Addiction Through the Eyes of the NHS

Описание: In this episode, we sit down with Eva, a Physician Associate working in urology at the Royal Free Hospital in London, to explore how addiction presents on the NHS front line.

Eva shares what she sees day to day in hospital and reflects on how national addiction statistics compare with real clinical experience. She discusses the growing prevalence of ketamine use, particularly among younger patients, and the severe and often shocking bladder damage it can cause. In urology, ketamine is the only drug Eva regularly sees that directly leads to organ damage, with some patients in their early twenties presenting with bladders that are already beyond repair.

The conversation also explores wider drug trends Eva encounters in hospital, including marijuana, cocaine and heroin. While these substances are not always the direct reason patients are admitted, Eva explains how drug use often plays a significant role in worsening health outcomes, delaying treatment and complicating recovery.

We also discuss the rise of polysubstance use, especially among young people, and why mixing substances dramatically increases the risk of overdose and death. Eva breaks down the dangers of combining depressants such as alcohol and heroin, as well as the risks associated with stimulants like cocaine and MDMA.

Eva offers insight into how the NHS manages patients with substance use issues, from repeat hospital attenders to referrals to drug and alcohol liaison teams. She highlights the ethical and practical challenges clinicians face when treating patients who are intoxicated, lack capacity or refuse help, and why building trust and rapport is essential.

The episode covers specific risks linked to commonly used substances, including:

Ketamine and severe bladder damage
Cocaine and long-term heart damage, stroke and death
Marijuana and its links to psychosis
MDMA and the risk of fatal water intoxication
Paracetamol overdose and life-threatening liver failure

Eva also discusses prescription drug addiction, particularly benzodiazepines, opioids and medications used for ADHD, insomnia and mental health conditions. She explains how the NHS tries to prescribe safely, and why addiction can still develop despite strict controls.

Finally, Eva speaks honestly about the limitations of NHS resources, long waiting times for community support and the urgent need for better education around addiction within healthcare. She explains why rehab facilities play a crucial role and encourages anyone struggling with addiction to seek help early, starting with their GP or by having a free, confidential conversation with a specialist service.

This episode offers a powerful, honest look at addiction through the eyes of an NHS clinician and the real-world consequences seen in hospitals every day.

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