Paul, Phoenix’s Reducing Harm Manager and I sit down on a Teams call with Ishara; she has recently completed treatment at our Wirral Residential service. Being 21, makes her younger than most people we normally work with in our residential services. We wanted to learn from her to better understand her experience - what brought her into treatment, how her needs differ from adults in treatment.

Ishara is confident and friendly with amazing long red hair. We introduce ourselves and I ask her if she could tell us more about what led up to her coming into rehab, she pauses, reflects and starts to talk openly about her past.

“I was quite mentally ill from the age of 12, I started smoking weed at 15 and by at the age of 17 I was using Ket, experimenting with a group of people, in a bad place”

As she speaks, she takes her time to articulate her thoughts. She describes how, at the time, ketamine was being talked about online as a therapeutic drug—how discussions focused on its benefits while failing to acknowledge the long-term physical and mental consequences of prolonged and heavy use.

“I read up on it online, there was nothing about the long-term effects, but more around it being relatively safe, a Class B and unlikely to cause an overdose. Typically, my use snowballed. I went from snorting Ket a couple of times a week to everyday. Quite quickly I realised I had a problem; I just didn’t want to do anything about it at the time.

University provided an environment where her drug use escalated.

“Once I went to uni, my use spiralled. I realised I could just be high all the time; I didn’t have to hide anything from anyone. But then the side effects started to kick in.”

With little accessible information on ketamine, she turned to social media platforms like Reddit to make sense of what was happening to her body.

“The only real source of information was Frank, and that is limited. I didn’t know that Ket can affect your kidneys, liver, stomach. When I got symptoms that I didn’t think were normal I used Reddit to find out more, that is how I found out about ‘Ket Cramps’ and realised that being sick after a line was because I had damaged my stomach.”

By her second year at university, she was seriously unwell.

“I couldn’t walk more than a few steps without needing to sit down, I got repeated UTI’s and awful pain, I tried medication, opioids etc the only thing that took the pain away was more Ket.”

Her first attempt at seeking support was though a community drug and alcohol service but being a young woman in an adult’s service made her feel vulnerable and unsafe. She had to engage to get funding for detox and rehab.

”I would have much preferred to access a specialist young person’s service, the adult services are intimidating. I am an emotionally intelligent person; I can self-reflect and engage in conversations about myself and what’s going on for me, but I was often dismissed because of my age. I felt unheard and that was frustrating.”

She describes a hierarchy of drug use within services, where there was an unspoken competition over who had used the longest or had the most severe addiction.

“It created an environment of invalidation. It’s like, because I was younger, my experience didn’t count as much.”

I am struck Ishara’s level of emotional awareness. She speaks with a level of self-reflection that is rare in people of any age.  

We turn to her physical health since entering rehab.

“Since I came into rehab, I have accessed treatment for my physical and mental health. I have been seen by Urology, I had tests and now I am on bladder tablets and have to go back for scans on a yearly basis. I feel lucky, I know people who have had to have bladder stretches, Botox and all sorts. I am also working with a councillor and am having DBT therapy for my eating disorder.”

She emphasises how deeply her drug use was connected to her mental health and how essential it was to receive support for both.

“It’s a bit scary being a young person in recovery knowing I have my life ahead, but I know that I can’t use drugs again, I am not a big drinker anyway. It might mean that social situations will be uncomfortable and a bit awkward but if I use drugs, I won’t realise all the things that I want from life. “

Ishara has to go, she has a creative writing class that she is headed to, we wrap it up with one last question. What would your advice be for another younger person struggling Ketamine use.

I would say to any young person who is struggling with Ketamine use to try and stop, I know Ketamine is often used instead of alcohol, but even casual use can have side effects. Fuck the peer pressure, there is support out there to help you come off it, if you want it.”

With that, she smiles, says goodbye. As we end the call, Paul and I later reflect on the challenges, the lessons, and the importance of ensuring that young people like Ishara feel seen, heard, and supported on when engaging with services.