1. Dear Drugs-Forum readers: We are a small non-profit that runs one of the most read drug information & addiction help websites in the world. We serve over 4 million readers per month, and have costs like all popular websites: servers, hosting, licenses and software. To protect our independence we do not run ads. We take no government funds. We run on donations which average $25. If everyone reading this would donate $5 then this fund raiser would be done in an hour. If Drugs-Forum is useful to you, take one minute to keep it online another year by donating whatever you can today. Donations are currently not sufficient to pay our bills and keep the site up. Your help is most welcome. Thank you.
    PLEASE HELP
    Dismiss Notice

Health - 'Street ketamine'–associated bladder and kidney dysfunction: a report of 10 cases

Discussion in 'Ketamine' started by enquirewithin, Jun 22, 2007.

  1. enquirewithin

    enquirewithin Newbie

    Reputation Points:
    3,666
    Joined:
    Dec 11, 2004
    Messages:
    5,809
    Male from bermuda
    The Standard (Hong Kong)

    [​IMG]

    Caroline Savello

    Friday, June 22, 2007

    Abuse of the party drug ketamine can lead to permanent organ damage, doctors have warned.According to doctors at Tuen Mun and Princess Margaret hospitals, abuse of ketamine - the second-most abused drug in Hong Kong - may cause severe bladder dysfunction or even kidney failure.

    It is the first time the drug has been linked to severe damage in vital organs, and it is also the first time such damage has been recorded anywhere in the world.

    The doctors' report, to be published in the August issue of the Hong Kong Medical Journal, said they have detected severe bladder and kidney damage among 10 Hong Kong young adults, aged 21 to 30, who have abused ketamine for up to four years.

    In certain cases, damage was so serious that patients could hold no more than 15 milliliters - or one tablespoon - of urine and needed to urinate every 15 minutes. One of the abusers also experienced acute kidney failure, where the kidneys cannot concentrate urine without losing vital electrolytes. Such failure is potentially life-threatening and requires intensive treatment.
    These new problems might now be added to a long list of other harmful effects of ketamine abuse, including permanent damage to memory, IQ, impaired long-term function and respiratory or heart problems.
    The study was initiated by Dr Peggy Chu Sau-kwan of Tuen Mun Hospital, who called other Hong Kong hospitals to see if they had found similar cases.

    "Princess Margaret Hospital had three similar cases, and we combined research programs," Chu said, adding the study of this potential effect of ketamine abuse will continue. "The urinary symptoms are very stressful and diminish the quality of life."
    Ketamine is also highly habit-forming, said Dr Kenneth Lee Kwing-chin of the Chinese University of Hong Kong, though it remains less potent than cocaine or heroin.

    Though the study's findings are new, Lee cautions that clinical evidence beyond these 10 cases needs to be established to prove a link of causation. "But, based on existing evidence, we can still use this study to warn abusers that there is another potential effect of ketamine abuse," he said.

    As with some other medical problems caused by the drug, such as heart arrhythmias, the impaired renal and urinary functions can return to normal over time if abuse ends. In spite of its extremely deleterious effects, ketamine - also known as "Special K" - remains a popular drug among youths. It ranks only behind heroin in terms of popularity and is known for its hallucinogenic properties.

    A spokeswoman for the Narcotics Bureau said they hoped the new finding will act as a further deterrent to teenagers considering trying the drug.

    "Most young people do not realize the extent of damage ketamine will do to their body," the spokeswoman said. "It's the right time to emphasize the serious harm this kind of substance will do to their health, and that the effects will be lasting and very damaging."

    Ketamine is the leading abused substance among youth under age 21, she said.
    Lee noted the 10 cases involved abuse of "street ketamine," which can often consist of up to 90 percent of other substances, including cocaine and marijuana, which can "definitely contribute to kidney and urinary failure."
    The Hong Kong Medical Journal has decided to release an early online report due to the importance of the findings "for frontline doctors dealing with ketamine abuse around the world."

    Ketamine abuse has made headlines in recent weeks, as police have discovered worrying evidence of growing abuse and trafficking. Earlier this month five students, aged 13 to 17, were arrested at a Fan Ling secondary school for allegedly selling or taking ketamine on school grounds. Four girls, aged 13 or 14, were hospitalized after taking the drug, and two boys were arrested on suspicion of selling the drugs to the girls. The students were released on bail and ordered to report back to police early next month. No charges have yet been laid. Earlier this week police also arrested a sixth suspect - a 15-year-old boy - in connection with the case. He has also been freed on bail.

    Late last month police smashed a drug packaging and distribution center in a flat in Mong Kok, seizing HK$1.13 million worth of drugs, including 80 grams of ketamine, and arresting a couple.
     
    Last edited: Jun 22, 2007
  2. Bajeda

    Bajeda Platinum Member & Advisor

    Reputation Points:
    4,895
    Joined:
    Jul 13, 2006
    Messages:
    4,408
    Male from U.S.A.
    Re: Doctors raise alarm on ketamine

    Ummm.... wow. Up to 90% of other substances and they are already jumping up and down screaming about Ketamine's deleterous effects?
     
  3. enquirewithin

    enquirewithin Newbie

    Reputation Points:
    3,666
    Joined:
    Dec 11, 2004
    Messages:
    5,809
    Male from bermuda
    Re: Doctors raise alarm on ketamine

    The article is, as you have noticed, is full of nonsense. I really like this sentence:

    Cocaine is much more expensive than ketamine in Hong Kong. And, ketamine cut with marijuana? LOL! People just might notice!

    Also note this:

    That seems to contradict some of the other sensational comments.

    The article below is more informative, but not as amusing.
     
