Published on 1 Jun 2013 Sections , ,

Ketamine linked to irreversible bladder damage

Ketamine has been described as the drug of choice for this generation, but it’s doing irreversible damage to users’ bodies, writes Cordelia Lynch.

Warning: some viewers may find the content of the report above distressing

When it first took hold in Britain, it was closely associated with dance music, but it has spread to the mainstream, taken at parties and in homes in cities, towns and villages across the country.

According to Frank, the national drug education service, the average price of cocaine in the UK is £42 per gram. Ketamine is cheaper, around £20 per gram.

When I realised that having my bladder removed was the only option, it was devastating. 21-year-old ketamine user, Bristol

It’s an anaesthetic with hallucinatory properties. Users can feel completely detached from their body and surroundings – some compare it to having a near-death experience, sometimes called “entering the k-hole”.

One former user in Bristol said, “The best way of describing it is it makes you feel wonky, drunk, but the affect is instant.”

Severe side effects

But surgeons in Leeds, London and Bristol say there are a growing number of young people struggling with severe side effects. Teenagers are having their bladders stretched and removed as a result of taking it.

Some face wearing a catheter for life.

David Gillatt, one of the UK’s leading urological surgeons, told Channel 4 News that he has removed three bladders already this year.

He described what the drug does: “Ketamine gets into the urine and inflames the bladder, it makes the lining come off like a burn. As it tries to heal itself, it scars and becomes a small shrunken bladder.

“Some users experience pain in the lower abdomen, blood in their urine and problems controlling their bladders.

A 21-year-old woman we spoke to in Bristol had her bladder removed and replaced with part of her bowel. She told us “I was in severe pain. I couldn’t work. I couldn’t walk, I was cramped over, running to the toilet every five minutes and when I realised that having my bladder removed was the only option, it was devastating.” She had been taking the drug for four years, sometimes up to 15 grams a day.

Bladder issues

Channel 4 News has seen figures that show a rise in the number of people being referred to urologists with ketamine related bladder issues in three cities.

In Bristol, in the past 12 months surgeons have seen 25-ketamine cases – an increase of more than 90 per cent. In Leeds, 24 users have been referred to urologists – a 50 per cent increase on the previous year. And in London, 75 per cent of those who make it to the club drug clinic show symptoms of bladder problems.

I’d rather sit at home and stay with friends using it than go and be sociable out in the public and meet new people. It becomes reclusive. Ketamine user

But medical professionals fear it is just the tip of iceberg. Many more aren’t seeking help and ketamine use goes unreported.

Pete Weinstock from the Bristol Drugs Project said they first made the connection with ketamine and bladder problems in 2008 after speaking to surgeons – both sides had heard similar stories from users. But some health professionals still struggle to identify the cause.

One former user in Bristol said she went to the GP, but was told she had cystitis, rather than a ketamine related issue – she later had to have her bladder removed.

Vicious cycle

One of the cruel aspects of the drug, is because it’s an anaesthetic, when users experience pain, they often take more of it to help ease that pain.

It’s a vicious circle facing more and more young people. There are online forums where users offer advice to manage urinary tract infections and so called ‘k-cramps.’ Most users we spoke to, continued to take the drug, knowing the potential risks.

Club Drug Clinics are offering support for ketamine users and are working hard at raising the profile of what is available for ketamine users. But many working on the frontline find users are in denial about their addiction and embarrassed by their symptoms.

Dr John Roche from the Leeds Club Drug Clinic described seeing professionals continuing to work despite taking the drug regularly. One man we spoke to at the Bristol Drugs Project, who said he was a former user, told us, “I’d say most ketamine users would not class themselves as hard drug addicts like crack cocaine or heroin users.”

It can take just months of heavy use before users suffer urinary problems. The drug is not physically addictive, but there is a social pressure that’s developed with it.

‘K-communities’ have emerged and they are not just in urban centres. One person told us: “It just becomes such a social thing – it’s taken over. I’d rather sit at home and stay with friends using it than go and be sociable out in the public and meet new people. It becomes reclusive.”

Another former user said “I did it in Bristol, Hungerford, London – it was everywhere.”

Class C

Research carried out by David Gillatt and published in March 2012 in the Journal of the British Association of Urological Surgeons, surveyed 251 ketamine users. It showed for most users, the urinary problems improved when they stopped taking the drug.

A report by Karen Logan, a nurse consultant, at Llanfrechfa Grange Hospital published in 2011, highlighted the need for greater awareness among health professionals of the impact of the drug. The report described its popularity elsewhere in the world, in Asian communities, particularly Chinese.

In Hong Kong, the government is educating people about the dangers of the drug by advertising in newspapers and on television, as well as on public transport.

But Britain has a long way to go in tackling ketamine. It is still a Class C drug, but the Home Office has ordered a review into it.

A group of independent experts on the Advisory Council on the Misuse of Drugs (ACMD) have been asked to update their advice and report back by the end of this year. It may well mark a significant shift in attitudes towards the drug and the support provided.