'Worrying Link' Between Ketamine Use And Severe Bladder Problems

By chillinwill · Jun 7, 2009 · ·
  1. chillinwill
    Medical experts have warned of a "worrying link" between ketamine use and serious bladder and kidney problems.

    The recreational use of ketamine - an anaesthetic commonly used by vets - has increased in recent years because of its powerful hallucinogenic qualities. But there have been recent reports of serious urological side effects from heavy use of the Class C drug, including severe pain, haematuria (blood in the urine), incontinence and even kidney failure.

    Doctors and drug workers from Bristol Urological Institute at Southmead Hospital and the Bristol Drugs Project teamed up to evaluate the symptoms experienced by ketamine users. They present their findings today at the Royal College of Psychiatrists' 2009 Annual Meeting in Liverpool.

    The researchers found that 15 patients in the West Country had recently been referred to urologists with a history of chronic ketamine use and severe urgency, frequency, pain and haematuria.

    A separate survey of urologists across the UK found that most had seen similar cases. In around a third of cases, the patients' symptoms improved when they stopped using ketamine.

    However, in the remaining two-thirds of cases the symptoms either stayed the same or got worse - even after the patients stopped using the drug. If patients continued using ketamine, their symptoms became very difficult to control.

    Lead researcher Dr Angela Cottrell said: "There is a worrying link between ketamine use and urinary tract pathology that is proving difficult to manage. A multidisciplinary approach involving psychiatrists, drug workers, pain consultants, urologists and GP is needed to tackle this growing problem. A harm reduction strategy to increase awareness of the risks and help people reduce their intake is also needed."

    Annual Meeting of the Royal College of Psychiatrists, BT Convention Centre, Liverpool, 2 -5 June 2009

    Main Category: Urology / Nephrology
    Article Date: 07 Jun 2009 - 1:00 PDT
    Medical News Today

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  1. Nature Boy
    SWIM notices some bad side effects with ketamine alright so he's probably never going to touch the stuff again. He's got all that he needs out of it and won't really miss it that much. Although he wasn't a heavy user or anything, it just doesn't seem worth the risk for a drug that has limited potential as a recreational pursuit.
  2. Finn Mac Cool
    Doctors' warning on ketamine risk

    By Jim Reed Newsbeat reporter

    Doctors have told Newsbeat there's growing evidence the drug ketamine is causing serious bladder problems in some users.

    GPs' surgeries are seeing more clubbers with symptoms ranging from serious stomach pain right up to incontinence.

    In extreme cases, it's thought the drug can cause permanent damage. A handful of patients have needed an operation to have their bladders removed.

    "People need to be more aware of this," said Doctor Angela Cottrell, who is researching the link between ketamine and bladder damage at the Bristol Urological Institute.

    "The short term effects can be severe enough but we just don't know what the long term effects are."

    Ketamine was developed as an anaesthetic used on both animals and humans. As a recreational drug, it has been around on the dance scene for over a decade but was only made illegal in 2006.

    In most cases it's snorted as a powder but it can be drunk or injected. Even in small doses users have reported hallucinations and a strange out-of-body feeling unlike other stimulants.
    Increasing use

    3.6% of all 16 to 24-year-olds have tried the drug, according to the British Crime Survey. Use in that age group has doubled in the last year.
    Continue reading the main story

    Simon, 28, experienced side effects from using ketamine

    Drug workers also reckon ketamine is getting more popular as alternatives like ecstasy and cocaine are increasingly mixed with cutting agents.

    "It was a big part of the [club] scene and everyone did it," said 28-year-old Simon from Bristol. "People thought it was a clean drug - one that wouldn't mess up your body."

    But he started noticing painful side effects soon after taking it.

    "I kept having to go the toilet all the time. I got cramps in my stomach and really bad kidney pains," he said.
    'Information lacking'

    After seeing his GP, he was told to stop overnight or he'd have to get a small plastic tube or catheter fitted to drain the liquid out of his bladder.

    "I was absolutely mortified," he said. "I worked long hours at the time and liked a drink so I didn't put two and two together and realise it was the ketamine that was to blame.

    "The information just isn't out there at the moment. It is still seen as a safe option in clubs."
    Simon Simon says ketamine is seen as being a safe option in clubs

    Doctors and drug workers have told Newsbeat they are hearing more stories like that.