    Last edited: Jun 22, 2007
  4. enquirewithin

    enquirewithin Newbie

    Reputation Points:
    3,666
    Joined:
    Dec 11, 2004
    Messages:
    5,809
    Male from bermuda
    Ketamine linked to bladder, kidney dysfunction

    Ketamine linked to bladder, kidney dysfunction

    [​IMG]

    Reuters

    By Tan Ee Lyn


    HONG KONG (Reuters) - Ketamine, widely abused as a party drug, has been linked to severe bladder and kidney dysfunction in 10 young adults in Hong Kong, doctors said.

    Writing in the latest issue of the Hong Kong Medical Journal, the doctors said some of the cases were so severe that the young people could hold only 30 milliliters -- or two tablespoons -- of urine in their bladders and had to pass water every 15 minutes.

    "One went into acute kidney failure and all of them had evidence of liver damage as well," the doctors from two public hospitals in Hong Kong wrote. However, as bladder and kidney damage have not been linked to ketamine anywhere in the world before, the researchers said the disorders may be a result of other toxins that "street ketamine" might be contaminated with.
    "The authors would like to alert frontline doctors, especially those working in primary care, emergency departments and psychiatry, to this new form of uropathy and its association with ketamine abuse. Early urology referral for comprehensive investigation and management would help combat this new form of urinary tract disease," they added.

    Ketamine is mostly used as a veterinary anesthetic. In humans, it causes hallucinations and high blood pressure.

    But it had become widely and illicitly used as a party drug in some parts of the world by the 1990s, and has since been banned or classified as a controlled substance in places like Britain, the United States, Canada and Hong Kong.

    The seven men and three women in Hong Kong had used ketamine for between one and four years, and their cases came to light when they sought medical help for their incontinence from 2000 to 2007. They have a mean age of 25.

    Their early morning urine samples tested negative for acid-fast bacteria, but urine and blood samples taken from some of them tested positive for ketamine and benzodiazepam -- a common sedative-hypnotic drug.

    One of them, who identified himself only as "Ah Tsai", spoke of his experience on Hong Kong's Cable Television.
    "Even to make a short subway trip (of 15 minutes), I would have to go to the bathroom very urgently as my bladder would be bloated and painful. But the amount of urine I pass out would be very little," he said, with his back to the camera.

    All 10 people are being treated. However, the researchers added that no association has ever been reported between "street ketamine" and bladder or renal impairment and they urged for more research to be done. "Ketamine abusers are likely to be exposed to other drugs and chemicals either purposefully added as a cutting agent or being co-abused in a soft drug cocktail," they wrote.
     
  5. enquirewithin

    enquirewithin Newbie

    Reputation Points:
    3,666
    Joined:
    Dec 11, 2004
    Messages:
    5,809
    Male from bermuda
    'Street ketamine'–associated bladder dysfunction: a report of 10 cases

    'Street ketamine'–associated bladder dysfunction: a report of 10 cases

    [FONT=Arial, Helvetica, sans-serif]Hong Kong Medical Journal 2007;13:Epub 2007 Jun 21

    [FONT=Arial, Helvetica, sans-serif]PDF linked here[FONT=Arial, Helvetica, sans-serif]

    Ketamine abuse has caused severe bladder and kidney damage in 10 young Hong Kong adults, doctors in Tuen Mun and Princess Margaret Hospitals report. This is the first time such damage has been seen anywhere in the world.

    The research report, due to be published in the August edition of the Hong Kong Medical Journal has been released early online because the findings provide such important information for frontline doctors dealing with ketamine abuse around the world. The paper can be accessed online.

    According to the report, some of the young ketamine abusers had such severe damage they could only hold 30 millilitres (two tablespoons) in their bladder and needed to pass urine every fifteen minutes. One went into acute kidney failure and all of them had evidence of liver damage as well.

    Because bladder and kidney damage has not been reported anywhere else in the world before, the researchers suspect it may be due to other toxins that the 'street ketamine' has been contaminated with.

    "The authors would like to alert frontline doctors, especially those working in primary care, emergency departments and psychiatry, to this new form of uropathy and its association with ketamine abuse. Early urology referral for comprehensive investigation and management would help combat this new form of urinary tract disease," says the report.
     
    Last edited by a moderator: Apr 30, 2017
  6. Nose Dive

    Nose Dive Titanium Member

    Reputation Points:
    208
    Joined:
    Mar 6, 2007
    Messages:
    206
    Male
    Re: Doctors raise alarm on ketamine

    I have my reservations about this. I think that this is one of those incidents for which drugs are the scape-goat. I'm not saying anything about communist brainwashing but.... XD
     
  7. enquirewithin

    enquirewithin Newbie

    Reputation Points:
    3,666
    Joined:
    Dec 11, 2004
    Messages:
    5,809
    Male from bermuda
    Re: Doctors raise alarm on ketamine

    Can you clarify? I am not sure what conclusions can be drawn from the study but I don't understand what drugs are supposed to be a "scapegoat" for? Nor were there any communists involved.
     
  8. Nose Dive

    Nose Dive Titanium Member

    Reputation Points:
    208
    Joined:
    Mar 6, 2007
    Messages:
    206
    Male
    Re: 'Street ketamine'–associated bladder and kidney dysfunction: a report of 10 cases

    I am sorry, it was very early when I wrote this and swim was not a little lean.
     
  9. Bajeda

    Bajeda Platinum Member & Advisor

    Reputation Points:
    4,895
    Joined:
    Jul 13, 2006
    Messages:
    4,408
    Male from U.S.A.
    Be sure to take a look at the medical article here, that the articles are based on. They seem to have looked over an important part.

