Ketamine Use: Understanding the Risks and Finding Recovery with Cheshire Sobriety Clinic

Ketamine has shifted from being a specialist anaesthetic used in surgery to a common recreational drug, particularly among younger adults in the UK. Its reputation as a “party drug” or a means to escape emotional pain hides a darker side: growing evidence shows that frequent ketamine use can lead to serious physical, mental, and social harms.

Across the North West, including Cheshire and Greater Manchester, ketamine use has increased over the past decade, with treatment admissions for ketamine-related harms rising year on year (Public Health England, 2021). For some, what starts as experimental use can become a pattern of dependence, withdrawal, and worsening wellbeing.

This article explores the risks and difficulties associated with ketamine use, and how Cheshire Sobriety Clinic can support recovery through an integrated approach combining Rapid Transformational Therapy® (RTT®) and talking therapy.

Understanding Ketamine and How It Works

Ketamine is classified as a dissociative anaesthetic, it alters perception of pain, body awareness, and reality. At medical doses, it is used for pain control and anaesthesia, but at recreational doses it can induce hallucinations, out-of-body experiences, and detachment from self and surroundings (Curran & Morgan, 2020).

Its main mechanism involves blocking NMDA (N-methyl-D-aspartate) receptors in the brain, which play a role in memory, emotion, and learning. This mechanism explains why users report profound distortions in perception and why long-term use can affect memory and cognition (Mion & Villevieille, 2013).

Although ketamine has recently gained attention for potential antidepressant effects at controlled doses in medical settings, recreational or unsupervised use carries very different risks.

Physical Health Risks

Urinary and Bladder Damage

Repeated ketamine use can cause ulcerative cystitis, an extremely painful and debilitating condition that affects the bladder and urinary tract. Symptoms include urinary urgency, blood in urine, incontinence, and chronic pelvic pain (Chu et al., 2008). In severe cases, individuals may require surgical intervention or bladder removal (Morgan & Curran, 2011).

UK hospitals, including in the North West, have reported a surge in young people presenting with “ketamine bladder”, a term used by clinicians to describe these symptoms (Wood et al., 2011).

Liver and Gastrointestinal Damage

Chronic ketamine use has also been linked to liver inflammation and biliary tract abnormalities. Studies suggest that high-dose, long-term users show elevated liver enzymes and structural changes similar to gallbladder disease (Lo et al., 2011).

Cognitive Impairment

Research shows that prolonged ketamine use impairs memory, attention, and executive functioning. Morgan et al. (2010) followed chronic users over a year and found measurable declines in spatial memory and pattern recognition. This means users can struggle with concentration, planning, and learning, making it difficult to work, study, or sustain relationships.

Physical Injury

During intoxication, users may lose coordination and spatial awareness, increasing risk of falls or accidents. Dissociative experiences may also lead to risky behaviour, as pain sensitivity and danger awareness are diminished (Corazza et al., 2012).

Mental Health and Psychological Effects

Depression and Emotional Instability

While low-dose ketamine under medical supervision is being studied as a rapid-acting antidepressant, recreational use shows the opposite effect. Studies demonstrate that frequent, unsupervised use increases rates of depression, anxiety, and mood instability (UCL News, 2025). Rebound depression after use, linked to disrupted glutamate regulation is common (Li et al., 2011).

Dissociation and Trauma

Ketamine induces intense dissociative states, often described as entering a “K-hole”. These experiences can be frightening or traumatic, especially for those with prior mental health issues. Repeated dissociation may lead to emotional numbing and difficulty connecting with reality or relationships (Morgan & Curran, 2012).

Psychosis and Hallucinations

Repeated use can trigger psychotic-like symptoms such as paranoia or auditory hallucinations. Morgan et al. (2020) found that ketamine administration significantly increases positive psychotic symptoms, even in healthy individuals. For those with a predisposition to schizophrenia or bipolar disorder, these effects can be longer lasting.

