She Emailed a Stranger 'I Think I'm Dying.' He Wrote Back With the Only Help That Existed.

In 2016, Amy Massey emailed a man she’d never met and told him she thought she was dying. Years of heavy ketamine use had damaged her bladder badly enough that surgery to remove it was already scheduled. She’d found a YouTube video by a harm reduction worker named Mat Southwell and reached out on instinct, the way you grab whatever’s closest when you’re going under. “I emailed him and said, ‘I think I’m dying,’” she told Filter Magazine. What Southwell sent back — practical, specific harm reduction guidance that nobody in a clinic had offered her — worked well enough that Massey canceled the surgery.

The system built to treat ketamine damage didn’t have anything to say to the person living through it. So the people living through it built their own.

Massey now trains other peer workers alongside Southwell, and together they helped found the Ketamine Peer Advisory Group, K-PAG — one node in a wider community that includes a 10,500-member Reddit forum and a WhatsApp group supporting more than 700 people, most of them navigating bladder damage that clinicians still don’t fully understand how to treat. If you’ve ever sat in a waiting room and realized the person across the desk knows less about what’s happening to your body than you do, you already know the specific loneliness Massey is describing.

The numbers behind her story are not small. Treatment entries for ketamine problems in England climbed from 426 in 2014/15 to 5,365 in 2024/25 — a twelvefold rise in a decade, per the government’s own drug advisory body — and two-thirds of those entering treatment are between 16 and 24. Southwell, who now runs the harm reduction organization Coact, doesn’t soften what that growth curve means: “We’re seeing children starting at 11 or 12,” he told Filter. “They’re turning up in children’s urology services at 13, 14 and 15.” He’s blunt about who’s responsible for the gap Massey fell into: “The first thing that needs to happen is an acknowledgement that we’ve really, really fucked up.”

Part of the problem is structural, not just a shortage of funding. Standard drug treatment models are built around a threshold — come to us once you’re ready to stop — that doesn’t match how ketamine damage actually works. “Drug services have this way of saying, ‘Come to us when you’re ready,’” Massey said. “That doesn’t work for ketamine users. The damage has already been done” long before most people reach the point clinics are designed to receive them. By the time someone walks in, the bladder harm is frequently irreversible; waiting for readiness isn’t neutral, it’s a countdown.

What’s filled that gap isn’t a new clinical protocol. It’s people like Massey, describing exactly what worked for them, to people who are exactly as scared as she was. Two of the Reddit community’s moderators put it in terms any clinician should sit with: Mason Stillings called the forum “a lighthouse, a lifeline”; fellow moderator Abbie Christie said it’s “become almost a central hub for passing on information” precisely because specialist care is “few and far between.” None of them are supposed to be the ones holding this. They’re the ones who showed up anyway.