2511002339
  • Open Access
  • Article

Ketamine-Related Deaths Registered in Scotland 2013–2024

  • John Martin Corkery 1,*,   
  • Amira Guirguis 1,2,   
  • Fabrizio Schifano 1

Received: 24 Oct 2025 | Revised: 13 Nov 2025 | Accepted: 19 Nov 2025 | Published: 04 Jan 2026

Abstract

Background: Ketamine, a dissociative anaesthetic and non-competitive NMDA receptor antagonist, has legitimate medical applications. However, rising illicit use across the United Kingdom (UK) has been accompanied by growing reports of toxicity, dependence, and deaths. These have led to renewed policy discussions. Rationale and Aim: Previous national studies have reported ketamine-related deaths elsewhere in the UK, but not in Scotland. This study examined all Scottish deaths (2013–2024) where ketamine was implicated, to provide a comprehensive evidence base for UK-wide policy discussions. Methods: Data were derived from anonymised National Records of Scotland records. All cases where ketamine was implicated in death were identified. Descriptive and comparative analyses were undertaken by year, sex, age, manner, and substances co-implicated. Results: Eighty-eight deaths were identified (≈0.5% of cases), with a steady increase over time. Most decedents were male (81.8%); mean age was 35 years. Most (84%) were accidental and involved polysubstance use—typically opioids (58%), stimulants (55%), benzodiazepines (48%), gabapentinoids (25%), and alcohol (22%). Acute drug use was the principal cause of death in 85% of cases. Discussion: The marked upward trend parallels that observed elsewhere in the UK. Polysubstance involvement, especially combinations of ketamine with opioids or benzodiazepines, substantially increases fatal risk through additive central nervous system depression. These findings reinforce the need for clearer public health messaging, targeted harm-reduction interventions, and careful monitoring of misuse, prescribing and diversion trends. Conclusions: Scottish ketamine-related deaths increased twentyfold in a decade. Most are preventable, highlighting the need for continued targeted education, intervention, and epidemiological monitoring.

References 

  • 1.

    Gitlin, J.; Chamadia, S.; Locascio, J.J.; et al. Dissociative and Analgesic Properties of Ketamine Are Independent. Anesthesiology 2020, 133, 1021–1028. https://doi.org/10.1097/ALN.0000000000003529.

  • 2.

    Ricci, V.; De Berardis, D.; Shoib, S.; et al. Psychotic-Like Experiences in Young Recreational Users of Ketamine: A Case Study. J. Psychoact. Drugs 2025, 1–10. https://doi.org/10.1080/02791072.2025.2449909.

  • 3.

    Natoli, S. The multiple faces of ketamine in anaesthesia and analgesia. Drugs Context 2021, 10. https://doi.org/10.7573/dic.2020-12-8.

  • 4.

    Yavi, M.; Lee, H.; Henter, I.D.; et al. Ketamine treatment for depression: A review. Discov. Ment. Health 2022, 2, 9. https://doi.org/10.1007/s44192-022-00012-3.

  • 5.

    Ragnhildstveit, A.; Roscoe, J.; Bass, L.C.; et al. The potential of ketamine for posttraumatic stress disorder: A review of clinical evidence. Ther. Adv. Psychopharmacol. 2023, 13. https://doi.org/10.1177/20451253231154125.

  • 6.

    Chaves, T.V.; Wilffert, B.; Sanchez, Z.M. The use of ketamine to cope with depression and post-traumatic stress disorder: A qualitative analysis of the discourses posted on a popular online forum. Am. J. Drug Alcohol Abus. 2020, 46, 613–624. https://doi.org/10.1080/00952990.2020.1769118.

  • 7.

    ACMD. ACMD Technical Committee: Report on Ketamine. Available online: https://assets.publishing.service.gov.uk/media/5a7acfffed915d71db8b2a54/ketamine-report.pdf (accessed on 12 October 2025).

  • 8.

    UK Statutory Instruments. SI 2005 No. 3372. The Misuse of Drugs (Amendment) (No. 3) Regulations 2005. Available online: https://www.legislation.gov.uk/uksi/2005/3372/contents/made (accessed on 13 October 2025).

  • 9.

    Home Office. Letter from Home Secretary to Chair of the Advisory Council on the Misuse of Drugs. Available online: https://assets.publishing.service.gov.uk/media/5a78ec83ed915d07d35b37e8/hs-acmd-priorities-2012-2013.pdf (accessed on 13 October 2025).

  • 10.

    ACMD. Ketamine: A Review of Use and Harm. 10 December, London: Advisory Council on the Misuse of Drugs. 2013. Available online: https://assets.publishing.service.gov.uk/media/5a7ce1bbed915d7c849adce3/ACMD_ketamine_report_dec13.pdf (accessed on 12 October 2025).

  • 11.

    Home Office. Letter from the Minister for Crime Prevention to the Chair of the Advisory Council on the Misuse of Drugs. Available online: https://assets.publishing.service.gov.uk/media/5a7c44c240f0b6321db380d3/ResponseACMDketamineReclassification.pdf (accessed on 13 October 2025).

