KASPR: Ketamine Assessment, Screening and Progression Risk

A new clinical framework has been developed to help services respond more effectively to ketamine-related harm.

KASPR (Ketamine Assessment, Screening and Progression Risk) has been developed by Phil Harris.

Drawing on more than 36 years of frontline practice, training and service development, KASPR responds to growing evidence that ketamine-related problems can develop in ways that are not always adequately captured by generic substance use models. Significant physical, psychological and functional harm may emerge before conventional signs of dependence or visible social breakdown become apparent.

The need for more tailored responses is increasingly clear. Government treatment statistics show that 5,365 adults began treatment for ketamine problems in England during 2024–25;  more than 12 times the number recorded in 2014–15. The Advisory Council on the Misuse of Drugs also published an updated national review of ketamine use and harms in January 2026.

A 2025 study of people identifying as having ketamine use disorder found that, among those who sought treatment, only 36% were satisfied with the care they received. Participants commonly reported that services lacked ketamine-specific knowledge and that available treatment was not sufficiently tailored to their needs.

KASPR offers a different way of understanding and responding to these presentations, grounded in how ketamine-related harm develops in practice.

In simple terms, it provides a structured way to:

• recognise emerging harm at an earlier stage
• understand the interaction between use, underlying drivers and resulting harm
• identify the most appropriate clinical priorities
• match intervention intensity to the person’s presentation

The KASPR framework includes:

• recognition of emerging harm through sentinel symptoms
• a structured clinical formulation covering Exposure, Drivers and Harm
• a suite of ketamine-specific psychological interventions
• a four-tier treatment pathway supporting proportionate and progressive care.

The overall aim is to support earlier identification, more consistent clinical decision-making and better alignment between presentation and intervention across substance use, mental health and related services.

The KASPR website is now live:

Ketamine - Assessment, Screening & Progression Risk

Feedback is welcomed, particularly from practitioners and managers working across substance use, mental health, young people’s services and related areas.