Children as young as 13 are suffering from ketamine-induced uropathy, a severe bladder condition caused by non-prescribed ketamine use that damages the bladder, urinary tubes, and kidneys.

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COMP360 is designed to slot directly into existing clinic workflows, utilizing the same multidisciplinary staff that currently monitors Spravato patients.

Johnson & Johnson's Spravato, an inhaled esketamine treatment approved in 2019, established the clinical infrastructure that Compass Pathways plans to utilize for COMP360.

Compass Pathways expects the hourly reimbursement rate for COMP360 administration to be higher than the rate currently paid for Spravato.

Compass Pathways CEO Kabir Nath states that COMP360 will target the estimated 4 million treatment-resistant depression patients who are not currently taking Spravato.

The UK's first ketamine-induced uropathy clinic for children under 16 opened at Alder Hey Children's NHS Foundation Trust in Liverpool in May 2025.

An analysis of the first 60 patients at the Alder Hey Children's NHS Foundation Trust clinic showed that approximately two-thirds of the patients were girls, and roughly two-thirds lived in the most deprived areas.

Ketamine-induced uropathy can cause irreversible damage to the bladder wall, including ulceration and fibrosis, which in the most severe cases may require major surgery, bladder removal, or dialysis.

Patients referred to the Alder Hey clinic had been using ketamine for an average of one to two years before referral, with half reporting using other drugs, 48% vaping, and 27% drinking alcohol.

Symptoms of ketamine-induced uropathy in children include frequent urination, loss of bladder control, blood in the urine, and severe pain described by some patients as feeling like "weeing over broken glass."

Johnson & Johnson's Spravato generated more than $1 billion in revenue during the first half of 2026.

Interventional psychiatry clinics have built excess capacity ahead of new drug approvals, partly because Spravato requires 25 to 50 three-hour visits per year.

Children with emotional trauma report using ketamine, which is sold at cheap "pocket-money" prices, to quieten or "shush" their brains.

Some children enter a vicious cycle or "K loop" where they use ketamine to temporarily relieve the severe bladder pain caused by the drug itself, which ultimately worsens their condition.

Non-prescribed ketamine use and its associated adverse effects are rising in the UK, with 8.4% of young people currently in drug treatment reporting ketamine use.

The Alder Hey clinic has received over 100 referrals since opening, averaging about one referral per week from GPs and emergency departments in regions including Cheshire and Merseyside.

The Advisory Council on the Misuse of Drugs has recommended to the UK government that ketamine remain classified as a Class B controlled substance, despite calls to reclassify it to Class A.