same period.

Belgium led the investigation, with Germany and the EUDA as co-leads. The resulting report, Ketamine in Europe: EMPACT Situation Report, draws on contributions from 32 countries and stands as the first comprehensive multi-country intelligence picture of its kind.

A WHO Essential Medicine Caught in a Regulatory Gap

Ketamine occupies a peculiar position in medicine. The World Health Organisation (WHO) lists it as an essential medicine, and hospitals rely on it for anaesthesia, pain relief and emergency care. The EU also centrally authorised its S-enantiomer, esketamine, under the brand name Spravato, for treatment-resistant depression.

Those same qualities that make ketamine so valuable medically, its reliability, affordability and stability, also make it attractive to criminal networks. It can move across borders with comparatively little regulatory friction. No international UN control applies to it, so the strict reporting obligations that cover morphine or fentanyl simply do not exist here.

Investigators describe this gap in global regulation as the structural weakness that drives ketamine diversion in Europe.

India to Germany: The Ketamine Diversion Route Into Europe

The EUDA report tracks the main supply route for the illicit ketamine market in Europe back to large-scale pharmaceutical manufacturing in India. Supriya Lifescience Ltd, the world’s largest legitimate ketamine producer, manufactures an estimated 150 to 200 tonnes of racemic ketamine each year.

Some of that legitimately produced material is ending up on European illicit markets. Seizures across multiple countries repeatedly turned up ketamine still in the distinctive red-label packaging of Supriya, with minimal modification between production and street sale.

Germany sits at the centre of the legal import chain. Pharmaceutical companies there bring in ketamine API at EUR 350 to 500 per kilogram. Once criminal actors redirect that material, wholesale illicit prices climb steeply, reaching EUR 2,970 per kilogram in the Netherlands and over EUR 21,000 per kilogram in Norway. At retail level, gram prices hit as high as EUR 75 to 120 in Finland.

German authorities found no evidence that domestic pharmaceutical companies knowingly participate in criminal activity. What investigators describe instead is a lucrative legal grey area. Criminal actors further down the supply chain exploit it, often using foreign intermediaries to obscure the trail.

The Netherlands Drives the Illicit Ketamine Market in Europe

Germany may be the entry point, but the Netherlands functions as the engine of distribution. The country accounted for 63 per cent of all ketamine seized by quantity across the EU between 2022 and 2024. That concentration points directly to its role as the primary hub for the illicit ketamine market in Europe.

Wholesale prices in the Netherlands dropped from EUR 5,325 per kilogram in 2020 to EUR 1,605 by 2024. Falling prices signal rising supply. Darknet monitoring confirms the same trend: EU-based advertisements for ketamine jumped tenfold in a single year, from 975 listings in 2023 to 9,957 in 2024.

A court case from late 2022 and early 2023 shows exactly how these operations run. Dutch authorities broke up a transnational criminal network that smuggled 2,372 kg of ketamine from two German pharmaceutical suppliers into the Netherlands. The group ran five coordinated shipments over three months, using escort vehicles, encrypted communications and a shell company. When prosecutors brought the case, ketamine fell outside the Dutch Opium Act. Charges came under medicines and economic crime legislation instead, with substantially lighter sentencing as a result.

Ketamine Diversion in Europe Feeds a Global Market

The illicit ketamine market in Europe does not stay in Europe. A significant share gets re-exported to markets in Australia, Canada, New Zealand and the United States. Investigators also report shipments heading to Hong Kong, Japan, Malaysia, South Korea, Taiwan, Viet Nam and Mexico.

Trafficking networks build deliberate complexity into their routes. In one documented case, a shipment mislabelled as glutamine transited through Kenya and then Georgia before crossing into the EU. The detour served two purposes: hiding the drug’s true origin and making interdiction harder for law enforcement.

Health Harms Are Growing, Especially Among Young People

Non-medical ketamine use across the general European population remains relatively low. The harms, though, concentrate heavily in specific groups and the numbers are rising fast.

Across Belgium, Germany, Italy, the Netherlands, Spain and France, people entering specialist drug treatment for ketamine-related problems grew from 289 in 2018 to an estimated 1,329 in 2023. In the United Kingdom, that figure more than doubled in just two years, from 512 in 2021 to 1,201 in 2023.

Ketamine-related emergency presentations made up 4 per cent of all drug emergencies across 29 sentinel hospitals in 2024. Male patients accounted for 81 per cent of those cases. Nearly half also involved alcohol.

Heavy or frequent use causes severe urological damage. Ketamine-induced cystitis, chronic bladder dysfunction and kidney damage are increasingly common among regular users. Some countries now run specialised clinics to manage these complications. Many users receive repeated antibiotic courses for urological symptoms without realising ketamine is the underlying cause. By the time doctors make the correct diagnosis, the damage can be irreversible.

The United Kingdom faces a particularly sharp problem among young people. Research from Greater Manchester describes daily use in the range of 1 to 7 grams per day among a subset of users, with some consuming up to 20 grams daily. Use among school-aged children between 11 and 16 is now a documented and serious public health concern.

Fragmented Laws Fuel Ketamine Diversion Across Europe

The inconsistency in how EU Member States classify ketamine sits at the heart of the enforcement problem. Some states schedule it as a narcotic with strict controls. Others apply new psychoactive substance (NPS) laws. A minority rely only on medicines legislation with no additional drug law restrictions at all.

Criminal networks exploit this patchwork deliberately. They route shipments through jurisdictions with lighter controls. Prosecutors pursue charges under medicines or economic crime statutes rather than drug trafficking laws, and sentencing reflects that. Cross-border intelligence sharing remains limited. The data picture stays fragmented.

The EUDA report sets out eight recommended actions to address ketamine diversion in Europe. These include permanent inter-agency task forces, EU-wide supply chain mapping, harmonised data collection, direct engagement with manufacturers and source countries, and investment in forensic profiling techniques that can distinguish diverted pharmaceutical product from other sources.

What Comes Next

The EUDA continues to examine how pharmaceutical substances enter illicit markets. On 24 March 2026, the agency hosts a webinar on the unexpected decline in fentanyl overdose deaths in North America during 2023 and 2024. Experts will explore whether disruptions to illicit fentanyl supply chains, possibly linked to Chinese government action on precursor exports, helped drive that fall.

The situation with ketamine in Europe is at an earlier stage, but the questions are similar. The EUDA report makes one thing clear: inaction carries a cost. Current trends already reflect the delayed effects of supply-side developments from previous years. Without coordinated intervention, criminal exploitation will intensify and health harms will follow.

Source: dbrecoveryresources