Ketamine use is increasing across Australia, with new research pointing to a shift beyond clinical settings and into recreational use, particularly in urban and more affluent areas.
The study, led by researchers at University of Adelaide, analysed wastewater samples collected between December 2020 and April 2025. Data was drawn from treatment plants in both capital cities and regional locations, covering just over half the national population.
Researchers found a steady rise in ketamine levels from 2022 onwards. Measured excretion rates moved from around 1.6 milligrams per day per 1,000 people in early 2022 to 5.8 milligrams by late 2025. While early patterns broadly reflected prescribed medical use, later data showed clear spikes during weekends.
Professor Cobus Gerber, from the university’s School of Pharmacy and Biomedical Sciences, said those weekend increases point to growing non-medical use. The data suggests that recreational consumption is becoming more common, particularly in areas with higher socioeconomic status and in or near major cities.
Ketamine is legally used in medical settings as an anaesthetic and for treating severe pain and certain mental health conditions, including depression. Its dissociative effects have also led to interest in therapeutic research, alongside substances such as MDMA. Researchers caution that this growing visibility may be influencing some people to experiment outside clinical supervision.
The study, published in the journal Environmental Advances, also highlights risks linked to non-medical use. Long-term exposure has been associated with cognitive and cardiovascular issues, while international data points to a rise in overdose deaths involving ketamine. The drug is often used alongside other substances, a trend reflected in increasing references to “kitty flipping”, a combination of ketamine and MDMA.
Findings from the wastewater analysis align with broader national data. The Australian Institute of Health and Welfare has reported an increase in the proportion of Australians who have used ketamine at least once, rising from 1.9 per cent in 2016 to 4.3 per cent in 2023 through the National Drug Strategy Household Survey.
Wastewater monitoring offers a different lens compared to surveys, capturing actual consumption patterns rather than relying on self-reporting. Because the data is anonymised and collected at scale, researchers say it can identify trends in communities where other information is limited.
Professor Gerber said the approach helps fill gaps in understanding drug use, particularly in terms of timing and location. It can also guide where public health responses may be most effective, including education campaigns and harm reduction strategies.
The research team has called for further work to better understand why people are turning to ketamine outside medical contexts. This includes examining how and where the drug is used, how often it is combined with other substances, and how it enters local supply chains.
The project was supported by the Australian Criminal Intelligence Commission and Preventative Health SA, and conducted in partnership with the Queensland Alliance for Environmental Health Sciences. While the findings add to a growing body of evidence, researchers say they represent an early step in mapping a trend that is still developing.
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