    "We thought we had a huge cluster [of cases] in Bristol," said Dr Cottrell, "so we surveyed other specialists across the UK and they came back saying they are seeing cases as well. It's nationwide."

    Most of the patients referred to the unit are regular users but Dr Cottrell says problems have been reported in people using the drug for just two or three months.

    Most are put on a course of strong pain killers and told to stop taking it immediately. But there is growing evidence that some users may be suffering from permanent problems after giving up.
    Possible upgrade?

    In a handful of extreme cases the entire bladder had to be removed, a complex operation that can leave the patient incontinent.

    At the moment ketamine is a Class C drug alongside steroids and some prescription medicines.

    Anyone found carrying it for personal use could face up to two years in jail although a simple warning is far more likely.

    There has been speculation that it could be upgraded to Class B alongside cannabis and amphetamines with a stronger punishment for possession.

    That decision would typically be made by the Home Office following a recommendation from its group of independent drug experts.

    The former chairman of the government's advisory council, David Nutt, told MPs in October that "class C may be the wrong class" for ketamine because of growing evidence over the health risks.

    Professor Nutt was sacked last month by Home Secretary Alan Johnson, who accused him of campaigning against the government's decision to reclassify cannabis as a Class B drug.

    It is thought the advisory council still plans to review the status of ketamine in the future, although the timing of that study is uncertain following the resignation of a number of its members.

  3. Terrapinzflyer
  4. Finn Mac Cool
    Re: Doctors' warning on ketamine risk

    Sorry but I fail to see how those articles match this one, for although the first one uses the same the statistics, the second one is completely different. This one gives a users first hand experience and the implications these and other statistics might have concerning future classification, both I'm sure users will find interesting.
  5. chillinwill
    Re: Doctors' warning on ketamine risk

    Since this is a drug news article, it would probably be better suited for the Drug News Forum and merged in with one of the threads that Terrapinz pointed out. Otherwise, the forum would be cluttered up real quickly with the amount of drug news articles that are posted if they are posted both in the Drug News forum and in the forum that the article is referring to (in this case, the Ketamine Forum).
  6. Finn Mac Cool
    Re: Doctors' warning on ketamine risk

    Is it not the case that if a news article is posted, it's posted in the proper sub forum, then the creator reports it to the moderator, who then redirects to the news forum?

    Can I ask why you think it should be merged even though it's clearly not the same as either of those articles?

    I think all this is being taken way too seriously and will put me off posting anymore articles, hopefully a mod can clear these matters up.
  7. chillinwill
    Re: Doctors' warning on ketamine risk

    Not as far as I know. In this case, you could do this and report the post and ask a moderator to move it there for you.

    We are not trying to come off as hostile and certainly don't want to put you off posting more articles, although threats like that do no good around this forum. We are just giving friendly reminders on how to post a news article since posting threads in the Drug News Forum are slightly different compared to the rest of the forum.

    After posting about 3,000 news articles and getting a good idea on how the Drug News forum operates, the fact remains that it should be merged in with one of those other articles, since they are on the same topic, especially considering one of the articles uses the same stats as yours as you said so yourself. It helps keep the forum free from glutter if very similar topics can be merged together.
  8. Terrapinzflyer
    Re: Doctors' warning on ketamine risk

    no offense was in tended SIB. was just trying (poorly perhaps) to point out news stories should be posted in the news forum, and if a very similiar story already exists, the new story should be posted in that thread.

    If someone wants to discuss a topic raised by a news story in the appropriate subforum, then just copy and paste the appropriate bit into the post and link back to the story in the news forum...
  9. Finn Mac Cool
    Re: Doctors' warning on ketamine risk

    Yes guys I take on board what you're saying, I just thought you were going all repost police on me, I'm not fond of being policed :)

    I just followed the guidelines, which I think were at the top of the forum for a while there.

