Experts have sounded the alarm about a little-known side effect of ketamine, a popular drug among college students.
Ketamine, also used as a horse tranquilizer and sold for as little as £3 a dose, can inflame the bladder and stop users from urinating. The effects can mimic those of cystitis, a painful urinary tract infection.
Academics labeled it a “misunderstood” phenomenon, since it has only documented in a handful of medical reports.
But up to a quarter of patients who use ketamine recreationally experience the side effect, they estimate.
Their warning comes on the back of a British man who is knocked down with ketamine-associated cystitis.
The dissociative aesthetic – a class of psychedelic drugs – often attracts students because it is half the price of cocaine; a single dose costs around £3. But side effects, including damage to users’ kidneys, have long been known. Yet doctors are now warning of a ‘poorly understood’ phenomenon, which causes users to get an inflamed bladder
Write in the American Journal of Medical Case Reportssaid doctors at the Countess of Chester Hospital in Cheshire An unnamed man told his GP that he was suffering from recurrent urinary tract infections (UTI) and heartburn.
He confessed that he had used ketamine before, but did not specify how long.
Blood tests and ultrasound showed that his kidney function and appearance of his kidneys were ‘normal’.
But he couldn’t fill his bladder, despite several attempts to drink fluids in the ultrasound department.
A healthy adult’s bladder can comfortably hold about 500ml of urine, which is equivalent to just under half a liter of urine, the NHS says.
Still, the man could only hold 45 ml and complained of a “severe urge” to urinate, medics said.
The bladder also appeared abnormally shaped, with doctors noting that it was three times thicker than normal.
After being referred to the urology team for further testing, a cystoscopy – a procedure to look inside the bladder with a thin camera – showed that his bladder could only hold 100ml.
CT scans also revealed that he suffered from bilateral hydronephrosis – when the kidneys become swollen due to an inability to drain urine into the bladder.
“Our patient’s symptoms and examination results were typical of long-term ketamine use,” doctors wrote.
They advised the unknown man to stop using ketamine.
A follow-up ultrasound, on later data, showed that his kidneys were no longer swollen.
Medics noted that cystitis has become more common “as the availability and use of illicit drugs increases.”
The medics warned that the infection could cause ‘irreversible’ kidney damage if left untreated.
It is therefore vital that patients are diagnosed early, stop taking ketamine and treat any complications, the team said.
“Clinicians should be aware of the disease and consider it as a possible cause of unexplained lower urinary tract symptoms, especially in young patients,” they said.
Ketamine, also known as Special K, Ket, or Kit Kat, was popular as a party drug in the late 1990s, when it was commonly used at late-night raves.
But its popularity declined in the 2000s when it became a Schedule III drug and concerns were raised about side effects, including hallucinations and, in rare cases, seizures.
However, the drug is now seeing a return, with surveys indicating it is once again trickling into the party scene.
Still, medics have previously warned about the impact of ketamine-associated cystitis, dubbed “K-bladder,” on young people taking the drug.
These problems were so serious for a young user that he attempted suicide.
A May study by researchers in the US found that ketamine could alleviate depression in people with the most severe form of the condition. Researchers at Mass General Brigham Hospital in Boston recruited 403 patients with major depression who were not helped by standard treatments such as medications. Of those offered ketamine through an intravenous drip, 55 percent said their symptoms improved over the next six months. The graph above, which shows the results of the study, shows that ketamine was at least as effective as ECT
On another occasion, the man “woke up on the bathroom floor covered in blood, appropriately because the pain had gotten so bad.”
A second sufferer also previously called the condition the “worst pain I’ve ever had” and thought they were going to lose their bladder.
In some cases, the only solution for K-bladder is surgery or even removal of the bladder.
Other side effects of taking the drug have long been known.
Some users describe a terrifying experience known as a “K-hole” when the mind and body seem separated and the power of movement is lost.
One dose can be fatal, especially when mixed with other substances, including alcohol.
The drug was dubbed Britain’s “campus killer” earlier this year when it was revealed to have caused 41 student deaths since 1999, according to the National Program on Substance Abuse Deaths.
Seven British students died in 2021 alone, the latest date data is available.
However, a growing body of research suggests there could be a place for the drug in the treatment of mental health problems.
A May study by researchers in the US found that ketamine could alleviate depression in people with the most severe form of the condition.
Researchers at Mass General Brigham Hospital in Boston recruited 403 patients with major depression who were not helped by standard treatments such as medications.
Of those offered ketamine through an intravenous drip, 55 percent said their symptoms improved over the next six months.
The study adds to growing evidence that ketamine – along with other psychedelics – could be an effective treatment for depression, potentially helping people by reshaping connections in the brain and stimulating the formation of new ones.