     
  10. INSANEPOOKIE

    INSANEPOOKIE Silver Member

    Reputation Points:
    63
    Joined:
    Feb 5, 2007
    Messages:
    53
    Male
    I wish they would indicate the actual dosage and form of intake when they refer to these few cases. What has always annoyed and flabbergasted me was the simple lack of specific information they provide. They might as well create a news report EVERYTIME a person dies from a prescription drug without any details. They state no specific dosage or method of intake just to say again! Additionally I have no trouble assuming (yes, assuming is not always the most valid thing to do) the abusers of K did exactly that, abused it! This meaning they probably were taking higher doses than it has been stated as safe or plausable safe and far too often. Then factor in some of the rec drug users who mix drugs together that are known to be problematic. Blah blah.



    A nifty book that provides real information in regards to Ketamine:
    Ketamine : Dreams and Realities
    by Karl Jansen
     
  11. Bajeda

    Bajeda Platinum Member & Advisor

    Reputation Points:
    4,895
    Joined:
    Jul 13, 2006
    Messages:
    4,408
    Male from U.S.A.
    It would appear in these cases the high amount of adulterants in the Ketamine was the likely suspect, if you look at the other posts in this thread and the medical article in the archive linked to earlier that was the impetus for these news articles.
     
  12. enquirewithin

    enquirewithin Newbie

    Reputation Points:
    3,666
    Joined:
    Dec 11, 2004
    Messages:
    5,809
    Male from bermuda
    The other thing is that the condition is not permanent anyway. The effects may well be linked to an adulterant, as I've never heard of such sypmtoms before in high dose users (for example, Lilly never mentions it). However, SWIBeltane did complain of stomach pains after heavily abusing K-- could there be a link?

    BTW, some of my cat's friends in Hong and China do take K regularly (although not in quantity)but none have ever suffered those symptoms. They would have said!
     
  13. enquirewithin

    enquirewithin Newbie

    Reputation Points:
    3,666
    Joined:
    Dec 11, 2004
    Messages:
    5,809
    Male from bermuda
  14. raven3davis

    raven3davis R.I.P. Palladium Member

    Reputation Points:
    939
    Joined:
    Jan 6, 2005
    Messages:
    1,490
    Male
    "Late last month police smashed a drug packaging and distribution center in a flat in Mong Kok, seizing HK$1.13 million worth of drugs, including 80 grams of ketamine, and arresting a couple."

    Why even mention this? Not to discuss prices or anything, but obviously, 80 grams of ketamine isnt worth anywhere near 1.13 million. By no means is 80gs a big bust. What other drugs were seized? How the hell can ketamine be cut with marijuana? I have no doubt that extreme use of almost any drug can lead to problems, but in moderation, the side effects are low to non existant.

    "Lee noted the 10 cases involved abuse of "street ketamine," which can often consist of up to 90 percent of other substances, including cocaine and marijuana, which can "definitely contribute to kidney and urinary failure.""

    So marijuana and cocaine can both lead to kidney and urinary failure? If the ketamine involved in the said cases was only 10% pure then I think its fare to cast reasonable doubt on the analysis of these findings. This study needs to be done with pure pharm ketamine and to people who only abuse ketamine. There are just too many outside factors that can alter the results.
     
  15. enquirewithin

    enquirewithin Newbie

    Reputation Points:
    3,666
    Joined:
    Dec 11, 2004
    Messages:
    5,809
    Male from bermuda
    The article is badly written and how could ketamine be cut with marijuana? LOL.

    However, it's not just in Hong Kong that urinary probelms with ketamine have been noted now, a mentioned in the above link:

    This must also be 'street ketamine.'
     
  16. ThirdEyeFloond

    ThirdEyeFloond Platinum Member & Advisor

    Reputation Points:
    2,770
    Joined:
    Nov 12, 2004
    Messages:
    727
    Male from denmark
    An old thread but SWIM just saw it in a DXM-thread and figured he'd add a little personal experience. SWIM and his genetalia can certainly vouch this is a risk factor with severe ketamine abuse.
    After a period of a about two years of daily ketamine use, he started experiencing symptoms as described in the articles. He had trouble urinating, very little liquid would come out at the time, but the little that came was accompanied by immense pain, 'pissing glass shards' is quite fitting. He would more or less constantly feel like having to go to the bathroom and most of the time he was right. This happened about once each 30 mins. 24/7.
    He had trouble holding it so had to rush to the bathroom every time he felt it was time. Needless to say this is quite a handicap when even though way behind on fashion still not keen on starting wearing diapers in his mid-20s and he remembers well how much of a struggle just crossing town, og taking the train etc. would be. This was definately linked to ketamine.
    It took him over a week to build up the courage to cross town to see the doctor (and could have gotten a fair share of fines for peeing in public along the way). After leaving a urine sample SWIM got the rather broad diagnose of bladder infection and was put on antibiotics and told to drink plenty of water and 2 glasses of cranberry juice every day. This helped the first time or so it seemed but it returned after a few days, and kept making SWIMs life a hell for about 2 months.
    The first month SWIM didn't abstain from his ketamine use, partially because of addiction and partially because he made himself believe it soothed his problem. Whatever intelligent forces that roam the K-realm had long told him that it was time to quit, and now it blamed the ketamine for his recent health problem, SWIM was hardly convinced but found the Hong Kong article googling and started to realize that it probably wasn't a coincedence and that ketamine probably was involved.
    After some struggling a while he eventually quit the habit and his condition slowly started to improve. It took about a month and a half before everything was pretty much back to normal, he feels he still visits the toilet more often than he did before all this happened but not to such extent that it bothers him, he doesn't have to go at night, which was the worse part while it lasted he didn't get much sleep at all at the time.
    If eating or drinking certain foods and beverages (alcohol in particular) there is a persistent irritability in his bladder that he'll probably just have to live with, he hasn't thought much of it for along time till he saw this thread.
    Some things should be noted though. The particular batch of ketamine was produced in India and SWIM doubts the same batch would be flowing around Hong Kong, where atleast at the time, China would seem a more obvious source. This however doesn't rule out that it could be common impurities / biproducts in sub par ketamine synthesis that's causing this, he didn't have the purity tested for that batch, he didn't feel the need as the subjective in vivo and visual experience of the product didn't make him doubt the quality at all, he would have liked to have known here later on though.
    But SWIM has a gut feeling its caused by the ketamine itself even though the pharmaceutical company marketing ketamine hasn't experienced this as stated in the Medical Practice article. He's unsure how much and how long 'longterm exposure' means in clinical terms but doubts this compares fully to binging all day for years, SWIM means well over the first year and a half there was no problems at all.
    He was also the only one experiencing such negative effects from the batch, despite that lots of people used it, SWIM doesn't know anyone that were at his level of abuse either though so the amount is a key factor.
    Although speculative he also reckons the concentration of mg ketamine/mL may be a factor, as it wasn't untill his tolerance was very high the problems started and with only 2mL syringes at hand he had to almost saturate the water with ketamine, around 450-500mg/2ml was possible (but probably not adviceable).
    It would make sense to SWIM if this put further stress on the bladder but is purely speculative. Contaminants on cotton, syringes etc. was considered but since this seems not to be a problem with other drugs used for injection this was ruled out.
    A final factor that atleast may be involved is malnutrition, SWIM was living quite unhealthy at the time, didn't bother to make much food, he would rather take another ride down the hole, and this could very well be the case with other heavy addicts as well (usually is) and no doubt hasn't helped. It may even have screwed with SWIM kidneys which in turn screwed with his bladder, this is a possibility ISO.
    With sensible use none of this should be a problem though, and the +1100 (according to his empty 100 piece needle boxes that eventually piled up) trips SWIM had during the period were probably about 1000 too many, he learned his lesson though.
     
