Ketamine deaths increase twenty-fold since 2014 with mixing drugs on the rise, new Herts research shows
The study, led by King’s College London in collaboration with the University of Hertfordshire and Manchester Metropolitan University, analysed coroner’s reports across England, Wales and Northern Ireland. It found 696 deaths with detections of illicit ketamine between 1999 and 2024 – the most detailed assessment of its kind to date.
Ketamine is a Class B anaesthetic drug that has hallucinogenic effects. Its cheap cost – around £15-30 for a gram compared to £80 for cocaine – could be driving increased consumption say researchers.
The number of people using ketamine in England and Wales has continued to rise with an estimated 299,000 people aged 16-59 reporting illicit ketamine use in 2024. The drug has been implicated in the deaths of celebrities, including Friends actor Matthew Perry, and Elon Musk is reported to use ketamine for his moods.
Whilst annual deaths with post-mortem detections of illicit ketamine have risen over the past decade, the proportion of deaths where ketamine was the sole or primary cause has fallen, reflecting a shift towards increasingly risky patterns of polydrug use. Opioids, cocaine, benzodiazepines, and gabapentinoids were frequently co-implicated in deaths, with the average number of substances involved in each case also rising.
The study also identified a demographic shift. While harms of ketamine use among young people – such as bladder injury and dependence – remain a serious concern, deaths are increasingly occurring among older, socioeconomically disadvantaged and dependent drug users, rather than being confined to younger recreational populations.
Senior author Dr John Corkery, Associate Professor in Research (Psychoactive Substances’ Epidemiology, Toxicology and Mortality) at the University of Hertfordshire said: “This paper provides a timely update on deaths linked to the recreational use of ketamine. Official records, such as those from the Office for National Statistics, show a steady rise in ketamine-related drug poisoning deaths in recent years. However, the increase is largely driven by use of ketamine in combination with other substances.
“This research, based on a far wider range of information from coroners available from the death registration process, has allowed us to perform a ' deep dive' and look at factors such as deprivation and the impact of an ageing cohort of ketamine users on these patterns.
“As with all deaths involving psychoactive substances, it is usually a combination of factors which come together to contribute to a ketamine-related death; it is uncommon for the consumption of ketamine alone to cause death.
“Ketamine has a range of helpful medical applications in areas like emergency medicine, pain, certain forms of epilepsy and depression. However, its sedative properties, especially in combination with other central nervous system depressants, need to be recognised by potential and actual users of ketamine, as well as by those health professionals who look after them.
“Our figures are based on voluntary reports from coroners, so while the number of deaths following illicit ketamine use is alarming, it is likely an underestimation. The rising occurrence and context of these deaths underscores the urgent need for drug policies and treatment services to recognise the role illicit ketamine plays in complex, dependent drug use - rather than viewing it solely through the lens of recreational use.”
The study published today in Journal of Psychopharmacology also shows 85% of the deaths between 2020 and 2024 were men. Employment status was reported for 77% of the deaths between 2020 and 2024, with 42% employed, 42% unemployed and 11% students. The demographic profile of deaths shifted towards greater deprivation from 2020 to 2024. Death was deemed accidental in 88.9% of cases with 5.9% determined as suicidal.
The researchers are calling for expanded drug-checking services, better integration of ketamine users into treatment, and targeted education on the risks of mixing substances.
Dr Caroline Copeland, lead author of the study from King’s College London, said: “We are seeing more ketamine-related deaths, but these deaths rarely involve ketamine alone. They are increasingly part of complex polydrug use patterns, often among people facing social disadvantage and entrenched drug dependence. This means single-drug policies, such as reclassification, are unlikely to tackle the real drivers of harm.”
The authors of the paper are now calling for a more comprehensive response to address ketamine-related harms, including expanded drug checking services and overdose prevention schemes, better integration of ketamine users into treatment pathways, and targeted education on the risks of polydrug use.
Ketamine can be prescribed medically as a sedative and is commonly used on animals. But when ketamine is misused, it can cause serious and sometimes irrevocable damage to the bladder. Mixing ketamine – a dissociative – with depressant drugs like opioids and benzodiazepines makes it harder to judge the effect each drug is having, which can result in people taking more of each drug than intended.
Dr Copeland added: “Illicit ketamine use has moved beyond the recreational setting. To reduce deaths, we need harm reduction, treatment, and social support strategies that reflect the realities of polydrug use – not just legislative changes focused on one substance”.