Drug Science Responds to the ACMD’s Review of Ketamine Use and Harms
- Hannah Barnett
- 1 day ago
- 3 min read
Written by Hannah Barnett
In January 2025, the then Minister for Policing, Fire and Crime Prevention commissioned the Advisory Council on the Misuse of Drugs (ACMD) to provide an updated assessment of ketamine-related harms, consider its appropriate legal classification, and advise on how best to reduce harms associated with ketamine use.
In their newly-published guidance, ACMD advised that ketamine should remain a class B controlled substance. At Drug Science, we welcome this conclusion, which broadly mirrors our response submitted in August 2025 to the ACMD’s call for evidence. Our full response can be found here.
Prof David Nutt, Prof Adam Winstock and Dr Caroline Copeland recently published a piece in the British Medical Journal about this topic. That can be found using the button below.
What did the ACMD decide?
The ACMD assessed both acute and long-term harms associated with ketamine use to reach its verdict. It ultimately concluded that:
Acute harms, including toxicity and drug-related deaths, align with ketamine’s current Class B status.
Long-term harms, particularly those linked to high-dose and chronic use, remain a serious concern.
Many acute harms are significantly influenced by polydrug use, rather than ketamine use in isolation.
Notably, individuals with lived experience and care professionals who contributed to the review largely opposed reclassification, stating that harsher penalties would not deter use and would instead create additional barriers to accessing support.
Why reclassification is unlikely to reduce harms
Ultimately, the ACMD found little evidence to suggest that upgrading ketamine to Class A would reduce prevalence or misuse. This reinforces what national and international evidence has long shown: more punitive drug laws do not reduce drug prevalence, availability, or affordability. Instead, they risk:
Deterring people from seeking help or treatment
Exacerbating stigma and shame, particularly around sensitive health issues
Producing long-term social harms through criminal records
Disproportionately impacting vulnerable and marginalised populations
Diverting resources away from effective public health interventions
The ACMD was therefore right to recommend a public health‑centred approach to reducing ketamine-related harms, one that requires coordinated action across public bodies, health services, and community organisations.
Research indicates that many people who develop ketamine dependence were unaware of its addictive potential, which can lead to escalating use. Raising awareness across the wider population about ketamine’s health risks and potential for dependence will help signal that caution is warranted.
Ensuring responses remain focused on harm reduction
The ACMD proposes expanding measures such as field and roadside testing, drug testing on arrest, and increased recording of ketamine-related charges and convictions. If adopted, these measures must be designed as health-routing tools, with safeguards around data use and privacy, non-punitive routes into support, and careful evaluation of unintended consequences. Otherwise, even well-intentioned approaches risk widening the criminal justice net around people who use ketamine and increasing stigma and barriers to help-seeking.
What needs to happen next
More research is needed to better understand patterns of ketamine use and to develop clear, evidence-based harm reduction guidance, including advice on relative risk and safer use. This is particularly important as many young people report using small amounts of ketamine instead of alcohol because they perceive it to be less harmful and more affordable.
If the government is serious about reducing ketamine-related harms, it must invest in the ACMD’s recommendation for increased prevention, education, treatment, and research, and resist politically driven calls for reclassification that are unsupported by evidence.
