A startling new study has revealed that ketamine deaths in UK have increased twentyfold since 2014, with researchers highlighting a dangerous shift towards complex substance mixing patterns that challenge traditional approaches to drug harm reduction.

The comprehensive analysis, conducted by King’s College London alongside the University of Hertfordshire and Manchester Metropolitan University, examined coroner’s reports across England, Wales and Northern Ireland spanning 25 years. Between 1999 and 2024, investigators identified 696 ketamine-related fatalities, representing the most detailed assessment of ketamine mortality to date.

The Polydrug Crisis

Whilst ketamine deaths in UK have risen dramatically over the past decade, a critical finding has emerged: the drug is rarely responsible alone. The proportion of fatalities where the dissociative anaesthetic was the primary cause has actually fallen, reflecting an increasingly risky trend of mixing multiple substances.

Opioids, cocaine, benzodiazepines and gabapentinoids were frequently detected alongside ketamine in post-mortem examinations. The average number of substances involved in each ketamine death has also risen, painting a picture of complex polydrug use rather than single-substance misuse.

“We are seeing more ketamine-related deaths, but these deaths rarely involve ketamine alone,” explains Dr Caroline Copeland, lead author of the study and Director of the National Programme for Substance Use Mortality. “They are increasingly part of complex polydrug use patterns, often among people facing social disadvantage and entrenched drug dependence.”

A Shifting Demographic

The research, published in the Journal of Psychopharmacology, identified a notable demographic shift in ketamine-related fatalities. Whilst bladder damage and dependence among young recreational users remain serious concerns, ketamine deaths in UK are increasingly occurring among older, socioeconomically disadvantaged individuals with established substance dependencies.

Between 2020 and 2024, 85% of the deceased were men.Employment data, available for 77% of cases, showed that 42% held jobs, 42% were unemployed, and 11% were students. The demographic profile shifted markedly towards greater deprivation during this period.

Death was deemed accidental in 88.9% of cases, with only 5.9% determined as suicidal.

Rising Usage Fuels Concern

An estimated 299,000 people aged 16-59 in England and Wales reported illicit ketamine use in 2024, reflecting continued growth in consumption. Researchers suggest the drug’s relatively low cost—around £15-30 per gram compared to £80 for cocaine—may be driving increased uptake.

The Class B anaesthetic, which produces hallucinogenic and dissociative effects, has gained notoriety through high-profile cases. Public figures, including Elon Musk, have reportedly used ketamine therapeutically, and ketamine contributed to the death of Friends actor Matthew Perry.

The Danger of Mixing Substances

Medical experts emphasise that combining ketamine with depressant drugs creates particularly hazardous conditions. As a dissociative substance, ketamine can mask the effects of opioids and benzodiazepines, making it difficult for users to gauge their level of intoxication. This can result in unintentional overdoses as individuals consume more of each substance than intended.

Beyond overdose risks, illicit ketamine use carries additional health consequences. When misused, the drug can cause serious and sometimes irreversible bladder damage, a harm particularly prevalent among younger users.

Policy Implications and Solutions

The findings challenge the effectiveness of single-substance policy approaches, such as drug reclassification, in addressing the real drivers of harm. Dr Copeland argues that ketamine deaths in UK are symptomatic of broader issues around polydrug dependence and social disadvantage.

“Single-drug policies, such as reclassification, are unlikely to tackle the real drivers of harm,” she states. “Illicit ketamine use has moved beyond the recreational setting.”

The research team calls for a comprehensive response encompassing multiple strategies. Recommendations include expanded drug checking services, which allow users to verify substance contents and purity, alongside enhanced overdose prevention schemes.

Better integration of ketamine users into treatment pathways represents another priority, acknowledging that many affected individuals may not identify with traditional drug services focused on opioids or alcohol. Targeted education on the specific risks of polydrug use is also essential, particularly regarding dangerous combinations involving depressant substances.

Dr Copeland concludes: “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 study underscores that as ketamine deaths in UK continue to rise, effective responses must address the complex social and health factors driving harmful patterns of multiple substance use, rather than viewing ketamine in isolation.

Source: dbrecoveryresources