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At the urology department of Burnley General Hospital, 26-year-old Ryan (not his real name) is having a drug solution inserted through a catheter – part of his treatment for a condition known as ketamine bladder. This procedure will not completely reverse the damage inflicted by Ryan’s previous addiction to the Class B drug, but it will help him manage the symptoms.
Ketamine, a powerful horse tranquiliser and anaesthetic, is a licensed drug and can be prescribed medically. However, when misused, it can cause serious and sometimes permanent damage to the bladder. The hospital is watching Ryan for signs of kidney failure, too. He worries about finding a girlfriend and having children. But he is stoical when he talks about passing blood and having to urinate numerous times a day.
“You could not be a ketamine addict for 30 years, 20 years,” he says.
He is under the care of consultant urologist Haytham Elsakka, who says he has witnessed a rise in young patients whose bladders have been damaged by ketamine use. “Some of them are in their 30s, but most of them are 16 to 24,” says Dr Elsakka. Around half of young patients end up needing surgery, he adds. Other risks from recreational use include liver failure, damage to the urethra, incontinence and impotence.
In and around the town of Burnley, Ryan is far from alone. Lancashire County Council says it is helping a growing number of families affected by ketamine addiction in the Burnley area. According to WithYou, which runs a ketamine support service for young people aged 11 to 24, the number seeking help across Lancashire increased from 32 in 2018-19 to 123 by the end of 2024.
Families in the Burnley area say the authorities also need to do more to help those suffering as a result of what Fr Frost calls an “epidemic” of ketamine use. In response, Lancashire County Council says it is “dedicated to supporting children and young people affected by ketamine use in our community” and that it “will continue to work tirelessly to address the challenges posed by ketamine use and to provide the necessary support to those in need”.
There is scepticism from those on the frontline that increased enforcement will solve the issue. “It’s not a case that we can just arrest our way out of the ketamine issue,” says Insp Plummer. “You could arrest 10, 15 people a day for the possession of ketamine if you found them, but it’s not going to change the cycle, particularly with kids.” He adds that generally children caught with ketamine are given informal words of advice and referred for support, not charged.
And some experts query how effective reclassification would be. These include Prof Ralphs, who observes that the 2014 shift from Class C to Class B has not prevented the recent rise in usage among young people. He also suggests that would have no impact on people’s decisions to supply it either, as most ketamine dealers already supply Class A substances as well. He adds that reclassification “will not deter young people from using it if their underlying mental health and wellbeing needs continue to be unmet”.
In the meantime, no one yet knows what the long-term effects will be for children who start taking ketamine at 12, 13 or 14. Community leaders and the families the BBC spoke to say they cannot wait for change, and that urgent action is needed now to try to prevent more young people suffering. Lexi says she is trying to move forward with her life. Since the doctors at the hospital told Lexi where her life could be heading, she has not used ketamine. Getting the drug out of her head is still not easy. She insists she will never take another dose of ketamine. But, she says, “the urge is always there for me to do it again”.
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