DOSE:

Ketamine

The following is an excerpt from:

Winstock AR, Mitcheson L. 'New recreational drugs and the primary care approach to patients who use them'. BMJ. 2012;344:e288.


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A patient's perspective: A user's account of urinary symptoms associated with using ketamine

My ketamine misuse started off recreationally but escalated. The first time I visited a doctor because of problems with my bladder I was given antibiotics and sent on my way. I urinated what looked like a thick jelly, sometimes with blood in it, and had nasty involuntary bladder spasms that left me unable to walk upright. I even told the doctor about my ketamine use, but he just said I was a silly boy for taking drugs. The antibiotics did not work so I went back to the doctor and was told just to drink lots of water and cranberry juice to flush out what was left of the infection. My symptoms did not resolve so I self medicated with ketamine because it seemed to be the only thing that helped to alleviate the terrible pain, and I stopped seeing doctors for a while.

After about a year of constant ketamine misuse, I became really ill for the first time. I had intense bladder and abdominal pain and I was admitted to hospital. I managed to do about a month clean without ketamine after this, while taking the painkillers (diclofenac) that I was prescribed from the doctor at the hospital, but I started using ketamine again.

Over the next six months, I made three more attempts to stop using ketamine, all of which failed. None of the services I accessed at the time seemed to help. During this time, I passed a clot that was about the thickness of my little finger, and from this point on, I was incontinent of urine. The painkillers had stopped working. As I was a drug user, my doctor would not prescribe me anything stronger for pain. So I just continued using the one thing that helped--ketamine--knowing that every time I took it I was doing more damage. At least if I took ketamine I could walk to the shops in no pain and just about get on with things. As time went on, my bladder pain got worse. I started to get scared of eating meals because defecating was even more painful than when I was just urinating, because of contraction of the abdominal muscles, and afterwards I might urinate blood for days. Ketamine also affected my mind. I could not remember what had happened a couple of days earlier. I started to forget passwords, PIN numbers, even people's names.

I made a few attempts to kill myself and an old friend of mine, who had observed the change in me, made me register at a local general practitioner. My friend had done some investigation and found out about the specialist drug and alcohol service and the inpatient unit in the city. I asked the doctor that I was assigned to for the referrals I needed and for help.

I needed strong pain relief if I was to stop taking the ketamine completely. My doctor helped me to try different painkillers to see what worked. I tried tramadol, diclofenac, and Buscopan [hyoscine], but they did nothing. Oromorph [morphine solution] stopped the pain, but was not ideal; my doctor was not happy with my having a big bottle of morphine in the house--since my memory was not very good and because of my previous suicide attempts. I then moved on to Zomorph [morphine capsules], 10 mg twice daily with a daily collection from the chemist. I started to notice a dramatic reduction in pain lasting for roughly 6 hours after taking the first pill in the morning. This would then wear off and leave me feeling uncomfortable for the hours leading up until my next dose. From this point my ketamine intake started to decrease, as I wanted to use ketamine only when I was in pain. I explained this to my doctor, and she increased my dose of Zomorph until my admission to an inpatient addiction unit in Bristol.

After the first couple of days at the detox unit, I started to come out of my shell and participate in inpatient discussion groups. In the inpatient unit, I was put on a benzo reducing regimen to help the ketamine detox--a reducing dose of Librium [chlordiazepoxide] for a week along with my other painkillers, followed by Phenergan [promethazine hydrochloride] when needed as I came off the Librium. I came out of the inpatient addiction unit and started to change my life. The first six months were a really slow process with regard to my bladder healing itself. It started becoming manageable six months after my last ketamine use, but it continued to be very sore and painful at times. I have to drink plenty of fluid and avoid caffeine. My bladder capacity is slowly improving but I had to wear absorbent pads at work for a long time and struggled with waking frequently in the night to go to the toilet. I am now two years clean from ketamine. My bladder and urinary functions are at about 80% of what I remember them to have been. I have not used any drugs since 10 months after my detox. I still have to drink a lot. If I do think about using ketamine, it doesn't take long to remember what it did to me.

Exp Year: 2012	ExpID: 94983
Gender: Not Specified
Age at time of experience: Not Given
Published: Feb 21, 2012	Views: 16,356
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Ketamine (31) : Various (28), Health Problems (27), Preparation / Recipes (30)