    So if the article that you want to post is about a topic that has a dedicated forum (For example Salvia divinorum), then post your thread there and hit the report button (!). In the report message, ask the moderator to move your thread to the news section with a permanent redirect. This will allow the thread to be accessed via both the substance-specific forum and News.
  10. chillinwill
    Re: Doctors' warning on ketamine risk

    Hmmm never seen that message there before but that is because if I already know it is a drug news article, I just post it in the Drug News Forum rather than creating two threads about it. The Drug News Forum provides a thread when the article is posted that will allow conversation to take place about the topic (same thing that is going on in this thread). There is no need to have two threads just having a redirect to the same topic.
  11. chillinwill
    Ketamine reality

    As the government prepares to classify mephedrone as a class B drug, Dina Rickman uncovers the dangers of young people's current drug of choice; Ketamine
    Three teenagers are huddled over a CD case in the corner of a Brighton squat. Rave music blares from the soundsystem as they cut lines of white powder from a crumpled wrap. Emily, the youngest of the group at 17, uses a £5 note to snort the largest line. She laughs, coughs a little, then passes the CD case to her friend. "This is just like Skins" she shouts, her voice barely audible over the pounding bassline. It could be any party, in any town in the UK. The powder is ketamine, a Class C dissociative anaesthetic which is also used as a horse tranquilliser. When taken, it causes euphoria and powerful hallucinations, with users reporting out-of-body experiences and conversations with god.

    In 2008 the British Crime Survey revealed it was the fastest growing "party drug" among 16-24 year olds, leading it to be dubbed the "new ecstasy." It now boasts an estimated 125,000 users in the UK and more users among young people in England and Wales than heroin and crack cocaine combined.

    But as the number of users rise, serious side effects are beginning to emerge. On internet forums for clubbers the stories all started the same. After about three months of regular use people were experiencing strange side effects; incontinence, blood in their urine and urine infections that did not respond to treatment.

    By May 2008, doctors from the Bristol Urological Institute (BUI) became concerned. They published a letter in the British Medical Journal reporting they had seen nine patients with severe urological symptoms associated with ketamine use over the last two years. The letter warned that these cases were "the tip of the iceberg." It was right. Since then, 15-20 people in the area have been put forward for bladder stretching, a surgical procedure performed under anaesthesia. Two users in their 20s had to have their bladders removed because they had incurred so much damage from the drug.

    Daniel, a 21-year-old heavy user from Brighton knows his body is beyond repair. Doctors have told him that drug abuse has given him the bladder of an 80-year-old, and he needs to have it surgically stretched, but he cannot stop taking Ketamine.

    "I've got a fixation, I just think 'one more line.' I'll go for a piss it will literally be a tablespoon's worth of urine. I'll piss out slugs of blood, like congealed jelly and the pain is horrific. It feels like a ball with loads of spikes just bouncing on your bladder. During a bad week I will go to the toilet every five minutes. I was in the job centre once having an interview and I had to stop halfway through because I was sitting there bursting."

    Also known as K, special K and wonk, can sell as cheaply as £6 per gram in the South West. But few of its users will have heeded the warning on the government's drug website, Frank, of "serious bladder and related problems found in ketamine users."

    Jess was 18 when she began taking ketamine. Two years later, she was wandering the streets of Bristol, high and covered in her own blood: Now 21, her health is a constant reminder of her drug use. She regularly suffers from cystitis because of the damage done to her bladder, and was hospitalised three times from kidney infections during her time on the drug. She also suffered from "k cramps", severe stomach pains associated with ketamine use. She says that the only cure for the cramps was talking more ketamine – trapping her in a vicious cycle of drug abuse and self harm:

    "It started off as very small amounts, when you start using K it's very attractive, it's cheap and the effects are strong."

    A leaflet circulated by the Bristol Drugs Project (BDP) and the BUI to GPs in the south west warns: "the symptoms can be severe enough to require hospitalisation... and can result in irreversible bladder and renal damage. Although commoner among those who use ketamine daily or at high doses, it can also occur with lower dose recreational ketamine use."

    The possibilities worry Jess, especially as she knows of 14 and 15 year olds injecting the drug:

    "It's really, really scary. One of my friends got really wasted on ketamine and walked into the sea and drowned themself. It can have a massive effect on your mental state. When I was a heavy ketamine user I spent most of my time in my room on my own self harming. I tried to give up many, many, many times. The only way I managed to do it was to get out of the country."

    Dr Rachel Ayres, from the BDP, said urinary symptoms associated with ketamine use were becoming more widely known in the medical community as more people are abusing it:

    "These problems are not due to contamination of ketamine, and they still develop even when you inject it rather than snort it. Some users think that damage is due to contaminated drugs but we think these problems are due to ketamine itself." Ayres emphasises that the users who had to have their bladders removed or stretched were at the severe end of the scale: "You have to be really bad to be referred to a urologist, and not everybody is."

