Increased recreational ketamine use and subsequent outbreak of urological complications in The Netherlands.
Antoinette J H P van Riel, Wouter M H van der Sanden, Laetitia M O de Kort
Clinical Toxicology June 17, 2025 DOI: 10.1080/15563650.2025.2513622 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Retrospective observational study Peer reviewed |
|---|---|
| Population | Patients with ketamine intoxication reported to the Dutch Poisons Information Centre and patients with ketamine-induced uropathy treated at Jeroen Bosch Hospital outpatient clinic, Netherlands |
| Duration | 2018 to 2024 |
| Topics | Ketamine Esketamine |
| Keywords | Designer drugs Drug withdrawal symptoms Public health Recreational drugs Urological disease Severe outcomes Health risks Adverse effects Ketamine-induced disease Illicit drug use Drug consumption Health awareness Public safety Health crisis Arylcyclohexylamines: dissociative anesthetics |
| Citations | 4 |
| Key findings | Recreational ketamine use and associated urological complications have increased in the Netherlands from 2018 to 2024, with 137 patients treated for ketamine-induced uropathy by 2024 and 51 requiring surgery. |
Abstract
Recreational ketamine use has increased in the last decades with incidental reports of urological complications. This study aimed to explore trends in the number of acute intoxications and urological complications from recreational ketamine use in the Netherlands. We retrospectively studied data from 2018 to 2024 from inquiries on ketamine toxicity to the Dutch Poisons Information Centre and data from the first outpatient clinic dedicated to ketamine-induced uropathy in the Netherlands at Jeroen Bosch Hospital, 's-Hertogenbosch. An increase was observed in the number of intoxications with ketamine reported to the poisons centre (from 33 in 2018 to 139 in 2024), in 12 cases (2.4%) urological complaints were reported. The number of patients with ketamine-induced uropathy treated by the outpatient clinic increased from zero in 2018 to 137 in 2024. Long-term and extensive ketamine use (>1 g/day for a median of 35 months, with a median amount of 18 g/week) was associated with urological complaints. Ketamine users in our study were predominantly males in their twenties. Co-exposures were common, 65.1% of acutely intoxicated patients and 72.1% of patients with uropathy reported using other drugs, including alcohol, in addition to ketamine. Fifty-one outpatients developed severe uropathy requiring surgery, ultimately leading to cystectomy and urinary deviation in three cases. This study combines data from a poisons information centre and a dedicated urological ketamine outpatient clinic and describes a large cohort of patients with ketamine-induced uropathy. The extent of complications from chronic recreational ketamine use in the Netherlands only became clear from the data of the urological outpatient clinic at Jeroen Bosch Hospital, 's-Hertogenbosch. Ketamine-induced uropathy is rising in the Netherlands. Cooperation between poisons centres and medical specialities can enhance toxicovigilance. Increased awareness among potential users and health care providers is pivotal to prevent this from developing into a public health crisis.
Comparable studies
Other observational and cohort studies on ketamine, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Taming the Ketamine Tiger Volunteers from a prison population | 2010 | Observational study | n = 20 |
| Increased spontaneous MEG signal diversity for psychoactive doses of ketamine, LSD and psilocybin Humans | 2017 | Observational study | |
| Disruption of Frontal–Parietal Communication by Ketamine, Propofol, and Sevoflurane Surgical patients undergoing induction of anesthesia with intravenous ketamine | 2013 | Observational cohort | n = 30 |
| Do the dissociative side effects of ketamine mediate its antidepressant effects? Treatment-resistant inpatients with major depressive disorder or bipolar disorder | 2014 | Observational cohort | n = 108 |
| Concomitant BDNF and sleep slow wave changes indicate ketamine-induced plasticity in major depressive disorder Patients with treatment-resistant major depressive disorder | 2012 | Observational cohort | n = 30 |
Citations in the library
Cited by 4
- Recreational drug poisonings reported to six European poison centres from 2021 to 2024 Clinical Toxicology March 4, 2026
- Ketamine for substance use disorders: a systematic review and meta-analysis Frontiers in Psychiatry July 17, 2026
- Ketamine abuse also affects sexual health Sexual Medicine July 22, 2026
- Health risks associated with non-medical use of ketamine in France: National surveillance insights from the French Addictovigilance Network, 2019-2023. Journal of Psychopharmacology February 23, 2026
Cites 6
- Ketamine Anesthesia & Analgesia November 1, 1998
- The clinical toxicology of ketamine Clinical Toxicology June 2, 2023
- Fatal intoxication related to two new arylcyclohexylamine derivatives (2F-DCK and 3-MeO-PCE). Forensic Science International July 1, 2021
- Can mind-altering prescription medicines be safe? Lessons from ketamine and esketamine. Clinical Toxicology August 1, 2024
- Characteristics of poisonings involving ketamine in the United States, 2019-2021. Journal of Psychopharmacology August 2023
and 1 more in the library