    Last edited: Jan 28, 2008
  17. Lunar Loops

    Lunar Loops Driftwood Platinum Member & Advisor

    Reputation Points:
    2,554
    Joined:
    Feb 10, 2006
    Messages:
    1,743
    Male from ireland
    Ketamine: just a harmless party drug?

    The following article is from Drink and Drug News (UK)'s monthly magazine for July 2008 (www.drinkanddrugs.net):


    Ketamine:
    just a harmless party drug?


    When Kat Deans, Rachel Ayres and Pete
    Weinstock began to see more long-term
    ketamine users at Bristol Drug Project, they
    joined forces with local urologist Angela

    Cottrell to devise more targeted advice

    At the beginning of this year, Sue visited the daily drop-in at the Bristol Drugs Project (BDP) asking to see a drugs worker to talk about her ketamine use. She was experiencing unwanted physical and emotional side effects from using up to 7gm of ketamine a day, but finding it extremely difficult to cut down. Sue was also seeing her GP on a regular basis for treatment for chronic cystitis, but as the prescribed antibiotics weren’t alleviating her symptoms, Sue’s GP referred her to a urologist. At this point neither Sue nor her GP were aware that there could be a link between her urinary tract problems and her ketamine use.


    Sue was not the only service user being seen by BDP for help with problematic ketamine use, and we realised that two other ketamine users were being treated by urologists in the area. We liaised with Dr Angela Cottrell from Bristol Urological Institute at Southmead Hospital, who told us that the local urology department was seeing an increased number of patients with similar symptoms who had a history of heavy ketamine use. She informed us that that there had been reports of urinary tract problems associated with chronic ketamine use in Hong Kong and Canada, but no published reports in the UK.


    Back in January there were seven young people being investigated by local urologists for possible bladder damage associated with ketamine use; by June this number had more that doubled. It was clear that we as drug service providers, as well as our colleagues in urology, needed more information on the scale of the problem.


    We began by running two well-attended workshops for users, and another for professionals – which to our surprise, attracted 45 people. In April of this year the first UK case of urinary-tract pathology associated with ketamine was published in the British Medical Journal. We responded with a letter highlighting the increasing number of cases in the South West. As we began to ask service users at BDP about urinary problems, it became apparent that many ketamine users had experienced similar symptoms – in fact this was common experience among heavy users. Chronic ketamine users told us of a list of typical symptoms varying with severity, such as

    pain and burning on passing urine, blood in the urine, necessity to pass urine [FONT=FranklinGothicLT-Book][SIZE=1][COLOR=#231f20][SIZE=2]frequently and suddenly, and leakage of urine. These effects seemed to be directly [/SIZE][SIZE=2]related to the damage done to the bladder lining, which bled as it became inflamed. [/SIZE][SIZE=2]More worryingly, the scarring found in the bladder might also appear in the ureters [/SIZE][SIZE=2](tubes from kidneys to bladder) and ultimately lead to kidney damage.[/SIZE][/COLOR][/SIZE][/FONT]
    [SIZE=2][SIZE=1]
    [LEFT][FONT=FranklinGothicLT-Book][COLOR=#231f20][SIZE=2]Some patients were unable to cope with the severe and frequent pain and had [/SIZE][SIZE=2]had a catheter inserted; one patient in the South West had their bladder removed [/SIZE][SIZE=2]as their symptoms were so bad. With patients tending to be very young (in their [/SIZE][SIZE=2]20s), these were not decisions to be taken lightly. The prognosis of patients who [/SIZE][SIZE=2]have bladder damage following ketamine use is unknown. Some patients’ symptoms [/SIZE][SIZE=2]worsen as they continue to take ketamine; others improve if they stop, but others [/SIZE][SIZE=2]continue to get worse despite stopping ketamine. There are reports of similar cases[/SIZE][/COLOR]
    [FONT=FranklinGothicLT-Book][COLOR=#231f20][SIZE=2]following long-term prescribed use of ‘pure’ ketamine for pain control.[/SIZE][/COLOR][/FONT][/FONT][/LEFT][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book]

