Ketamine in the UK - Rising Use, Youth Risk, and the Case for Tougher Controls - Then Nitazenes Deaths Also Increasing

8th January 2026

Ketamine use in the UK has increased sharply over the past decade, shifting from a niche club drug to a mainstream concern for public health, policing, and education.

Once perceived by many users as a relatively low-risk substance, ketamine is now associated with rising hospital admissions, long-term health damage, and growing use among teenagers and young adults.

These trends have prompted the UK government to review whether existing drug laws are strong enough and whether ketamine should be reclassified as a Class A drug.

A Drug on the Rise

The growth in ketamine use is not sudden or temporary. Evidence from surveys, treatment services, and law enforcement points to a sustained upward trend.

Ketamine has become more widely available and cheaper relative to other illegal drugs, making it attractive to younger users. It is increasingly common in nightlife settings but has also moved beyond clubs into casual social use. What is particularly concerning is that the rise in ketamine use has outpaced many other substances, suggesting a shift in drug-taking culture rather than a short-term spike.

Teenagers and Young Adults at Greater Risk

Teenagers and young adults are at the centre of this increase. Younger users are more likely to view ketamine as less dangerous than drugs such as cocaine or heroin, partly because of its medical and veterinary uses and its reputation as a "party drug." Cost and accessibility also play a role, as ketamine is often cheaper than stimulants and easier to obtain. As a result, experimentation can begin early, sometimes in mid-teens, increasing the risk of long-term harm.

Regular ketamine use is now linked to serious health consequences, including severe bladder and urinary tract damage, kidney problems, memory impairment, and mental health difficulties. Some of these conditions can be irreversible, particularly when use starts young and continues over several years.

Health professionals have reported growing numbers of young patients with damage more commonly associated with much older adults, underlining the scale of the problem.

Beyond COVID: A Structural Issue

While some social changes during and after the COVID period may have influenced drug-taking behaviours, the ketamine issue cannot be explained simply by pandemic disruption or the ending of temporary allowances or support measures. The rise predates COVID and has continued since. This points to deeper, structural drivers: changing attitudes to risk, normalisation of drug use in youth culture, and a perception that ketamine sits in a legal and moral grey area.

Government Response and the Class A Debate

Ketamine is currently classified as a Class B drug, placing it in the same legal category as cannabis. However, the scale of harm and the pace of growth in use have led the government to commission a formal review of its classification. Reclassifying ketamine as a Class A drug would place it alongside substances such as heroin and cocaine and would significantly increase the maximum penalties for possession and supply.

Supporters of reclassification argue that the current legal status underplays the seriousness of ketamine-related harm and fails to deter use or trafficking. They believe stronger penalties would send a clear signal about risk and give police greater powers to intervene. Critics, however, warn that tougher classification alone may not reduce demand and could disproportionately criminalise young people without addressing the underlying causes of use.

The Limits of Punishment Alone

There is broad agreement that law enforcement cannot solve the ketamine problem on its own. Education, early intervention, and accessible treatment services are essential, particularly for young users who may not recognise the damage being done until it is severe. Clearer public messaging about health risks, better drug education in schools, and improved access to support for those already experiencing harm are widely seen as necessary complements to any legal change.

Ketamine use in the UK is rising, and teenagers and young adults are disproportionately affected. The harms associated with the drug are more serious than its reputation suggests, and the problem reflects long-term cultural and social shifts rather than a temporary post-COVID effect.

The government's consideration of reclassifying ketamine as a Class A drug signals how seriously it now views the issue. Whether tougher penalties will be effective on their own remains open to debate, but there is little doubt that ketamine has become one of the most pressing and misunderstood drug challenges facing the UK today.

there are statistics showing an increase in deaths related to ketamine use in the UK. While ketamine isn't among the most common causes of drug-poisoning deaths overall, research and official data show a significant upward trend over the past decade.

Rising UK Ketamine-Related Deaths

Studies analysing coroners' reports across England, Wales and Northern Ireland have found that:

Ketamine-related deaths have risen dramatically over the last decade, increasing by roughly twenty-fold from the mid-2010s to the early 2020s.

Between 1999 and 2024, a total of 696 deaths were identified where illicit ketamine was detected at post-mortem.

Annual fatalities have climbed from around 15 deaths in 2014 to nearly 200 deaths in 2024 (with an estimated peak of around 197 in 2024), reflecting a sharp rise in ketamine being present in toxicology findings.

Although ketamine isn't always the sole cause of death — many cases involve mixing ketamine with other substances like opioids, cocaine, benzodiazepines or gabapentinoids — its presence in a growing number of coronial cases indicates a broader trend of ketamine-linked harm.

The proportion of deaths where ketamine was the primary cause has varied, but overall the absolute number of deaths with ketamine detected has increased substantially, highlighting the scale of emerging risk.

Official Death Certificate Data

More general drug-poisoning death statistics also include ketamine mentions:

In 2024 drug-poisoning statistics for England and Wales, ketamine was recorded on around 60 death certificates as one of the drugs involved.