    Nate, 24 from Milton Keynes didn't go to see a doctor, even when he couldn't sleep through the night because he had to use the toilet so frequently. Charlie, 24, a student from Brighton also didn't seek help when he had the same problem. He says there needs to more preventative education about ketamine's effects:

    "It's such a massive epidemic, it's something that you can get on any street corner. When ecstasy came onto the party scene there was a furore but there hasn't been for ketamine even though young people are destroying their bodies."

    Young people like Emily, the 17-year-old at the squat party in Brighton who snorted the largest line. She's notorious on the Brighton party scene now - not for her hedonism or youthful charm, but for being incontinent.

    *Some names have been changed

    Dina Rickman
    April 1, 2010
  12. Paradoxical Frog
    Re: Ketamine reality

    My cat has personally never understood the appeal of taking Ketamine on nights out, finding that it just makes her unable to move or converse with people without feeling like she's dribbling, but also appreciates the old saying "different strokes for different folks"...

    This is something she's heard of before though actually and kind of wondered when something would be reported in the news about it. Certainly at free parties last year kitty noticed that many of the younger crowd's (17-21/22) drug of choice was ketamine, and they were doing rather large quantities. On more than one occasion my cat found herself babysitting ket casualties, because she's too bloody soft to let people sort themselves out!

    Kitty also finds herself wondering why Ketamine is only a class C drug, when it's shown to have some pretty nasty side effects such as this and can be potentially lethal when combined with alcohol..
  13. John Doe
    Re: Ketamine reality

    SWIM thinks his only encounter with Ketamine was enough to put him off it for life. 1g between 4 people, 8 lines, two hits, one about midnight and another when SWIU started to come out of the haze. It was extremely intense and while SWIM is glad he can hold his hand up and say he's experienced and even enjoyed Ketamine it left him with no want whatsoever to take it ever again.

    That said though, all of these people taking it to go clubbing take it in small dosesand get a pickup from it. Meh, whatever floats your boat :)
  14. Mick Mouse
    Club drug "Special K" could leave users incontinent

    Long-term abuse of the recreational drug ketamine, often called "Special K" by the young party-goers who use it, is now linked to a heightened risk for pelvic pain and urinary incontinence .

    The finding is based on a 2009 survey conducted by a team of researchers out of Hong Kong. They questioned 66 male and female teen and young adult ketamine users (13 to 25 years old) about their drug experience.

    Although almost half said they did not believe they were addicted to the drug, the authors found that those with a two years plus history of ketamine abuse were subject to an increase both in pelvic pain and the urgent and frequent need to urinate.

    Relative to less frequent use, those who took "K" more than 5 times a week also experienced reduced bladder capacity.

    The team, led by Dr. Siu-king Mak, the Hong Kong coordinator of the andrology section with the Hong Kong Urological Association, is slated to report its findings in San Francisco at the annual meeting of the American Urological Association.

    Ketamine is considered one of the so-called "club drugs", due to its popularity in nightlife rave settings. Sometimes also referred to as "vitamin K", ketamine's intended purpose is as a veterinary anesthetic for use in animal surgery.

    However, when used recreationally, the "dissociative" anesthetic-which is chemically related to PCP ("Angel Dust")-functions as a hallucinogen, and can prompt euphoria, numbness, delirium, and a sense of being disconnected from time and space. It can also disturb motor function, trigger high blood pressure, and instigate respiratory distress.

    Among those surveyed, just over half said that they also engage in the recreational use of the hypnotic drug "nimetazepam" (brand name Erimin). About 46 percent reported cocaine use, while nearly 40 percent said they smoke marijuana.

    In addition to asking study participants to recount instances of pelvic pain as well as urination frequency when taking ketamine, Mak and his colleagues conducted kidney ultrasounds, urine flow analyses, and bladder scans.

    On a passive note, patients who stopped taking ketamine experienced a continuous dissapation of symptoms over time, the researchers said.

    Dr. Marc Galanter, director of the division of alcoholism and drug abuse in the department of psychiatry at new York University School of Medicine in New York City, believes ketamine use is widespread.