    [LEFT][FONT=FranklinGothicLT-Book][COLOR=#231f20][SIZE=2]Since the beginning of the year, our understanding of the short and long-term [/SIZE][SIZE=2]problems related to ketamine has increased greatly and we have been able to get a [/SIZE][SIZE=2]better picture of the problem. We are aware that ketamine (classified ‘C’ in January [/SIZE][SIZE=2]2006) is widely used in Bristol and surrounding areas, particularly among young [/SIZE][SIZE=2]people. It is cheap to buy, at between £6 and £10 a gram. The general perception, [/SIZE][SIZE=2]both locally and nationally, seems to be that users do not experience major physical[/SIZE][/COLOR]
    [FONT=FranklinGothicLT-Book][COLOR=#231f20][SIZE=2]problems if they are taking small amounts. Recreational users with low tolerance will [/SIZE][SIZE=2]experience a mild ‘trippy’ euphoric feeling from a dose (a ‘bump’) of 10-30mg.[/SIZE][/COLOR][/FONT][/FONT][/LEFT][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book]

    [LEFT][FONT=FranklinGothicLT-Book][COLOR=#231f20][SIZE=2]As the dose increases, the dissociative effect that most users seek, becomes more [/SIZE][SIZE=2]marked. This state can be reached with around 50-100mg, the size of a small line. At [/SIZE][SIZE=2]higher doses (anything over 100mg) users talk about entering the K hole, when the body [/SIZE][SIZE=2]starts to pass from a dissociative state to anaesthesia. As to be expected from an [/SIZE][SIZE=2]anaesthetic drug, this means that the user may become unconscious or paralysed for[/SIZE][/COLOR]
    [FONT=FranklinGothicLT-Book][COLOR=#231f20][SIZE=2]a while. In these situations ketamine users are extremely vulnerable, and unable to look [/SIZE][SIZE=2]after themselves and their belongings. Ketamine is associated with socially and sexually [/SIZE][SIZE=2]risky behaviours and can be a serious compromise to personal safety.[/SIZE][/COLOR][/FONT][/FONT][/LEFT][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book]

    [FONT=FranklinGothicLT-Book][COLOR=#231f20][SIZE=2]The majority of our local ketamine users snort the drug or take it orally. However, [FONT=FranklinGothicLT-Book][SIZE=1][COLOR=#231f20][SIZE=2]many of the older injecting drug users using the needle exchange at BDP inject [/SIZE][SIZE=2]ketamine as part of their poly-drug repertoire, as it seems to temporarily reduce their [/SIZE][SIZE=2]tolerance and therefore increase the effectiveness of opiates.[/SIZE][/COLOR][/SIZE][/FONT][/SIZE][FONT=FranklinGothicLT-Book]
    [SIZE=2][SIZE=1]
    [LEFT][FONT=FranklinGothicLT-Book][COLOR=#231f20][SIZE=2]Like Sue, many of the ketamine users that we have seen this year have also [/SIZE][SIZE=2]suffered from ‘K-cramps’ – prolonged and severe abdominal pain – and may need to [/SIZE][SIZE=2]be admitted to an A&E department. Our workshops revealed a wealth of acquired [/SIZE][SIZE=2]wisdom about the origin of K-cramps, including swallowing rather than snorting, and [/SIZE][SIZE=2]ketamine being cut with other substances. Several online user-forum sites advise [/SIZE][SIZE=2]using pharmaceutical grade liquid ketamine only, to avoid this.[/SIZE][/COLOR][/FONT][/LEFT][FONT=FranklinGothicLT-Book]

    [LEFT][FONT=FranklinGothicLT-Book][COLOR=#231f20][SIZE=2]Despite severe health problems, many people find it difficult to stop using[/SIZE][/COLOR]
    [FONT=FranklinGothicLT-Book][COLOR=#231f20][SIZE=2]ketamine, and tolerance to the drug and dependence on it can follow surprisingly [/SIZE][SIZE=2]rapidly. As users move from recreational use of less than 1mg once or twice a week, [/SIZE][SIZE=2]to several grams per day, they seem to stop experiencing the originally desired effects [/SIZE][SIZE=2]and find themselves using to feel well, and even to control the pain from their [/SIZE][SIZE=2]unwanted symptoms. The shift from recreational to problematic use is poorly [/SIZE][SIZE=2]understood. We don’t know how long it takes for tolerance to build up, or which groups[/SIZE][/COLOR]
    [FONT=FranklinGothicLT-Book][COLOR=#231f20][SIZE=2]of users are at risk of this happening.[/SIZE][/COLOR][/FONT][/FONT][/FONT][/LEFT][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book]

    [LEFT][FONT=FranklinGothicLT-Book][COLOR=#231f20][SIZE=2]Habitual daily use may leave users feeling paranoid and with a diminished capacity [/SIZE][SIZE=2]to cope with everyday life situations and emotions. Several workshop participants [/SIZE][SIZE=2]reported feeling anxious, having poor concentration and longer-term memory loss.[/SIZE][/COLOR][/FONT][/LEFT][FONT=FranklinGothicLT-Book]

    [LEFT][FONT=FranklinGothicLT-Book][COLOR=#231f20][SIZE=2]In our still-limited experience, anxiety and depression seem to be a feature of [/SIZE][SIZE=2]ketamine withdrawal. Ketamine is known to stimulate the production of dopamine in [/SIZE][SIZE=2]the reward parts of the brain, as well as producing adrenalin and endorphins. Perhaps [/SIZE][SIZE=2]low mood following a reduction, or cessation of use, is not surprising and may be [/SIZE][SIZE=2]treated symptomatically, as for stimulant detoxes.[/SIZE][/COLOR][/FONT][/LEFT][FONT=FranklinGothicLT-Book]