These figures sit alongside other drugs in official registrations and show that ketamine is a notable contributor to the broader drug-poisoning death count, even if it still represents a smaller share compared with opioids.

Key Points to Understand

Absolute numbers of ketamine-related deaths remain lower than those for opioids like heroin, morphine or synthetic opioids, but the rate of increase is unusually steep.

Much of the rise reflects polydrug use — ketamine often appears alongside other substances, which complicates causal interpretation but still signals a dangerous pattern of consumption.

The sharp relative increase has contributed to the debate about whether ketamine should be reclassified under UK drug law to reflect its growing role in drug-related fatalities and harms.

Nitazenes
Nitazenes are now an increasingly serious part of the UK’s drug-related death statistics, and they represent a different kind of crisis from traditional opioid deaths.

Here’s a clear picture of nitazene-related deaths in the UK, how they compare to other drug deaths like ketamine, and why they are a growing public health concern:

What Are Nitazenes?

Nitazenes are a class of synthetic opioids, chemical substances many times more potent than heroin and similar drugs. Some nitazenes can be up to 100-500 times stronger than heroin, meaning only tiny amounts can cause a fatal overdose. They are often produced illicitly and found mixed into other street drugs, including heroin, cocaine, or counterfeit prescription tablets, where users may not even know they are taking them. This makes them particularly dangerous.

Nitazene Deaths in the UK: Sharp Rise

Official data from the UK’s Office for National Statistics shows a dramatic rise in deaths involving nitazenes:

In 2024, there were 195 deaths involving nitazenes registered in England and Wales — almost four times the number in 2023 (52 deaths).

Nitazenes first began to appear on death records in 2020, and the numbers have climbed rapidly as these potent synthetic opioids have entered the illicit drug supply.

Between June 2023 and May 2024, laboratory testing found 179 confirmed deaths involving nitazenes in England.

Additional reporting and analysis indicate that hundreds more nitazene-linked deaths have likely occurred since, with some estimates suggesting more than 750 confirmed UK fatalities linked to nitazenes between mid-2023 and mid-2025.

This increase is part of a broader rise in synthetic opioid-related fatalities, which have contributed to record high drug poisoning deaths in the UK overall.

How Nitazene Deaths Compare to Other Drugs
Opioids and Overall Drug Deaths

In 2024, there were 5,565 drug poisoning deaths in England and Wales — the highest number on record. Almost half involved opioids or opiate-type substances such as heroin and morphine.
Office for National Statistics

Heroin and morphine alone were mentioned in 1,415 deaths in 2024.

Nitazenes vs Ketamine

Ketamine deaths — while rising — remain relatively small in absolute numbers compared with nitazenes and traditional opioids. For example, ketamine is mentioned in dozens of deaths per year, whereas nitazene fatalities were nearing two hundred in 2024 and potentially more in subsequent periods. (Discussed earlier — see prior summary.)

Cocaine and Other Drugs

Cocaine deaths, another rapidly rising category, numbered 1,279 in 2024, roughly seven times higher than nitazene deaths that year.

This shows that while nitazene-related deaths are lower than those for some other substances (like traditional opioids or cocaine), their rate of increase is among the fastest, and they are emerging in a graveside role in the broader drug mortality landscape.

Why Nitazenes Are Especially Dangerous

Nitazenes are particularly concerning because:

Extremely high potency: Only minute amounts can suppress breathing to the point of fatal overdose. This makes dosing hazardous, especially when users do not know a drug is present.

Undeclared in supplies: They are often mixed into other drugs, such as heroin or counterfeit pills, without the user’s knowledge, increasing the risk of accidental overdose.

Synthetic and unregulated: Unlike prescription narcotics, these are manufactured illicitly and can vary dramatically in strength from batch to batch.

Official Response and Controls

In recognition of the danger, the UK government has already taken steps to tighten legal controls on nitazenes:

In 2024, 15 additional synthetic opioids — including 14 nitazene compounds — were made Class A drugs, reflecting their lethality and lack of any recognised medical use.

This classification means possession carries much heavier penalties and aims to reduce supply and signalling that policymakers view these substances as extremely high risk.

What This Means for Public Health

The rapid rise in nitazene fatalities highlights several broader issues:

Synthetic opioids are altering the drug-related death profile in the UK, adding to existing crises with opioids like heroin.

Because nitazene use often goes undetected until after death, the true scale may be underestimated. Drug testing and toxicology services are still catching up to identify these substances consistently.

The potency and unpredictability of nitazenes make harm reduction measures — such as naloxone access and drug checking services — even more vital in saving lives.

Summary

Nitazene-related deaths are rising rapidly in the UK, from around 52 in 2023 to nearly 200 in 2024, and possibly hundreds more up to 2025.

While still lower in absolute terms than heroin, morphine or cocaine fatalities, the rate of growth and extreme potency make nitazenes a major emerging public health concern.

These synthetic opioids are now tightly controlled as Class A substances, and harm reduction efforts are being prioritised to help prevent overdoses.