'Green shoots of positive behavioural change' at first NHS ketamine clinic for young people
It was set up at Alder Hey earlier this year
A professor behind the first NHS ketamine clinic for children and young people in the country says they're seeing 'some green shoots of positive behavioural change'.
The clinic was opened earlier this year in response to to a sharp rise in young people coming in to Alder Hey with bladder issues after taking the drug.
Since launching in May, they have had around 30 referrals - an average of around one per week this year.
Professor Rachel Isba, Consultant in Paediatric Public Health Medicine at Alder Hey and Professor of Children and Young People’s Health at Lancaster University’s Medical School, said:
"We've got most, if not all, of the cases of ketamine-induced uropathy in under-16s in England and that's probably partly due to the fact that ketamine use has been an issue in parts of the North West for a while in under-16s, but also the drug is really cheap around here compared to, for example, in Bristol (where) you can pay two or three times as much for a gram as you can in St Helens.
"Potentially devastating consequences"
"I can't think of another drug that can have such potentially devastating consequences on young people so quickly.
"Your likelihood of developing ket bladder relates to how much you use over what time period, but we're not talking decades like you might with other drugs before you saw the really serious health consequences, we're talking six months, a year, two years. It's quite unusual to see children under the age of 16 already with serious effects of drug-use."
Ketamine abuse in children and young people is on the rise, with an anonymised 2023 survey of more than 13,000 secondary school children from 185 schools across England reporting that 11% of 15-year-olds had been offered ketamine at some point.
It also suggested that the use of ketamine among schoolchildren had more than doubled in the last decade from 0.4% in 2013, to 0.9% in 2023.
Professor Isba added:
"The issue of ketamine use in young adults for example, so people between the ages of 18 and 25, has been emerging over the last couple of years but this under-16s phenomena is quite surprising but has also come out of nowhere, in some respects.
"These young people have been using ketamine for a while and I think the evidence suggests that, in England and Scotland for example, ketamine use has pretty much doubled in the last year or two.
It's surprising the age groups that it's affected already"
"It's surprising the age groups that it's affected already, but I think it's on the background of a very complicated picture of increased use of ketamine more generally, but it does seem to be in younger populations, even if its young adults up to the age of 25 or 30.
"This isn't something affecting people in their 50s or 60s who've been using for 30 years- it's affecting quite young people."
The clinics involve starting conversations around reducing or stopping their use of ketamine, making sure they're connected with local community and drug alcohol services, and issuing harm reduction advice - particularly as ketamine use can alter your perception of the world, which can lead to accidents.
Other advice issued at the clinics include talking about the dangers of ketamine use and alcohol together, and how to stay safe.
Professor Isba is expecting demand to grow - and that more areas may soon follow in their footsteps.
She said:
"My concern is also that for every young person that comes to the hospital because they've got complications from their ket use, there are a number of other young people who are using ketamine who aren't having the physical complications and therefore aren't coming to our attention, who might need help.
"Whilst there are community drug and alcohol services (who) we work quite closely with in all areas, I think they are also experiencing a massive increase in demand but those are the young people who are seeking help.
"There's probably a much bigger group of young people, who we don't really know the size of, who are using ketamine, might be using it in a way that's having a negative impact on their health and wellbeing, and don't know where to go for help, or they want to stop using ketamine but their levels of use are so high that they would require a detox programme or something - and at the moment, those services don't really exist for children, so that's something that we're quite keen to work on with our colleagues in our community to develop."
Professor Isba added:
"We are seeing some green shoots of positive behavioural change amongst these children and young people and we are so proud of them - and we tell them that in the clinic.
"Any changes they can make that are positive and will improve their health and wellbeing, we're really here for that.
"The biggest thing they can do to improve their bladder health, if they've got issues as a result of ketamine use, is to stop using their ketamine or decreasing the amount that they're using and we might see some improvement in their symptoms.
"They may never get back to where they were to start off with, but in this younger population if they're able to make a positive change earlier on in their ketamine use journey, then they might see an improvement, for example, in the amount of times they need to go for a wee in a day and things like that."
What to do if you have a child/young person (CYP) known to be using ketamine:
- Direct them to the ‘Talk Frank’ website
- If the CYP has persistent bladder symptoms, then a medical professional can refer them to the specialist clinic via a referral to the urology consultant team
- If the CYP does not have bladder symptoms but is using ketamine and needs help, then please contact their local community drug and alcohol services who can signpost them