    [LEFT][FONT=FranklinGothicLT-Book][COLOR=#231f20][SIZE=2]At BDP we continue to support Sue through our community detox programme. [/SIZE][SIZE=2]However, we now know of two ketamine users that have recently completed ten-day [/SIZE][SIZE=2]inpatient detoxes in Bristol, and these were managed symptomatically, as for a [/SIZE][SIZE=2]benzodiazepine detox. Our next priority at BDP is to further develop and promote our [/SIZE][SIZE=2]harm reduction and detox support guidelines. We need to be imaginative in how we get [/SIZE][SIZE=2]messages out to people who do not traditionally come to drugs agencies and we need [/SIZE][SIZE=2]to adapt them to different target groups. Some questions still remain: What are the [/SIZE][SIZE=2]risks of using ketamine during pregnancy? What is ketamine cut with? Do [/SIZE][SIZE=2]manufacturers have a record of patients experiencing similar problems where [/SIZE][SIZE=2]ketamine has been prescribed therapeutically?[/SIZE][/COLOR][/FONT][/LEFT][FONT=FranklinGothicLT-Book]

    [LEFT][FONT=FranklinGothicLT-Book][COLOR=#231f20][SIZE=2]It seems that as ketamine use increases recreationally, so more users will move [/SIZE][SIZE=2]into problematic use and present to us, as well as to medical services. Locally there [/SIZE][SIZE=2]is an increasing demand for information; since writing the first draft of this article we [/SIZE][SIZE=2]have run another well-attended workshop for professionals in Bath, have one planned [/SIZE][SIZE=2]for local youth workers next week and two more user workshops planned before mid-[/SIZE][/COLOR]
    [FONT=FranklinGothicLT-Book][COLOR=#231f20][SIZE=2]August, for which we have a waiting list. We are keen to continue to gather information [/SIZE][SIZE=2]and get clear messages out to ketamine users, other services and to our local GPs.[/SIZE][/COLOR][/FONT][/FONT][/LEFT][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book]

    [SIZE=2][/SIZE]
    [FONT=FranklinGothicLT-Book][COLOR=#231f20][FONT=TheSans-B3Light][SIZE=3][COLOR=#2b2744][B][U]Reducing risk[/U][/B][/COLOR][/SIZE]
    [SIZE=3]
    [LEFT][FONT=FranklinGothicLT-Book][COLOR=#231f20][B][FONT=TheSans-B8ExtraBold][SIZE=2][COLOR=#2b2744]BDP offers some basic harm reduction advice to ketamine users[/COLOR][/SIZE][/FONT][/B][FONT=TheSans-B8ExtraBold][/font][/COLOR][/FONT][/LEFT][FONT=FranklinGothicLT-Book][COLOR=#231f20][FONT=TheSans-B8ExtraBold]


    [B][FONT=TheSans-B8ExtraBold][SIZE=1][COLOR=#231f20][SIZE=2]Guard against vulnerability and forgetfulness [/SIZE]
    [/COLOR][/SIZE][/FONT][/B][FONT=TheSans-B8ExtraBold][LEFT][FONT=TheSans-B5Plain][COLOR=#231f20][SIZE=2]by making sure you’re with [/SIZE][SIZE=2]people you can trust. Mixing ketamine with other drugs or alcohol will[/SIZE][/COLOR]
    [LEFT][FONT=TheSans-B5Plain][COLOR=#231f20][SIZE=2]make problems worse.[/SIZE][/COLOR][/FONT][/LEFT][FONT=TheSans-B5Plain]

    [LEFT][B][FONT=TheSans-B8ExtraBold][COLOR=#231f20][SIZE=2]Avoid severe and long lasting abdominal pain [/SIZE][/COLOR][/FONT][/B][/LEFT][B][FONT=TheSans-B8ExtraBold][COLOR=#231f20]
    [/color][/font][/b][/font][/FONT][/LEFT][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][B][FONT=TheSans-B8ExtraBold][COLOR=#231f20]
    [/COLOR][/font][/B][FONT=TheSans-B8ExtraBold][LEFT][FONT=TheSans-B5Plain][COLOR=#231f20][SIZE=2](referred to as K cramps) by [/SIZE][SIZE=2]not swallowing the drug – there is a strong belief that ketamine in the [/SIZE][SIZE=2]stomach makes cramps worse. Seek medical advice and mention your [/SIZE][SIZE=2]ketamine use to the doctor. If you sit in the bath to soothe the pain there [/SIZE][SIZE=2]is a risk of unconsciousness and drowning.[/SIZE][/COLOR]

    [LEFT][B][FONT=TheSans-B8ExtraBold][COLOR=#231f20][SIZE=2]If you have a panic or anxiety attack [/SIZE][/COLOR][/FONT][/B][/LEFT][B][FONT=TheSans-B8ExtraBold][COLOR=#231f20]
    [/color][/font][/b][/FONT][/LEFT][FONT=TheSans-B5Plain][B][FONT=TheSans-B8ExtraBold][COLOR=#231f20]
    [/COLOR][/font][/B][FONT=TheSans-B8ExtraBold][LEFT][FONT=TheSans-B5Plain][COLOR=#231f20][SIZE=2]stay with your friends. Make sure[/SIZE][/COLOR]
    [LEFT][FONT=TheSans-B5Plain][COLOR=#231f20][SIZE=2]someone is looking after you. Relax through slow, controlled breathing.[/SIZE][/COLOR][/FONT][/LEFT][FONT=TheSans-B5Plain]

