Ketamine is that crazy wobbly leg drug. The wacky student drug, the post club chill-out aid, the new gen LSD that gives users the power to become – according to 1970s K-hole explorer and dolphin whisperer John C Lilly – "peeping toms at the keyhole of eternity". But its reputation as a popular recreational drug, since filtering into the mainstream via the gay clubbing and free party scenes in the 2000s, does not tell the whole story of what's going on in modern British K-land.
Apart from a brief paragraph in the Brighton Argus's obituary column, Nancy Lee's drug death went unreported. There was no shock factor: she hadn't collapsed in public from a toxic reaction to a pill or a line of powder in a club. Instead, at the age of 23, Nancy had died slowly over seven years, her body trashed by a steady diet of ketamine.
Nancy started using ketamine aged 16 when she made new friends. Most teenagers getting high in the local Brighton park were necking cider and smoking skunk, but Nancy and her group of Indie kid outsiders used the open spaces to take ketamine. It was cheap, at 12 grams for £90, and importantly for Nancy, it transported her away from real life.
"She was sensitive and very caring but Nancy was a misfit," her father Jim, a college lecturer, tells me. "She was bullied at school because of a bad squint and for being a tomboy. She had a victim mentality, a feeling that the world was against her." It's just that Nancy ended up finding solace in ketamine. "If someone was to design the perfect drug for a teenager who is depressed and doesn't have much money, this would be it," says Jim.
Nancy's older sister Libby told me that when Nancy started using the drug regularly it left her stuck in a teenage world from which she was never able to escape. "When I asked her why she couldn't just stop taking it she said ketamine allowed her to get away from her life," says Libby. "She told me she took it because she didn't want to be herself."
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Meanwhile in reality, outside of ketamine's cartoon world, Nancy's body was beginning to disintegrate because she was taking ketamine but rarely eating, exercising or drinking water. At 21, because of the effects of heavy ketamine use on her bladder and appetite, Nancy was incontinent, suffering from a weak heart due to malnutrition and weighed 33 kilos. Her kidneys and bladder were barely functioning. She slept in the day and went out at night and flitted between her mother's and various friends' places, so no one knew how seriously ill she was until Jim intervened and took her into hospital, where he was told by doctors her condition was life threatening.
After spending five weeks on a urology ward surrounded by elderly patients, Nancy was discharged, but she was warned that she could have caused long-term damage to her body. In the end, it proved worse than that.
Unable to get a job because of her ill health, Nancy lived off sickness benefits. She occasionally lapsed into using ketamine, sometimes disappearing for days. At the start of this year, she appeared to be getting healthier, but in March, because of her weakened organs, she got a kidney infection and was dead within a week.
We know that cocaine, MDMA, mephedrone and LSD can end up damaging people and some can become addictive, but it appears none of these drugs has the ability to wreck the body or leave users mentally marooned in the way that ketamine does. Rather than being a window into the soul, for some ketamine has turned into a way of mollifying pain or getting through the day, like heroin and diazepam.
A heap of ketamine (Photo via Coaster420)
I spoke to Laura, a call centre manager from Bristol. Now 32, she's been taking ketamine for half her life. She started in 2001 and at one point was snorting three grams a day. She's spent seven years in drug counselling and NA.
"I really feel sorry for anyone that is in that lifestyle on a daily basis, because it's almost impossible to get out of. I can say for sure that if I didn't commit myself 40 hours a week to my job I would be on it all the time, or struggling with myself not to be. Even though I'm 'clean' this is only by default, from changing my social groups and prioritising life, love and work over ketamine. If you put the stuff in front of me now I'd still do it. It's more powerful than I ever anticipated."
Laura never used ketamine in a club, she took it every day, like a lot of her friends in Bristol did. "In the beginning K can wipe you out and make you pretty out of it. But after a while it becomes an everyday thing. I could easily get up and do it in the morning, hair of the dog, so to speak.
