Middleton described the damage to Leatham-Prosser’s bladder as “akin to acid attacks on the skin.” The young man died from a kidney infection and urinary sepsis, a fatal cascade of complications stemming from a condition now referred to as ketamine-induced cystitis—a painful, increasingly common illness that urologists across the UK say is surging.
Concerned, Middleton wrote to Britain’s Home Secretary. The government responded.
“Last year, we actually treated more ketamine users than every other drug put together.”
In a formal letter, Home Office Minister of State for Policing and Crime Prevention Diana Johnson conceded that the dangers of ketamine may be “significantly underestimated.” She ordered a new “harms assessment” and said the government would consider reclassifying ketamine from a Class B to a Class A drug—a shift that would bring harsher criminal penalties and, perhaps, a long-overdue spotlight on the toxic nature of the drug.
But for many, the damage is already done.
According to the Office for National Statistics, ketamine use among youth in England has tripled since 2016. Nearly 3 percent of 16–24-year-olds reported using it—up from slightly less than 1 percent a decade earlier. Nicknamed “Generation K,” these young users are increasingly landing in ERs, operating rooms and morgues.
Experts, accompanied by Minister Johnson, warn that the public remains dangerously unaware of the drug’s addictive pull and catastrophic physical effects. Government officials are deliberating anew over ketamine’s classification as coroners sound the alarm and families bury loved ones.
For Paul Spanjar, who runs an addiction rehab center in Bournemouth, a coastal resort town in Southern England, the rise in ketamine dependency is nothing short of “an epidemic.” That’s no exaggeration. “Last year, we actually treated more ketamine users than every other drug put together,” Spanjar said.
In Portsmouth, another port city on England’s south coast, recovering addict Casey Innalls confides that her use escalated so rapidly that she was snorting ketamine in her hospital bed while being treated for its effects.
How did this happen?
Ketamine, originally developed as an anesthetic, entered the UK’s underground rave scene in the 1990s. Its dissociative, hallucinogenic effects and low price—roughly £10 ($13.30) a gram—made it a popular, accessible high. But its numbing effect on pain and emotion is also what makes it so dangerous, particularly among young people struggling with mental health.
Britain, Spanjar avers, has got a “generation of young people who are so affected by anxiety, depression, loss of hope, fear of the future” that many find themselves “carrying around this huge burden” with no clear way to put it down.
“The perceived effect of ketamine is that it takes away those feelings,” he adds. “In the beginning, so many people take ketamine because it feels like the answer.”
But the answer quickly becomes a trap. The drug corrodes bladder linings, leading to chronic pain, frequent urination and—at the extreme—bladder removal. Doctors are reporting a growing number of cases that now require major reconstructive surgery. Some patients, like Leatham-Prosser, don’t survive the complications. As Coroner Middleton describes, after taking the drug, young people get trapped in a “vicious cycle” in which the only relief from bladder pain is more ketamine—a self-perpetuating spiral of addiction.
And still, many users believe ketamine is relatively safe.
In Manchester, Senior Coroner Alison Mutch issued a formal “Prevention of Future Deaths” report in November 2024 following the death earlier that year of 38-year-old James Boland, a successful business owner turned virtual recluse, as his parents described him. He died from sepsis triggered by long-term ketamine use. Like many, Boland thought ketamine was “less harmful” than Class A drugs.
“The extent of these risks [is] rarely understood by users until the damage has been done,” Mutch warned, adding that maintaining ketamine as a Class B substance risks reinforcing that illusion.
Government drug seizures tell a similar story: In 2023, law enforcement confiscated nearly triple the amount of ketamine compared to the previous year. The Home Office is reviewing ketamine’s status—again, in what’s beginning to feel like a national pastime.
As Britain debates penalties, classifications and supply chains, one truth remains: For a growing number of youth, the party drug of the moment is quietly becoming the public health emergency of a generation.
