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By Stephen Beech
Ketamine deaths have soared twentyfold over the last 10 years, reveals a new report.
There have been 696 fatalities involving the illegal sedative in England, Wales and Northern Ireland since 1999, according to the study.
Researchers found that an increasing number of deaths since 2005 are due to mixing ketamine - often used as a horse tranquilizer - with other drugs.
Experts say their findings raise doubts over whether single-substance drug policies can work.
Ketamine - sometimes known as "Ket" "Special K" or "Vitamin K" - is sold as a grainy white or light brown powder similar to cocaine, but doctors warn that it is a very different drug.
It has become increasingly popular with young people as it has hallucinogenic effects and is relatively cheap at around $15 to $30 for a gram, compared to about $80 for cocaine.
It is estimated that around 300,000 people took ketamine in England and Wales last year despite it being implicated in the deaths of celebrities, including Friends actor Matthew Perry.
Business mogul Elon Musk is reported to use ketamine.

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But experts say the Class B illegal substance can be dangerous when mixed with alcohol, opiates or other drugs because users don't feel pain properly.
It can also cause serious and sometimes irrevocable damage to the bladder.
The new study, by experts from King’s College London with colleagues from the University of Hertfordshire and Manchester Metropolitan University, is the most detailed assessment to date of ketamine-related deaths.
Their analysis of Coroner's reports in England, Wales and Northern Ireland between 1999 and 2024 found there were 696 deaths with detections of illicit ketamine in that period.
While annual deaths with post-mortem detections of illicit ketamine have risen over the past decade, the research team say 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, according to the report published in the Journal of Psychopharmacology, with the average number of substances involved in each case also rising.
The study also identified a demographic shift with more older people taking ketamine.
While the harms of ketamine use among young people – such as bladder injury and dependence – remain a serious concern, the research team found deaths are increasingly occurring among older, socio-economically disadvantaged, and dependent drug users, rather than being confined to younger recreational users.

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Study lead author Dr. Caroline Copeland, 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 study 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.
Death was deemed accidental in 88.9% of cases with 5.9% determined as suicidal.
The research team is calling for a more comprehensive response to address ketamine-related harms - including expanded drug checking services and overdose prevention schemes and targeted education on the risks of multi-drug use.
Dr. Copeland, director of the National Program on Substance Use Mortality, 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."
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