"I know lots of people with kids who'll happily get on it while they're at school. I preferred a line of K over a glass of wine after work. Life's busy, stressful, loud and intense. K is mellow, slow, relaxing and lets you drift away from it all. But one line turns into two and then your tolerance is high and suddenly you are doing a gram or two a day."
She said ketamine is a disaster as a coping mechanism. "I went through a major bereavement and found myself using two to three grams a day. It helped to an extent, but really it just separated me from my life and emotions. The problem is it all comes flooding back when you come down, which gives you the need to blanket yourself again – hence the vicious cycle." So far, Laura's organs are intact.
Laura tempered her ketamine use by eating well, exercising and being careful when you mix it with other drugs, most crucially alcohol. She knew how to reduce the dangers. However, the average kid receives a measly one hour of drug education before they leave secondary school. So Nancy never knew.
Most of the 93 recorded ketamine-related deaths (between 2005 and 2013) in the UK have been accidental poisonings – like at this year's Glastonbury festival, at an illegal rave in Croydon and at last year's Boomtown festival – or accidents. There have been nine drowning and three road traffic accident fatalities caused by the drug. There have also been suicides. In 2011 a depressed, jobless teenager, Adam Sephton, was found hanged in a football field in Barnsley after several months of heavy ketamine use.
Nancy's death, from long-term ketamine abuse, is one of the first of its kind in the UK. Doctors are hoping that as Britain's first ketamine-using generation grows older, Nancy's death is not the first of too many. In Hong Kong, which has a serious ketamine problem and where doctors have discovered that heavy ketamine use may cause liver cancer, there have so far been three deaths linked to long-term ketamine abuse.
Drug services and hospitals here are seeing a rising number of people suffering serious health problems due to heavy K use. In London, Leeds and Bristol there have been sharp increases in people being referred to urologists with ketamine-related bladder issues. Last year David Gillatt, the UK's leading urological surgeon, removed three bladders from ketamine users.
Consultant psychiatrist Dr Owen Bowden-Jones, lead clinician at the Club Drug Clinic in London, says around three quarters of ketamine users visiting the clinic have bladder-related symptoms.
Nancy with friends
As with Nancy, he says ketamine is prompted by and linked with depression, anxiety and addiction. Nearly one in five of those who told the Global Drug Survey they used ketamine in 2009 admitted that they were dependent on the drug.
The other problem with ketamine is that the anti-social nature of the drug means that heavy users, particularly the young, tend to be outsiders who hang out in groups with other heavy users. The lack of any recognised treatment for ketamine addiction means that many heavy users exist beyond the radar of local drug services.
An outreach worker at the drug charity CRI in Brighton told me that Nancy came into the project a few years ago to discuss worries over her ketamine use, but she missed her next appointment and never returned. Her dad Jim says Nancy refused attempts at getting her psychiatric or medical help because she had a phobia about visiting doctors and hospitals.
As with a growing number of parents of people killed through drug taking, Jim says the government is doing virtually nothing – beyond its rarely visited, zero credibility website Talk to Frank – to inform children about drugs. He wants to see a change in drug policy that is more focused on education and care than inaction and criminalisation.
"I hate it that we live in a world where we prefer to turn the other cheek and ignore what is happening on our doorstep. Brighton is a wealthy area, but in reality it's like Brighton Rock; it still exists on two separate worlds. We need to care for people who have drug problems, not treat them as outcasts. The government needs to listen to the advice of experts rather than the Daily Mail. Prohibition causes more problems than it solves."
But for a lot of people who get into trouble with drugs, the real problem is mental health issues. And in modern Britain, that some kids are using potent drugs like ketamine to deal with depression and a feeling of dislocation with the world, is tragic.
"I was quite depressed," 21-year-old Nancy said after coming out of hospital in 2011. "K takes your mind to a different world so you forget the bad stuff. But in the end, ketamine becomes the bad stuff."
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