Dependence and Craving

Ketamine was once thought to carry minimal dependence potential, but newer evidence shows that psychological dependence can develop rapidly. Users often report cravings and loss of control over use despite negative consequences (Liao et al., 2011).

Social and Behavioural Consequences

Impact on Relationships and Work

Cognitive and emotional blunting make it harder to maintain stable relationships, perform consistently at work, or pursue goals. Many users report drifting away from family or friends, experiencing isolation and shame.

Risk-Taking and Accidents

Under the influence, ketamine can impair judgement, increasing risk of accidents or unsafe sex. In nightlife settings, users may be unaware of injury, dehydration, or overdose (Winstock et al., 2012).

Legal and Social Impacts

As a Class B controlled substance under the Misuse of Drugs Act (1971), possession or supply carries serious legal consequences. A criminal record can further isolate individuals, reducing employment and housing opportunities (Home Office, 2024).

Regional Data: Cheshire and Greater Manchester

In the North West of England, ketamine-related hospital admissions have more than tripled since 2015, with the greatest rise among people aged 18–25 (Office for Health Improvement and Disparities, 2023). Treatment data from the Greater Manchester Combined Authority show that ketamine is now among the top five substances cited by young adults entering drug services (GMCA, 2024).

These trends highlight a growing need for specialist, local interventions capable of addressing both the physical and psychological dimensions of ketamine use.

Why Recovery Can Be Difficult

Quitting ketamine involves unique challenges:

1. Cognitive deficits – Memory and focus problems make therapy engagement and self-management harder (Morgan et al., 2010).

   
   

2. Emotional instability – Post-use mood swings and dissociation can create distress that drives relapse.

   
   

3. Social reinforcement – Ketamine use is often embedded in social scenes where abstinence feels isolating.

   
   

4. Lack of pharmacological treatment – There are currently no approved medications for ketamine dependence, so psychological therapy remains the cornerstone of care.

   
   

5. Stigma and shame – Fear of judgement deters many from seeking help early.

   
   

How Cheshire Sobriety Clinic Can Help

At Cheshire Sobriety Clinic, we understand that ketamine use is rarely just about the drug itself. Often it is tied to emotional pain, trauma, or stress management. Our approach combines Rapid Transformational Therapy ® (RTT®) with evidence-based talking therapy, helping clients heal both the subconscious and conscious factors driving their behaviour.

Rapid Transformational Therapy® (RTT®)

RTT® works by accessing the subconscious mind to uncover and reframe the beliefs or experiences underpinning substance use. Many clients using ketamine report feeling emotionally detached, unworthy, or overwhelmed by trauma. RTT® helps to challenge and replace these deep-seated patterns, restoring self-worth and emotional resilience.

Talking Therapy

We integrate Motivational Interviewing (MI), and Relapse Prevention Therapy. These methods teach practical coping skills, develop insight into triggers, and build new ways to manage stress without resorting to dissociation or substance use.

Integrated Mental Health Support

Because ketamine use often co-occurs with anxiety, depression, or trauma, we provide dual-focus support that treats mental health and substance use together. This avoids the fragmented care common in traditional systems.

Cognitive Support and Adapted Sessions

For clients experiencing memory or focus problems, sessions are structured with summaries, and flexible pacing. This ensures therapy remains accessible, even when cognition is affected.

Long-Term Recovery and Relapse Prevention

Sustained recovery requires structure and ongoing support. We help clients rebuild healthy routines, social networks, and daily habits that reinforce wellbeing. Continued follow-ups and daily RTT® hypnosis audio sessions support long-term success.

Conclusion

Ketamine is not a harmless party drug. Regular or heavy use can lead to serious physical, mental, and emotional harm, affecting the bladder, brain, mood, and relationships. Yet recovery is possible.

