A mother’s desperate pleas to save her daughter from a fatal ketamine addiction went unheard, an inquest has heard, as she told a coroner: “I said she’s going to die, I told everybody she was going to die and now here we are and she’s dead.”
Ann Moralee, a flight attendant and former nurse, spent the final 48 hours of her daughter’s life begging her to let her call an ambulance. Isabelle Sapherson-Moralee, known as Izzy, refused. “No more hospitals mum, I can’t do it anymore,” she said. She died 36 hours after returning home from hospital, freezing cold and with shallow breathing. Her mother performed CPR as she spoke to a 999 call handler, but it was too late.
“I have saved a lot of lives in my career, both as a nurse and flight attendant, but ultimately I couldn’t save my daughter,” Ms Moralee told the inquest at Bournemouth Town Hall.
A five-year descent into addiction
Isabelle, 22, a former estate agent, began taking ketamine regularly during the Covid lockdowns in 2020 after moving in with her boyfriend. Her mother said she did not discover the extent of the addiction until the end of 2023, when it had become “out of control and she couldn’t hide it anymore.”
The drug caused severe damage to her bladder. About a year before her death, she became incontinent, and Ms Moralee spent £500 a month on incontinence pads. Isabelle had to stop working around six months before she died.
Ms Moralee described a “vile” encounter with a urologist at Salisbury District Hospital that she said shattered her daughter’s trust in doctors. “From then on she had no trust in hospitals or doctors,” Ms Moralee said. “She was just seen as a ketamine addict and everything else was ignored, especially her back pain.”
Ketamine is a Class B drug in the UK, though the Home Office announced in January 2025 it was seeking expert advice on reclassifying it to Class A due to rising harms. The Advisory Council on the Misuse of Drugs has reviewed the drug, with concerns about increasing misuse among young people, but has recommended it remain Class B — a decision that was not unanimous.
‘Missed opportunities’ and a system that failed
Ms Moralee said she felt health officials had “missed opportunities” to intervene as her daughter’s condition deteriorated. She tried to get Isabelle into rehab using private medical insurance and even looked at treatment facilities in America — private residential programmes can cost between £2,500 and £4,000 a week, with a four-week programme upwards of £10,000.
The mother described a “last chance” when Isabelle was arrested for suspected ketamine possession. Ms Moralee believed her daughter should have been sectioned under the Mental Health Act for her own protection. “She couldn’t walk, she was disorientated — that was the last opportunity to save her,” she said. “They had a duty of care, they should have applied the Mental Health Act. She was deemed to have capacity, my argument is how could she possibly have capacity?”
The Mental Health Act 1983 allows for the detention of a person with a mental disorder who poses a risk to themselves or others, or requires treatment that cannot be given outside hospital. Ms Moralee argued Isabelle’s addiction and physical decline meant she lacked the capacity to refuse help.
Isabelle was discharged by the bladder and bowel service and the weight-loss team, who said she did not have an eating disorder. “Then she really just gave up,” her mother said.
Even during a hospital stay in March, Isabelle was still able to obtain ketamine. Ms Moralee said she was caught twice on the ward with the drug. “I followed her out of the building and tried to get the number plate of whoever was supplying my sick child with ketamine,” she said.
On 24 April 2025, Isabelle was admitted to A&E but discharged herself. Her mother pleaded with her to let an ambulance be called, but Isabelle refused. “She knew she was dying that last 48 hours,” Ms Moralee said. “So I made her hot water bottles, made her some French toast, she didn’t eat much.”
Despite everything, Ms Moralee said her daughter wanted to get better. “She said I’m going to get better, I’m going to do a psychology course then I want to help other children like me. Nobody should have to go through what I have been through. Her goal was to get better.”
The vicious cycle of ketamine abuse
The medical cause of death was given as respiratory depression due to combined severe morphine and gabapentin toxicity. Both pain drugs showed higher than normal therapeutic levels in her blood, and the gabapentin exacerbated the toxic effects of the morphine. A post-mortem also found biliary sepsis — localised sepsis in the liver — which was a contributing factor but not the cause of death. Sepsis was due to severe ketamine-related chronic liver disease.
Scott Davey, from the drug and alcohol support charity Reach, told the inquest that ketamine users often become trapped in a vicious cycle. “Ketamine normally starts as recreational. The dissociative factors of it mean it can be used to mask mental health, external factors going on — stresses with family, work. It becomes habitual,” he said. “It is very cheap, accessible, that plays into it massively. It’s not the acute effect, it’s the long-term effect where it’s done physical damage and then being used to manage the pain, it’s a catch 22.”
Reach is among a growing number of organisations seeing a surge in young people seeking help. In 2023-24, 3,609 people started treatment for ketamine misuse in England and Wales — more than eight times the number in 2014. Specialist clinics have reported a notable increase in young patients who struggle to engage with mainstream services.
Ketamine use has soared across the UK. In the year ending March 2023, an estimated 299,000 people aged 16 to 59 in England and Wales reported using the drug, the highest number on record. Among 16- to 24-year-olds, use has jumped 231% since 2013, reaching 3.8% in 2024. A gram of ketamine costs around £30, making it both cheap and accessible.
The health consequences are severe. Chronic use can lead to ketamine bladder syndrome — inflammation, ulceration and even tissue death in the bladder — as well as kidney damage, liver damage, cardiovascular issues and mental health problems including psychosis. About 30% of recreational users may experience bladder symptoms. In 2024, 5,565 drug-poisoning deaths were registered in England and Wales, the highest since records began in 1993, with Scotland having the highest mortality rate in Europe.
Ms Moralee acknowledged that those trying to help her daughter faced enormous challenges. “Isabelle was a beautiful, funny girl, highly intelligent, a talented photographer and dancer,” she said. “But as beautiful and smart as she was, she was also a master manipulator. The guys at her GP practice and Reach did everything they possibly could.”
The inquest continues.