    [LEFT][B][FONT=TheSans-B8ExtraBold][COLOR=#231f20][SIZE=2]If you experience urination problems [/SIZE][/COLOR][/FONT][/B][/LEFT][B][FONT=TheSans-B8ExtraBold][COLOR=#231f20]
    [/color][/font][/b][/font][/FONT][/LEFT][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][B][FONT=TheSans-B8ExtraBold][COLOR=#231f20]
    [/COLOR][/font][/B][FONT=TheSans-B8ExtraBold][LEFT][FONT=TheSans-B5Plain][COLOR=#231f20][SIZE=2]be aware that the symptoms will[/SIZE][/COLOR]
    [LEFT][FONT=TheSans-B5Plain][COLOR=#231f20][SIZE=2]not respond to cystitis treatments. Drink plenty of water. Seek medical[/SIZE][/COLOR]
    [FONT=TheSans-B5Plain][COLOR=#231f20][SIZE=2]help, tell your GP that you use ketamine and ask for a referral to an[/SIZE][/COLOR]
    [FONT=TheSans-B5Plain][COLOR=#231f20][SIZE=2]urologist to reduce the risk of permanent harm.[/SIZE][/COLOR][/FONT][/FONT][/FONT][/LEFT][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain]

    [LEFT][B][FONT=TheSans-B8ExtraBold][COLOR=#231f20][SIZE=2]If you find yourself needing to use higher and higher doses [/SIZE][/COLOR][/FONT][/B][/LEFT][B][FONT=TheSans-B8ExtraBold][COLOR=#231f20]
    [/color][/font][/b][/font][/font][/font][/FONT][/LEFT][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][B][FONT=TheSans-B8ExtraBold][COLOR=#231f20]
    [/COLOR][/font][/B][FONT=TheSans-B8ExtraBold][LEFT][FONT=TheSans-B5Plain][COLOR=#231f20][SIZE=2]and are using[/SIZE][SIZE=2]more frequently than intended, monitor yourself. Give yourself breaks[/SIZE][/COLOR]
    [LEFT][FONT=TheSans-B5Plain][COLOR=#231f20][SIZE=2]from using if you can.[/SIZE][/COLOR][/FONT][/LEFT][FONT=TheSans-B5Plain]

    [LEFT][B][FONT=TheSans-B8ExtraBold][COLOR=#231f20][SIZE=2]If you feel depressed and anxious [/SIZE][/COLOR][/FONT][/B][/LEFT][B][FONT=TheSans-B8ExtraBold][COLOR=#231f20]
    [/color][/font][/b][/font][/FONT][/LEFT][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][B][FONT=TheSans-B8ExtraBold][COLOR=#231f20]
    [/COLOR][/font][/B][FONT=TheSans-B8ExtraBold][LEFT][FONT=TheSans-B5Plain][COLOR=#231f20][SIZE=2]when stopping or reducing ketamine[/SIZE][/COLOR]
    [LEFT][FONT=TheSans-B5Plain][COLOR=#231f20][SIZE=2]use, get some professional help to manage your symptoms during a[/SIZE][/COLOR]
    [FONT=TheSans-B5Plain][COLOR=#231f20][SIZE=2]gradual reduction. Try to distract yourself with purposeful and enjoyable[/SIZE][/COLOR]
    [FONT=TheSans-B5Plain][COLOR=#231f20][SIZE=2]activities.[/SIZE][/COLOR][/FONT][/FONT][/FONT][/LEFT][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain]

    [LEFT][B][FONT=TheSans-B8ExtraBold][COLOR=#231f20][SIZE=2]Injecting ketamine [/SIZE][/COLOR][/FONT][/B][/LEFT][B][FONT=TheSans-B8ExtraBold][COLOR=#231f20]
    [/color][/font][/b][/font][/font][/font][/FONT][/LEFT][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][B][FONT=TheSans-B8ExtraBold][COLOR=#231f20]
    [/COLOR][/font][/B][FONT=TheSans-B8ExtraBold][LEFT][FONT=TheSans-B5Plain][COLOR=#231f20][SIZE=2]brings the additional risks of damaging your veins, skin [/SIZE][SIZE=2]infections and contracting blood borne viruses such as Hepatitis or HIV. [/SIZE][SIZE=2]Get safer injecting advice from your nearest needle exchange.[/SIZE][/COLOR]

    [LEFT][B][FONT=TheSans-B8ExtraBold][COLOR=#2b2744][SIZE=2]How do you support a ketamine detox?[/SIZE][/COLOR][/FONT][/B][FONT=TheSans-B8ExtraBold]
    [FONT=TheSans-B5Plain][SIZE=1][COLOR=#231f20][SIZE=2]Encourage a slow reduction so the body can adjust to lower dose levels and [/SIZE][SIZE=2]new, positive routines can be built into their day, advises Pete Weinstock, [/SIZE][SIZE=2]who drew up guidelines in consultation with BDP’s local prescribing service, [/SIZE][SIZE=2]in-patient detox unit and service users. Each symptom should be treated [/SIZE][SIZE=2]separately, but chlordiazepoxide (Librium) can alleviate anxiety. Shortterm [/SIZE][SIZE=2]promethazine (Phenergan) and complementary therapies can also be [/SIZE][SIZE=2]useful.[/SIZE][/COLOR][/SIZE][SIZE=1][/SIZE][/FONT][/font][/LEFT][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][SIZE=1]

    [LEFT][FONT=TheSans-B5Plain][COLOR=#231f20][SIZE=2]The person is likely to have difficulty sleeping initially or may need a[/SIZE][/COLOR]
    [FONT=TheSans-B5Plain][COLOR=#231f20][SIZE=2]considerable amount of sleep during the first few days of detox, and they[/SIZE][/COLOR]
    [FONT=TheSans-B5Plain][COLOR=#231f20][SIZE=2]will feel lethargic. Their mood may be low and they will feel demotivated,[/SIZE][/COLOR]
    [FONT=TheSans-B5Plain][COLOR=#231f20][SIZE=2]as serotonin and dopamine levels will be depleted by their drug use. Plan[/SIZE][/COLOR]
    [FONT=TheSans-B5Plain][COLOR=#231f20][SIZE=2]routine and structure, using meaningful and enjoyable activities to[/SIZE][/COLOR]
    [FONT=TheSans-B5Plain][COLOR=#231f20][SIZE=2]stimulate and reinforce positive progress.[/SIZE][/COLOR][/FONT][/FONT][/FONT][/FONT][/FONT][/FONT][/LEFT][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain]

