Why reclassification won’t solve the ketamine crisis

A voice from the frontline.

By James Pierce

Ketamine is a dissociative anesthetic used recreationally by people who enjoy the wide range of effects that can be experienced through its use. Within the UK ketamine is currently classified as a Class B drug under the 1971 Misuse of Drugs Act. With increasing concerns about ketamine related harms and associated media coverage, in January 2025 the government announced that it was seeking advice from the Advisory Council on the Misuse of Drugs (ACMD) about reclassifying the drug as Class A, placing it alongside drugs such as MDMA, heroin, Cocaine & LSD.

Ketamine was for many years considered quite a niche drug, with use mainly associated with underground dance scenes and a small ‘psychonaut’ population. That began to change in the late 2000’s with use of the drug becoming more mainstream and normalised, with that increased usage, inevitably there have been people who have begun to experience more problematic use. This includes dependency and also some of the serious physical effects associated with heavy use, notably damage to the bladder, kidney & urinary problems.

The government’s plan to potentially reclassify ketamine are a response to the increasing presentations to substance use services and health care providers but are unlikely to have a significant impact on the use of the drug or the problems that some users encounter. It is just over a decade since ketamine was first reclassified in 2014, moving from as Class C drug to its current Class B status. Far from reducing use the numbers of people using ketamine have steadily increased with figures from the Office of National Statistics demonstrating that in 2012 – 2013 0.8% of 16 – 24-year-olds reported use. This had increased to 3.2% in 2019-2020 and 3.8% by n 2022-2023. These numbers are based on the Crime Survey of England and Wales ( CSEW) and although this is often used to estimate substance use prevalence it’s important to note that these figures are often seen as an underestimate as they miss out population groups know to use drug at higher frequencies, in this context the CSEW does not take place in university halls of residences so it’s likely that the true numbers of younger people using ketamine are higher. Already then it can be seen from the increasing numbers of people using ketamine that the last effort to upgrade ketamine to a higher classification has had little impact on use.

The calls for reclassification also fail to recognise that many people who use drugs are not deterred by increased classification or the associated potential criminal penalties, rather drug use is influenced by social, economic and psychological factors not whether a drug is illegal or not.

Reclassification to Class A will further criminalise people who use ketamine with the potential for significantly increased criminal sanctions for possession and supply. Neither of these will address the factors that influence people to use ketamine and will in no way address the drivers of more problematic relationships with the drug. It’s also possible that reclassification could lead to wider availability of a range of ketamine like drugs (analogues) that may come with increased potential for harm. In April 2025 substance use organisation Cranstoun issued a warning about ‘fake ketamine’ thought to be a ketamine analogue, that had led to a range of unwanted and unpleasant side effects.

Reclassification may also have an impact on the veterinary uses of the drug and potentially impede research into the use of ketamine for the treatment of mental health issues such as depression, PTSD and alcohol dependency. Whilst it’s likely that this research may continue, higher classification will inevitably lead to more barriers for researchers seeking to gain permission to use the drug in research studies.

Ultimately reclassification of ketamine will have little impact on use and will do little to address the harms of the drug. Instead, a harm reduction approach where people are educated about possible risks and consequences of use would likely prove more effective. The move towards reclassification appears to be more of a governmental desire to be seen to ‘do something’ than a serious attempt to understand why use has increased and to identify why some users may experience the harms associated with heavier use. The reality is that most people who use ketamine, as with most drugs, experience few problems.

Rather than seeking further criminalisation of people who use the drug the government could instead focus on providing education to users about potential risks and harms and effective harm reduction advice. For those people who are already experiencing problems with ketamine reclassification risks making it harder for them to access help and support. A research report published in the Addiction journal in April 2025 found that 42% of users did not access substance use services because of stigma/ fear of judgement, a move to Class A risks further embedding this belief

Increased criminalisation demonstrates that the current criminal justice led approach is a failure. Use has increased, harms have increased, and ketamine is now more widely available than ever before, “quicker to get than a takeaway”. Problems with drugs are a public health issue, not a criminal justice one.

If the classification of ketamine increases, so do the risks, so do the harms, but so do the barriers for those seeking support!

James is a frontline harm reduction worker who has worked with people using ketamine and experienced the key related harms for over a decade