Ketamine (also known as K or Special K) has been known to be habit-forming. Some people establish routines of repeated use and find them difficult to break. Regular users may experience distress and extreme cravings when trying to quit. Furthermore, tolerance can build up pretty quickly with frequent use. The following symptoms typically occur when people binge on ketamine or use it frequently. These symptoms are less common for those who do not use ketamine on a regular basis (approximately 2-3 times a week).
Heavy use of ketamine can cause the user to experience severe abdominal pains known as “k-pains.” The pain is caused by the inflammation of the hepatic and common bile ducts, which connect the gallbladder to the liver. K pains are often extremely agonizing. Although taking more ketamine may temporarily take away the pain, it will likely only worsen the condition in the end. Depending on the severity of the inflammation, the pain can last a few minutes or up to a few days.
If you are experiencing pains:
- Avoid taking more ketamine (even though it may temporarily reduce pain), or try to cut down on your use.
- Take a warm bath (when you are sober), or place a warm cloth or hot water bottle over the painful region.
- Try to eat some vegetables or rice (they can really help).
- Avoid fatty foods because one of the main functions of the gallbladder is to digest fat.
- If they are severe and do not lessen, contact your doctor, call 911, or head to the nearest hospital.
Many users have also reported a significant decrease in side-effects by not swallowing their nasal drips after railing, which can be irritating and hard to process through the stomach and digestive system. Similarly, avoiding spicy, acidic, carbonated and otherwise ‘difficult’ foods can prevent discomfort. Your digestive system uses muscle contractions to move food along, and ketamine slows this process, so any irritating foods will linger for longer. This is often misunderstood to be true gallbladder-related “k-pains”, because of the anaesthetic and disassociative effects of ketamine making it difficult for you to properly feel and understand the sensations of indigestion.
It does appear that the bile duct returns to normal after cessation of ketamine use, although the long term effects on the gall bladder, bile ducts, and liver are still unknown.
Bladder and Urinary Tract Irritation and Damage
Ketamine can irritate the bladder and the tubes that connect it to the kidneys and to the urethra (the hole you pee through). If the bladder becomes irritated and the user continues to take ketamine, severe and irreversible damage may occur and users may become incontinent, or unable to control their bladder. Ketamine can also injure the bladder, causing ulcers (wounds) and fibrosis (stiffening of the bladder walls and shrinkage). Ulcers may scar the bladder, making it unable to expand. This bladder shrinkage results in having to urinate more often and sometimes pain in the bladder area. Although the bladder can heal to an extent, it will never be the same as it was before. Some people require bladder surgery or removal, and in serious cases, it can also lead to kidney damage.
The symptoms of ketamine bladder irritation/damage are:
- Burns while taking a piss
- Pain in genitals
- Pain in bladder
- Sometimes unable to urinate or takes a while to start (if you are unable to pee for several hours, go to the hospital!)
- Blood in urine (note that this might not be obvious)
- Unable to hold piss for long periods
- Leaking piss
- Mucous in piss from bladder
Sometimes people or doctors will confuse these symptoms with those of a urinary tract infection or UTI. Ketamine bladder damage and UTIs are not the same thing and should be treated differently, although they may appear at the same time.
If you are experiencing genital or bladder pains:
- Try to not take more ketamine, or cut down on your use.
- A warm bath (sober) may help ease genital pains.
- Refrain from ingesting acidic, sugar-heavy, or caffeinated beverages, which may worsen the pain.
- If you are have been experiencing symptoms for a while after you stop using, or you are experiencing a great deal of pain, you should see your doctor, call 911, or visit the emergency room. Tell them you suspect you injured your bladder from ketamine use, and they may refer you to a urologist. If your doctor or urologist needs more information about ketamine cystitis (or ketamine bladder syndrome), you can refer them to the case studies referenced here, or tell them to go to www.ketaminebladdersydrome.com
Moderation is important with Special K! If you do a lot of ketamine in a single sitting, or you use constantly for days, you are are more prone to damage. If you’re going to use K, you need to drink water to help prevent it from irritating your insides! We recommend you drink water even when you’re not on drugs, cause water’s awesome and aids in maintaining good health! But it’s very important to remember to drink plenty of water when you’re using K, especially if you’re using a lot. Just remember to eat some food or get some electrolytes (i.e. sports drinks, though beverages with little sugar are preferable). It’s good to drink water the day after as well because K is turned into other chemicals which stay in your body until the day after you use, which may also cause irritation. If you’re sufficiently hydrated, this may aid in drug metabolism and flushing toxins from the body. If you do end up with the symptoms listed above, keep drinking water, and cutting out K would be a good idea as well (or you can risk serious life-changing damage to your body).
Cranberry juice and/or cranberry extract supplements can help minimise the chances of developing urinary tract infections (UTIs) that are common in ketamine users. However, although cranberry juice may help prevent UTIs, it has no therapeutic effect if taken after bladder irritation has occurred, and it may even trigger more pain and irritation as it is naturally very acidic.
Avoiding other foods and beverages that may irritate your bladder such as artificial sugars, chocolate, coffee, tea, soda, and fruit juices may be beneficial as well.
It is also very important to try to refrain from mixing ketamine with other drugs (like alcohol for instance), as this can add to the strain on your body.
Ketamine can increase the general acidity levels in your body, and most of us already eat a diet that is off-balance towards acidity. Here is a list of foods that will help balance your pH levels (it’s not always intuitive – lemons are acidic at first but don’t act as an acidic food once they’ve been digested!).
Ketamine damages the bladder in a similar way to another condition called interstitial cystitis. Following the guidelines for treatment and self-help for this condition may help to varying degrees with ketamine bladder syndrome. You can find info and links here: http://ketaminebladdersyndrome.com/KBS/Self-Help.html
You can see a urologist to treat your bladder with instillations (liquids put inside the bladder) or oral medications to help your bladder heal and make it less sensitive so you don’t have to pee so much. If your bladder becomes severely damaged, you may need surgery to rebuild it or remove it. If you get your bladder removed, you will have to wear a bag to collect your urine. You may experience loss of sexual function as well. If you suffer kidney damage, you may need dialysis (which involves getting your blood filtered by a machine).
For more information, check out these resources:
- Ketamine Bladder Syndrome:
- One man’s personal story of K use:
- Hong Kong Ketamine bladder case study
- Hong Kong K Pains case study
- Toronto Ketamine bladder Case Study (St. Michaels hospital)
- A review of 233 cases of Ketamine use Hong Kong