    [LEFT][FONT=TheSans-B5Plain][COLOR=#231f20][SIZE=2]Encourage users to eat and drink regularly and healthily, and to avoid[/SIZE][/COLOR]
    [FONT=TheSans-B5Plain][COLOR=#231f20][SIZE=2]isolation. Engaging in a social support network can help to continue[/SIZE][/COLOR][/FONT][/FONT][/LEFT][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain]
    [FONT=TheSans-B5Plain][COLOR=#231f20][SIZE=2]reduction and abstinence.[/SIZE][/COLOR]
    [/FONT][/font][/font][/font][/font][/font][/font][/font][/font][/SIZE][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/FONT][/LEFT][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/COLOR][FONT=TheSans-B8ExtraBold][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][LEFT][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/left][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/SIZE][FONT=FranklinGothicLT-Book][FONT=TheSans-B8ExtraBold][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][LEFT][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/left][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/FONT][/COLOR][FONT=TheSans-B3Light][FONT=FranklinGothicLT-Book][FONT=TheSans-B8ExtraBold][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][LEFT][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/left][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/FONT][/font][/font][/font][/font][/font][/font][/font][/font][/font][/SIZE][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=TheSans-B3Light][FONT=FranklinGothicLT-Book][FONT=TheSans-B8ExtraBold][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][LEFT][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/left][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/SIZE][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=TheSans-B3Light][FONT=FranklinGothicLT-Book][FONT=TheSans-B8ExtraBold][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][LEFT][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/left][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/COLOR][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=TheSans-B3Light][FONT=FranklinGothicLT-Book][FONT=TheSans-B8ExtraBold][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][LEFT][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/left][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/FONT][/font][/font][/font][/font][/font][/font][/SIZE][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=TheSans-B3Light][FONT=FranklinGothicLT-Book][FONT=TheSans-B8ExtraBold][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][LEFT][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/left][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/SIZE][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=TheSans-B3Light][FONT=FranklinGothicLT-Book][FONT=TheSans-B8ExtraBold][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][LEFT][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/left][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font]
    [FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=TheSans-B3Light][FONT=FranklinGothicLT-Book][FONT=TheSans-B8ExtraBold][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][LEFT][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain]


    [SIZE=2][/SIZE][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/left][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font]
    [FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=TheSans-B3Light][FONT=FranklinGothicLT-Book][FONT=TheSans-B8ExtraBold][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][LEFT][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/left][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font]
    [FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=FranklinGothicLT-Book][FONT=TheSans-B3Light][FONT=FranklinGothicLT-Book][FONT=TheSans-B8ExtraBold][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][LEFT][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain]
    [/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/LEFT][FONT=TheSans-B5Plain][FONT=TheSans-B8ExtraBold][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][FONT=TheSans-B5Plain][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font][/font]
     
    Last edited by a moderator: Apr 30, 2017
  18. psychedelaholic

    psychedelaholic Silver Member

    Reputation Points:
    912
    Joined:
    Nov 2, 2005
    Messages:
    847
    Male from england
    Re: 'Street ketamine'–associated bladder and kidney dysfunction: a report of 10 cases

    One of SWIMs friends had to have an operation on her bladder because of doing too much ketamine. It somehow scarred her bladder lining and she had to have a piss bag for 2 weeks until it healed. Before the op she was pretty much incontinant and needed to wear adult nappies. Another one of SWIMs friends also had bladder problems such as only being able to hold the smallest amount of liquid before having to piss and having to sit on the loo for half an hour after drinking a cup of tea t let it all pass throught his body. He was told he needed an operation, but he cut down a lot and is almost better.

    It does seem ketamine can damage the bladder, kidneys and urinary function but only with chronic use of several grams a day everyday for months and months on end. SWIM has had a few minor urinary tract infections and kidney stones (not sure if they were from K though). SWIM has cut down a lot too though also mainly due to the excrutiating gastro reflux overdoing K gives him.

    The cases SWIM describes are with pure ketamine, definetely not been cut with anything.
     
  19. ThirdEyeFloond

    ThirdEyeFloond Platinum Member & Advisor

    Reputation Points:
    2,770
    Joined:
    Nov 12, 2004
    Messages:
    727
    Male from denmark
    A friend of SWIM who had the same bladder problem SWIM has experienced, still suffered from it 6 months after discontinuing his ketamine use. And was running to the toiled every 15mins. Nothing seemed to help much and a camera through his urinary tract showed that he had cystisis growing while making his urinary tract narrower which supported his own and the doctors belief that ketamine was to blame. If he didn't get better the doctors had planned to operate, moving a piece of his colon into his urinary tract to enlarge it. Sounds like fun eh? :s
    Luckily just a couple of days ago he found out that Alopam / Oxazepam helps him alot, making him able to both sleep at night, and making his toilet visits less frequent, and yesterday told SWIM thad he had only peed 3 times that day - major improvement from going every 15 mins.
     
  20. Lettish

    Lettish Titanium Member

    Reputation Points:
    202
    Joined:
    Nov 2, 2007
    Messages:
    350
    Male from U.K.
    Does Swim face any risk of the above described problems with his use?

    He has used ketamine about 6 times over the past year (likes to take a 2 month break, or at least try to), insufflating no more than half a gram during each session.

    If Swim continues to use ketamine like this (every couple of months, no more than half a gram at a time) will Swim experiences any bladder or kidney problems?