13-Year-Olds Referred to NHS for 'Ketamine Bladder' as NHS Doctors Reveal Patients 'Wee Over Broken Glass'

More than 100 young people have been referred to the UK's first NHS clinic for ketamine-related bladder damage since it opened at Alder Hey Children's NHS Foundation Trust in Liverpool in May 2025, including patients as young as 13.

Analysis of the first 60 patients treated by researchers from Alder Hey and Lancaster University found an average age of 14, with patients aged between 13 and 15. Forty-three were girls, while around two-thirds lived in the most deprived areas.

Doctors have warned that sustained ketamine use can cause serious and potentially irreversible damage to the urinary tract. Some young patients have described the pain as like 'weeing over broken glass', while severe cases can result in major surgery or kidney dialysis.

First 60 Patients Reveal Extent of Problem

The clinical analysis, published in Archives of Disease in Childhood, found that 16 of the 60 patients had autism, ADHD or both. One in five had experience of the care system, while 72 per cent had experienced emotional trauma during childhood.

The researchers said the findings describe the characteristics of children attending the service but do not establish that those factors caused their ketamine use or bladder problems.

Ketamine-induced uropathy, commonly known as 'ketamine bladder', can affect the bladder, ureters and kidneys. Symptoms include painful or frequent urination, urgency, incontinence and blood in the urine. Alder Hey says prolonged ketamine use can damage the bladder wall through ulceration and fibrosis, with severe effects potentially becoming irreversible.

Some patients had been using ketamine for a year or more, meaning some may have started as young as 12. The BBC reported that children treated at the clinic had experienced bedwetting, accidents, frequent urination and severe bladder pain.

Doctors Warn of a Cycle of Pain

Prof Rachel Isba, who runs the specialist clinic, told the BBC that some children use ketamine again to dull the pain caused by the bladder damage, creating a cycle that can worsen the condition.

She has also described ketamine as being available at 'pocket-money' prices in parts of the North West, with some young people using it at school. Earlier work by Isba and colleagues similarly reported that under-16s in the region had described the drug as cheap and accessible.

Patients have also described shedding part of the bladder's protective lining as 'peeing a jellyfish'. Alder Hey says stopping ketamine use can prevent further damage, although serious cases may require bladder surgery or removal and, in some circumstances, dialysis.

Under-16s Face Treatment Gap

Alder Hey opened its specialist service after seeing a rise in children presenting with bladder problems linked to non-prescribed ketamine use. The hospital saw one young patient with ketamine-related problems in 2023 and nine in 2024, followed by a rapid increase in referrals during 2025 before the clinic opened.

The service now receives referrals from GPs and emergency departments across Cheshire, Merseyside and nearby areas, providing specialist urological treatment alongside support for young people trying to stop using ketamine.

Isba told the BBC that some under-16s who would qualify for inpatient detox if they were 18 cannot access equivalent facilities because of their age. The lack of dedicated inpatient treatment for this age group leaves clinicians working to prevent further urinary damage while supporting children who may already have significant bladder problems.