“We’re facing a new epidemic” Ireland’s growing problem with Ketamine

Health care providers have warned of an epidemic of ketamine use.

Health care providers are warning of an epidemic of ketamine use and lack of funding and resources to tackle it across Ireland.

While England is currently in the grips of a ketamine crisis with its young people, those who work in Irish addiction and health services say we are only a few years behind the same problem.

Nikki Killeen from the HSE’s emerging drug trends project says Ireland is currently in “the longest and most sustained period of ketamine use”, however ketamine use in Ireland has not been adequately researched.

“At Irish festivals, ketamine the second most commonly used substance… with an equal gender balance,” she said.

“With ketamine, what we see when we speak to particularly younger people, so there will be higher rates of use with 18 to 24 year olds, they absolutely have no idea about the effect ketamine, so they think of it as a club drug, and it's something that you do in nightlife spaces.”

The relatively cheap price of ketamine around 35 a gram in Dublin, compared to cocaine 100 per gram and rising alcohol prices mean the drug is likely to be more popular with a young cohort.

JOE spoke with one urologist who say there has been a rise in people presenting to Irish hospitals with so-called “ket bladder”.

Ketamine has a direct irritative effect on the bladder, inflaming the lining. The early stages of inflammation can cause blood in the urine, stomach pain, frequent toilet use and incontinence. 

Further inflammation causes the bladder to become rigid and small in capacity. Over time, if the bladder isn't able to hold urine, effectively, serious kidney damage can occur or the bladder may need removed. 

Dr Eabhann O'Connor, a consultant urologist in St Vincent's Hospital, Dublin says interventions are key to preventing long-lasting bladder issues.

“Certainly I am seeing more of these (ketamine-related) issues the line of work I'm in, I see people with bladder symptoms and who maybe initially think there are recurrent UTIs, however it’s actually “ket bladder,” she said.

“I probably am only seeing people when their symptoms have become severe enough that they've presented to a GP and then been referred to me. So I think there's probably a lot more going on we're not seeing in the community. 

“Part of the reason of wanting to talk about it, is reassuring people that there's help there, and  if symptoms are in that mild stage, that it's very reversible.”

One urology nurse told JOE on condition of anonymity that young people are often not truthful about their ketamine use when attending hospital, making it more difficult to diagnose.

Dr O’Connor says a judgement-free atmosphere for patients is essential. 

“What frightens me about ket-bladder is sometimes people develop that pain and then use ketamine as a way of self medicating to soothe that pain, and that can just perpetuate the vicious cycle of exacerbating the bladder dysfunction,” she said.

Recreational drug use in Ireland is on the rise. Dublin features in the top 20 of 128 European cities for levels for cocaine, ketamine and MDMA (commonly known as ecstasy) detected in wastewater, according to the latest survey conducted by the EU Drugs Agency (EUDA).

HSE Safer Nightlife Programme — which operates a back-of-house drug-checking service aiming to identify drug market trends at festivals found that across four events in 2022 and 2023, 266 substances were surrendered to the HSE as part of the back-of-house drug-checking programme. One hundred and seventeen substances were MDMA, 40 were ketamine and 34 were cocaine.

In the European Web Survey for Drugs 2021, 23pc of respondents from Ireland reported using ketamine, considerably higher than the overall proportion of ketamine use from the other 30 participating countries, which was 13pc.

One addiction counsellor, Joanne O’Dwyer says young, more middle class young people seem to be using ketamine more than other groups.

“We are at the very, very start of a pandemic with young people and ketamine,” Joanne said. 

“Young people are using it recreationally, socially, nightclubs, festivals. There are definitely people in the community that are struggling with it. It's become something more than just a recreational use.

In the next two to three years, we are going to see an epidemic of young people who are really struggling with their ket use. It's become a dependency and addiction.”

While Joanne acknowledges most people who use drugs recreationally may not become addicted, appropriate services are not there for those who do.

“There's loads of people out there that do coke or that drink alcohol. They never get addicted, but I do feel like ketamine, we're going to see a whole new cohort of people that would never probably got addicted before, that will now.

“We have to catch people before they fall for any issue around addiction. 

“So when we're looking at helping someone who now has a problem with their bladder from ket, but why did they end up like this? Why did they start taking drugs in the first place? 

What's going on for young people, around their mental health, around them, happiness, around loneliness, around social media, everything that's going on in our society at the moment that we need to kind of grab people way upstream, not when they end up in addiction.”

The latest figures recorded by the National Drug-Related Deaths Index in Ireland show eight poisoning deaths where ketamine was implicated between 2011 and 2020. Five of these deaths were recorded between 2018 and 2020.