    "Ketamine is not all that uncommon as a drug of abuse among young people," he said. "Even though its use should be restricted to veterinary situations requiring anesthesia, young people do get a hold of it, and inject it intramuscularly and get high. So it is a significant issue."

    "Now, it is unusual to have people abusing it as frequently and to the degree reported in this study," Galanter noted. "So this finding concerns a select population. But there are certainly people where this kind of complication might come into play."

    But Dr. Adam Bisaga, an associate professor of psychiatry at Columbia University, as well as an addiction psychiatrist at New York State Psychiatric Institute in New York City, believes use of Special K may not be rampant.

    "My take on this is that ketamine use as a whole is not a big public health problem, in the way that cocaine, marijuana, and opiate abuse are," he said. "Yes, this sort of complication with K can happen. It can certainly be an issue for some patients. But it's not honestly something that has been occupying the attention of most drug abuse treatment providers."

    Galanter said ketamine abuse remains a troublesome problem, however. "I would say that ketamine has always been a bad idea," he stressed. "And this is just one more reason that it clearly is a bad idea."

    There is more information on ketamine and other "club drugs" at the U.S. National Institute on Drug Abuse

    Sources: Adam Bisaga, MD, associate professor, psychiatry, Columbia University, and addiction psychiatrist, New York State Psychiatric Institute, New York City; Marc Galanter, MD, director, division of alcoholism and drug abuse, department of psychiatry, New York University School of Medicine, New York City;May 30, 2010 presentation, American Urological Association annual meeting, San Francisco

    Alan Mozes
  15. mickey_bee
    Re: Club drug "Special K" could leave users incontinent

    Swim finds it really annoying that in any article about Ketamine, they always refer to it as a 'horse tranquiliser' or 'veterinerary anaesthetic'.

    Ketamine's first use was in human anaesthesia IIRC, particularly in cases where breathing mustn't be suppressed. It was often used on children - but stopped after they woke up, obviously scared, having just been in and out of a hardcore K-hole.

    Swim hates sensationalism around drugs, or any other subject matter - it just breeds ignorance, and an ignorant population is a population falling apart. Swim wants FACTS in the media, not sensationalism - and so should any other relatively intelligent individual!!!
  16. Mick Mouse
    Re: Club drug "Special K" could leave users incontinent

    While I applaud your knowledge of the early history of this substance and I totally agree with you regarding sensationalism in the media, I don't see that as being the focus of this news article. I find two references to ketamine being used in a veterinary setting and what I gathered from reading the article was that this is its present use, not what it was originally created for. Perhaps I am wrong, though. The focus of the article as I read it is a study of bladder/urinary tract issues in long-term users. Admittedly, it does go into some detail regarding its effects and the most common settings it is recreationally taken in, but that serves to quantify the test subjects and their usage patterns. As far as having more"facts", one would presume that they would be found in the minutes of the presentation/meeting referenced in the sources section included at the end of the article.

    Normally, facts don't sell, while sensationalism does. That has been a fact (pardon the pun) since printed media first became wide-spread. As I mentioned earlier, I agree with you that sometimes it does get out of hand, but truthfully, that's what most of the readers want. They want to be titillated with lurid details, even when they know that they may only have a passing resemblance to the truth. I believe that is why we (D-F) requires a source line or other means of verification, so that interested readers can do follow-up research or investigation in hopes of bringing new facts to light.

    Also, when I say "most of the readers", I mead readers of news media in general and not necessarily members of this forum.
  17. Jatelka
    There's a large number of papers in the archive on Ketamine associated Urinary Tract problems...

    I suggest a search using "cystitis" as a key word

    (essentially because there are too many to link to, and I'm feeling lazy!)
  18. Mick Mouse
    I was curious about this, because nothing at all came up in "similar threads" when I began posting this particular article.This same situation has also occurred in a few other articles that I have recently posted. It is quite frustrating, as this subject appears to have been covered in detail, and my post was essentially a waste of time and sub-forum space. Should all future posts be preceded by UTFSE, rather than trusting the "similar threads" function to be accurate?
  19. Terrapinzflyer
    ^^ Indeed- the "similar threads" function is rudimentary at best. Even the regular search isn't foolproof -it can be a challenge to find the right keep words and limiters... but infinitely better then the "similar thread" function
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