  • 12.

    UK Statutory Instruments. 2014 No. 1106. The Misuse of Drugs Act 1971 (Ketamine etc.) (Amendment) Order 2014. Available online: https://www.legislation.gov.uk/uksi/2014/1106/contents/made (accessed on 12 October 2025).

  • 13.

    Home Office. Updated Harms Assessment of Ketamine: Commissioning Letter. Available online: https://www.gov.uk/government/publications/updated-harms-assessment-of-ketamine-commissioning-letter/updated-harms-assessment-of-ketamine-commissioning-letter (accessed on 5 October 2025).

  • 14.

    Dieth, J.; Collins, J. Generation K: The Disturbing Rise of Ketamine Abuse among Young People. Available online: https://www.bbc.co.uk/news/articles/c5y0g2gnjrqo (accessed on 12 October 2025).

  • 15.

    Independent Drug Expert Alliance. Quick Reference—Average UK Drug Price Guide 2023. Available online: https://www.drugwise.org.uk/wp-content/uploads/IDEAQuickReferenceAveragePriceGuide2023.pdf (accessed on 12 October 2025).

  • 16.

    Independent Drug Expert Alliance. Quick Reference—Average UK Drug Price Guide 2024. Available online: https://www.independentdrugexpertalliance.co.uk/_files/ugd/6625ee_2742b0b567fa4797bb033748e016dc6d.pdf (accessed on 12 October 2025).

  • 17.

    Independent Drug Expert Alliance. Quick Reference—Average UK Drug Price Guide 2025. Available online: https://www.independentdrugexpertalliance.co.uk/_files/ugd/6625ee_e3491d116d2e4cd287dadf0c299be001.pdf (accessed on 12 October 2025).

  • 18.

    Hamilton, I.; Sumnall, H. Ketamine: What You Need to Know about the UK’s Growing Drug Problem. Available online: https://theconversation.com/ketamine-what-you-need-to-know-about-the-uks-growing-drug-problem-239412 (accessed on 12 October 2025).

  • 19.

    Corkery, J.M.; Hung, W.C.; Claridge, H.; et al. Recreational ketamine-related deaths notified to the National Programme on Substance Abuse Deaths, England, 1997–2019. J. Psychopharmacol. 2021, 35, 1324–1348. https://doi.org/10.1177/02698811211021588.

  • 20.

    ONS. Drug misuse in England and Wales: Year ending March 2024. Available online: https://www.ons.gov.uk/peoplepopulationandcommunity/crimeandjustice/articles/drugmisuseinenglandandwales/yearendingmarch2024 (accessed on 12 October 2025).

  • 21.

    Home Office. Wastewater Analysis: Measuring Illicit Drug Consumption in 2023 and 2024. Available online: https://www.gov.uk/government/publications/wastewater-analysis-measuring-illicit-drug-consumption/wastewater-analysis-measuring-illicit-drug-consumption-in-2023-and-2024 (accessed on 12 October 2025).

  • 22.

    Home Office. Seizures of drugs in England and Wales, Financial Year Ending 2024. Available online: https://www.gov.uk/government/statistics/seizures-of-drugs-in-england-and-wales-financial-year-ending-2024 (accessed on 12 October 2025).

  • 23.

    PSNI. Police Recorded Drug Seizures and Arrests in Northern Ireland 2006/07 to 2024/25. Available online: https://www.psni.police.uk/system/files/2025-09/1291333407/Police%20Recorded%20Drug%20Seizures%20and%20Arrests%20in%20Northern%20Ireland%202006-07%20to%202024-25.pdf (accessed on 12 October 2025).

  • 24.

    OHID. Substance Misuse Treatment for Adults: Statistics 2023 to 2024. Available online: https://www.gov.uk/government/statistics/substance-misuse-treatment-for-adults-statistics-2023-to-2024 (accessed on 12 October 2025).

  • 25.

    OHID. Substance Misuse Treatment for Young People: Statistics 2023 to 2024. Available online: https://www.gov.uk/government/statistics/substance-misuse-treatment-for-young-people-2023-to-2024 (accessed on 12 October 2025).

  • 26.

    Schifano, F.; Corkery, J.; Oyefeso, A.; et al. Trapped in the “K-hole”: Overview of deaths associated with ketamine misuse in the UK (1993–2006). J. Clin. Psychopharmacol. 2008, 28, 114–116. https://doi.org/10.1097/jcp.0b013e3181612cdc.

  • 27.

    Pullen, J.; Corkery, J.M.; McKnight, R.; et al. Deaths following illicit ketamine use in England, Wales and Northern Ireland 1999–2024: An update report to inform the reclassification debate. J. Psychopharmacol. 2025. https://doi.org/10.1177/02698811251373058.

  • 28.

    ACMD. Advisory Council on the Misuse of Drugs—Ketamine Report Appendix. Available online: https://www.gov.uk/government/publications/advisory-council-on-the-misuse-of-drugs-ketamin-report-appendix (accessed on 12 October 2025).

  • 29.

