Ketamine abuse and the urinary tract

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What is Ketamine?

Ketamine is a medication that was developed in the mid-1960’s as an anaesthetic, helping to numb pain during medical procedures. Ketamine can be given in different ways, such as through a needle in a vein, or as a pill, liquid, or spray.

In recent years, ketamine has been studied as a treatment for depression. While it’s not the first choice of treatment for depression, researchers are continuing to study the drug to see how effective it might be.

Medical use of ketamine is known to cause some side effects, such as hallucinations, bad dreams, drowsiness or dizziness, blurred vision, restlessness, or vomiting. It can also increase blood pressure and heart rate.

Did you know?

During the Vietnam War, ketamine was commonly used as an anaesthetic for surgeries in the military. It was particularly useful in combat situations where resources were scarce, as it effectively reduced pain for injured soldiers.

Effects of ketamine abuse on the urinary tract

Some people use ketamine at parties or social gatherings to purposely experience hallucinations and altered perceptions. It is also sometimes used illegally by people to manage chronic pain conditions. While ketamine abuse is not very common among the general population, its recreational use has increased in recent years, especially among teenagers and young adults.

Although young people may think the short-term effects of ketamine, such being in a dream-like state or having out-of-body experiences are harmless, ketamine is addictive and dangerous.

A “bad trip” can cause a frightening sensation of total dissociation that has been likened to a near-death experience. Since ketamine is tasteless and odourless, it can be added to drinks without the intended victim knowing and used as a “date rape” drug.

Long-term use of ketamine can cause significant issues with brain function, such as amnesia, flashbacks, memory problems, and anxiety. It can also lead to bladder complications, like damage to the urinary tract, bladder inflammation, an increased need to urinate, blood in the urine, incontinence and pain passing urine.

When taken in high amounts, ketamine can affect the upper urinary tract, leading to problems with how the kidneys work.

The exact number of ketamine abusers experiencing urinary tract problems is not known for sure, but studies suggest that between 25% and 33% of intensive ketamine abusers may be affected.

Treatment for ketamine abuse

It is crucial for ketamine users to quit the drug completely, but quitting can be difficult due to its addictive nature and pain-relieving effects.

Treatment in the early stages focuses on managing pain and bladder symptoms with medications. Talking therapy is also offered to help overcome addiction and increase the chances of recovery.

Many people can recover from their symptoms if treatment is started early. However, in some cases, permanent damage may result in the need for different treatments, like having liquid drugs inserted directly into the bladder (called a bladder wash) or injections of botulinum toxin into the bladder wall. In some cases, an operation called electrocoagulation is needed to repair the damage inside the bladder.

In severe cases, a partial cystectomy (surgically removing part of the bladder) or an operation to make the bladder bigger may be needed. In rare situations, when pain makes it impossible to avoid drug abuse, the entire bladder may need to be removed.

Glossary

Botulinum toxin
Botulinum toxin works by paralysing nerve endings. You may have heard this being referred to as Botox®. While most of us think of botulinum toxin as a cosmetic procedure to reduce the visible signs of ageing, botulinum toxin injections have several medical purposes including treating muscle and nerve-related health problems.

Bladder wash
A bladder wash, also called a bladder instillation, is a treatment where a liquid drug, such as sodium hyaluronate or chondroitin sulphate, is administered into the bladder via a catheter to coat the bladder wall and help to reduce symptoms.

Electrocoagulation
Electrocoagulation treatment involves using a special tool that uses heat from an electric current to remove and thicken the damaged tissue inside the bladder. This helps to get rid of the damaged parts and supports the healing process of the bladder.

Street names for ketamine include:

K, Special K, Vitamin K, Super Acid, Super C, Bump, Cat Valium, Green K, Honey Oil, Special La Coke, Ket, Kitty, Kit Kat, New Ecstasy, Purple and Jet. A mixture of ketamine and cocaine is called Calvin Klein or CK1. In Hong Kong, the street name is Kai-Jai.

Awareness

It’s crucial to be aware of the risks associated with ketamine abuse, as it can be harmful to both physical and mental health. If you are struggling with ketamine abuse, or you suspect your child or someone you know is struggling, seek professional help and support as soon as possible.

Disclaimer

The content of this leaflet is based on a narrative review of the literature. No EAU Guidelines exist on the diagnosis and treatment of ketamine-induced Cystitis.

Contributors:

  • Dr. Dick Janssen (NL)
  • Ms. Jane Meijlink (NL)
  • Prof. Dr. Eamonn Rogers (IE)
  • Dr. Wouter Van der Sanden (NL)

References

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