At Cheshire Sobriety Clinic, our integrated approach of RTT® and talking therapy offers a compassionate and effective route toward healing. By addressing the root causes beneath the behaviour and building the tools to manage life’s stresses, we help individuals move from dependency and detachment to clarity, confidence, and lasting wellbeing.

If ketamine use is affecting your life, or that of someone you love, reach out today. Recovery starts with a single step. That step doesn't need to be perfect. It just needs to be yours.

References

Chu, P. S. K., Kwok, S. C. H., Lam, K. M., Chu, T. Y., Chan, S. W., Man, C. W. and Yu, M. K. (2008) ‘The destruction of the lower urinary tract by ketamine abuse: a new syndrome?’, BJU International, 102(11), pp. 1616–1622.

Corazza, O., Schifano, F., Simonato, P., Fergus, S., Assi, S. and Stair, J. (2012) ‘Phenomenon of ketamine misuse in the UK: findings from an online survey’, Human Psychopharmacology: Clinical and Experimental, 27(3), pp. 254–259.

Curran, H. V. and Morgan, C. J. (2020) ‘Cognitive, dissociative and psychotomimetic effects of ketamine in recreational users: a review’, Psychopharmacology (Berl.), 237(5), pp. 1335–1349.

GMCA (2024) Drug and Alcohol Strategic Needs Assessment 2024: Greater Manchester. Greater Manchester Combined Authority.

Home Office (2024) Misuse of Drugs Act 1971: Controlled Drugs Classification. London: Home Office.

Li, N., Lee, B., Liu, R. J., Banasr, M., Dwyer, J. M. and Duman, R. S. (2011) ‘mTOR-dependent synapse formation underlies the rapid antidepressant effects of NMDA antagonists’, Science, 329(5994), pp. 959–964.

Liao, Y., Tang, J., Ma, M., Wu, Z., Yang, M., Wang, X., Liu, T. and Hao, W. (2011) ‘Frontal white matter abnormalities following chronic ketamine use: a diffusion tensor imaging study’, Brain, 134(7), pp. 2115–2122.

Lo, R. S., Krishnamoorthy, R., Freeman, R. and Macdonald, S. (2011) ‘Biliary tract and liver abnormalities in ketamine users’, Clinical Radiology, 66(9), pp. 854–858.

Morgan, C. J., Muetzelfeldt, L. and Curran, H. V. (2010) ‘Consequences of chronic ketamine self-administration upon neurocognitive function and psychological wellbeing: a 1-year longitudinal study’, Addiction, 105(4), pp. 749–761.

Morgan, C. J. and Curran, H. V. (2011) ‘Ketamine use: a review’, Addiction, 106(7), pp. 1212–1223.

Morgan, C. J., Muetzelfeldt, L. and Curran, H. V. (2020) ‘Association of ketamine with psychiatric symptoms and implications for its therapeutic use: a systematic review and meta-analysis’, Journal of Psychopharmacology, 34(8), pp. 847–861.

Office for Health Improvement and Disparities (2023) Substance Misuse Treatment Statistics for the North West 2022–23. London: OHID.

Public Health England (2021) Adult Substance Misuse Treatment Statistics 2020 to 2021. London: PHE.

UCL News (2025) ‘Physical and psychological symptoms of ketamine abuse revealed’. University College London, 12 April. Available at: https://www.ucl.ac.uk/news/2025/apr/physical-and-psychological-symptoms-ketamine-abuse-revealed (Accessed: 3 November 2025).

Winstock, A. R., Mitcheson, L., Gillatt, D. A. and Cottrell, A. M. (2012) ‘The prevalence and natural history of urinary symptoms among recreational ketamine users’, BJU International, 110(11), pp. 1762–1766.

Wood, D. M., Cottrell, A. M., Baker, S. C., Southgate, J. and Dargan, P. I. (2011) ‘Ketamine: an update on its recreational use and associated bladder dysfunction’, Drug Testing and Analysis, 3(9), pp. 560–568.

© 2025 Cheshire Sobriety Clinic. All rights reserved.