Medical professionals at Alder Hey Hospital in Liverpool have identified a significant rise in ketamine-related bladder injuries among children, prompting the establishment of a specialized clinic last May. The facility has received more than 100 referrals since its opening, treating patients as young as 13 years old, with evidence suggesting some may have initiated use at age 12 or younger.
The condition manifests through various urinary symptoms, including frequent and urgent urination accompanied by substantial pain. Patients describe sensations ranging from “peeing over broken glass” to shedding of bladder lining, colloquially referred to as “peeing a jellyfish.” Advanced cases can result in incontinence, uncontrolled urination, and kidney failure. According to the British Association of Urological Surgeons, approximately 3 out of every 10 frequent ketamine users develop bladder complications. When severe, the damage may require surgical intervention including bladder repair or removal.
Clinic director Prof Rachel Isba noted that referrals have accelerated notably, with one case documented in 2023, nine in 2024, and a marked increase in 2025. The clinic currently receives approximately one referral per week from general practitioners and emergency departments across Cheshire, Merseyside, and surrounding areas. Among the first 60 patients treated, 43 were female. Many children had been consuming ketamine for extended periods, often more than a year.
Users frequently report that the drug provides psychological relief, particularly for those experiencing emotional trauma, creating what clinicians term a “K loop” where patients use ketamine to manage pain caused by ketamine itself. The substance is marketed affordably at “pocket-money level” prices, and adolescents cite its accessibility, especially within school environments, as a barrier to cessation. Many patients have concurrent substance use patterns, including cannabis, alcohol, and vaping.
Despite calls to reclassify ketamine as a Class A drug, the Advisory Council on the Misuse of Drugs has recommended it remain classified as Class B. Clinicians express concern about resource limitations, noting that children under 16 lack access to inpatient detoxification services that would be available to adults, creating treatment disparities for those motivated to discontinue use.
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