Children as young as 13 have been referred to a specialist clinic at Alder Hey Children’s Hospital in Liverpool for a bladder condition linked to the long-term use of ketamine, a drug typically used as an anesthetic but also abused recreationally. The clinic, the first of its kind in the UK, was created in response to a growing number of cases involving urological problems caused by the non-prescribed use of ketamine. Analysis of the first 60 patients treated at the clinic shows that most are girls and many come from areas with high levels of deprivation. The average age of the patients is 14, with some as young as 13 and others as old as 15. Ketamine-induced uropathy, also known as ketamine bladder, is a serious and painful condition caused by the drug damaging the bladder, urinary tubes, and kidneys. Symptoms include frequent urination, loss of bladder control, and blood in the urine. Some children affected by the condition are using incontinence pads and urinating in buckets next to their beds at night due to bladder problems caused by ketamine addiction. According to the analysis, about two-thirds of the patients were girls, and roughly the same proportion lived in the most deprived areas. Of the 60 patients, 16 had autism or ADHD, or both, and one in five had experience of the care system. Almost three-quarters (72%) had experienced emotional trauma during childhood. Harriet Corbett, a consultant paediatric urologist at Alder Hey, said the damage caused by ketamine can be devastating, leading to ulceration and fibrosis of the bladder wall, chronic pain, and incontinence. In severe cases, patients may require major surgery or dialysis. Corbett emphasized the importance of understanding the young person behind the diagnosis and the need to prevent further harm by addressing the underlying factors. The study, published in the Archives of Disease in Childhood, found that children had been using ketamine for one to two years on average before being referred to the clinic. Half of the patients reported taking other drugs alongside ketamine, with more than a quarter (27%) reporting alcohol use and 48% using vapes. Rachel Isba, a consultant in paediatric public health medicine at Alder Hey and professor emerita at Lancaster University, noted that ketamine use does not occur in isolation and that the analysis is helping to explore the factors associated with serious health problems in young people. The clinic aims to provide a non-judgmental environment where young people can discuss their lives and develop plans to stop using ketamine and prevent further damage.