    World Health Organization (WHO). The ICD-10 Classification Of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. Available online: https://apps.who.int/iris/handle/10665/37958 (accessed on 12 November 2025).

  • 30.

    ONS. Deaths Related to Drug Poisoning in England and Wales: 2024 Registrations. Available online: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsrelatedtodrugpoisoninginenglandandwales/2024registrations (accessed on 22 October 2025).

  • 31.

    Ramesh, B. Uses of Ketamine in the Paediatric Population. In Ketamine Revisited—New Insights into NMDA Inhibitors; IntechOpen: London, UK, 2022. https://doi.org/10.5772/intechopen.103658.

  • 32.

    Fountoulakis, K.N.; Saitis, A.; Schatzberg, A.F. Esketamine Treatment for Depression in Adults: A PRISMA Systematic Review and Meta-Analysis. Am. J. Psychiatry 2025, 182, 259–275. https://doi.org/10.1176/appi.ajp.20240515.

  • 33.

    Marsh, S.; Devlin, H. Warning of ‘Wild West’ in Depression Treatment as UK Clinics Offer Ketamine. Available online: https://www.theguardian.com/science/2021/nov/12/growing-number-of-uk-clinics-offer-ketamine-for-depression-say-experts#:~:text=A%20growing%20number%20of%20private,offer%20the%20drug%20for%20depression (accessed on 12 November 2025).

  • 34.

    NHSBSA. Prescription Cost Analysis—England. Available online: https://www.nhsbsa.nhs.uk/statistical-collections/prescription-cost-analysis-england (accessed on 12 November 2025).

  • 35.

    NHSWSPP. Prescription Cost Analysis. NHS Wales Shared Services Partnership, Nantgarw, Wales, 2025. Available online: https://nwssp.nhs.wales/ourservices/primary-care-services/general-information/data-and-publications/prescription-cost-analysis/ (accessed on 12 November 2025).

  • 36.

    PHS. Dispenser payments and prescription cost analysis. Public Health Scotland, Edinburgh, Scotland, 2025. Available online: https://publichealthscotland.scot/publications/dispenser-payments-and-prescription-cost-analysis/dispenser-payments-and-prescription-cost-analysis-financial-year-2024-to-2025/ (accessed on 12 November 2025).

  • 37.

    HSCBSO. Prescription Cost Analysis. Health and Social Care Business Services Organisation, Belfast, Northern Ireland, 2025. Available online: https://bso.hscni.net/directorates/operations/family-practitioner-services/directorates-operations-family-practitioner-services-information-unit/general-pharmaceutical-services-and-prescribing-statistics/prescription-cost-analysis/ (accessed on 12 November 2025).

  • 38.

    Corkery, J.M. Developments in the Epidemiology of Drug-Related Mortality in the United Kingdom over the last 30 Years: Continuity, Change, Consistency, and Challenge. Available online: https://uhra.herts.ac.uk/id/eprint/15986/ (accessed on 5 October 2025).

  • 39.

    NISRA. Drug-Related and Drug Misuse Deaths 2013–2023. Available online: https://www.nisra.gov.uk/publications/drug-related-and-drug-misuse-deaths-2013-2023 (accessed on 5 October 2025).

  • 40.

    NRS. Drug-related deaths in Scotland, 2024. Available online: https://www.nrscotland.gov.uk/publications/drug-related-deaths-in-scotland-2024/# (accessed on 5 October 2025).

  • 41.

    Dinis-Oliveira, R.J.; Carvalho, F.; Duarte, J.A.; et al. Suicide by hanging under the influence of ketamine and ethanol. Forensic Sci. Int. 2010, 202, e23-7. https://doi.org/10.1016/j.forsciint.2010.04.047.

  • 42.

    Boileau-Falardeau, M.; Contreras, G.; Gariépy, G.; et al. Patterns and motivations of polysubstance use: A rapid review of the qualitative evidence. Health Promot. Chronic Dis. Prev.Can. Res. Policy Pract. 2022, 42, 47. https://doi.org/10.24095/hpcdp.42.2.01.

  • 43.

    Vivolo-Kantor, A.M.; Mattson, C.L.; Zlotorzynska, M. Notes from the Field: Ketamine Detection and Involvement in Drug Overdose Deaths—United States, July 2019–June 2023. Morb. Mortal. Wkly. Rep. 2024, 73, 1010–1012. https://doi.org/10.15585/mmwr.mm7344a4.

  • 44.

    Chiappini, S.; Guirguis, A.; Schifano, N.; et al. Comparative safety of prescribed Esketamine and ketamine in relation to renal and urinary disorders: A pharmacovigilance perspective. Prog. Neuro Psychopharmacol. Biol. Psychiatry 2025, 136, 111213. https://doi.org/10.1016/j.pnpbp.2024.111213.

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Corkery, J. M.; Guirguis, A.; Schifano, F. Ketamine-Related Deaths Registered in Scotland 2013–2024. Clinical Neuropsychopharmacology and Addiction 2026, 2 (1), 1. https://doi.org/10.53941/cna.2026.100001.
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