Updated 18 March 2015

'Special K' club drug leads to incontinence

Long-term abuse of the recreational drug ketamine, often called "Special K" by the young partygoers who use it, is now linked to a heightened risk for pelvic pain and urinary incontinence.


Long-term abuse of the recreational drug ketamine, often called "Special K" by the young partygoers who use it, is now linked to a heightened risk for pelvic pain and urinary incontinence.

The finding is based on a 2009 survey conducted by a team of researchers out of Hong Kong. They questioned 66 male and female teen and young adult ketamine users (13 to 25 years old) about their drug experience.

Although almost half said they did not believe they were addicted to the drug, the authors found that those with a two-year plus history of ketamine abuse were subject to an increase both in pelvic pain and the urgent and frequent need to urinate.

Relative to less frequent use, those who took "K" more than five times per week also experienced reduced bladder capacity.

The team, led by Dr Siu-king Mak, the Hong Kong coordinator of the andrology section with the Hong Kong Urological Association, will report its finding Sunday in San Francisco at the annual meeting of the American Urological Association.

Ketamine actually used by vets

Ketamine is considered one of the so-called "club drugs," due to its popularity in nightlife rave settings. Sometimes also referred to as "vitamin K," ketamine's intended purpose is as a veterinary anaesthetic for use in animal surgery.

However, when used recreationally, the "dissociative" anesthetic - which is chemically related to PCP ("Angel Dust") -- functions as a hallucinogen, and can prompt euphoria, numbness, delirium and a sense of being disconnected from time and space. It can also disturb motor function, trigger high blood pressure and instigate respiratory distress.

Among those surveyed, just over half said they also engage in recreational use of the hypnotic drug "nimetazepam" (brand name Erimin). About 46% reported cocaine use, while nearly 40% said they smoke marijuana.

In addition to asking study participants to recount instances of pelvic pain as well as urination frequency and urgency when taking ketamine, Mak and his colleagues conducted kidney ultrasounds, urine flow analyses and bladder scans.

On a positive note, patients who stopped taking ketamine experienced a continuous dissipation of such symptoms over time, the researchers said.

Drug use is widepsread

Dr Marc Galanter, director of the division of alcoholism and drug abuse in the department of psychiatry at New York University School of Medicine in New York City, believes ketamine use is widespread.

"Ketamine is not that uncommon as a drug of abuse among young people," he said. "Even though its use should be restricted to veterinary situations requiring anesthesia, young people do get a hold of it, and inject it intramuscularly and get high. So it is a significant issue."

"Now, it is unusual to have people abusing it as frequently and to the degree reported in this study," Galanter noted. "So this finding concerns a select population. But there are certainly people where this kind of complication might come into play."

But Dr Adam Bisaga, an associate professor of psychiatry at Columbia University, as well as an addiction psychiatrist at New York State Psychiatric Institute in New York City, believes use of Special K may not be rampant.

"My take on this is that ketamine use as a whole is not a big public health problem, in the way that cocaine, marijuana, and opiate abuse are," he said. "Yes, this sort of complication with K can happen. It can certainly be an issue for some patients. But it's not honestly something that has been occupying the attention of most drug abuse treatment providers."

Galanter said ketamine abuse remains a troublesome problem, however. "I would say that ketamine has always been a bad idea," he stressed. "And this is just one more reason that it clearly is a bad idea. - (HealthDay News, May 2010)


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Prenevin Govender completed his MBChB at the University of Cape Town in 2001. He obtained his Fellowship of the College of Urologists in 2009 and graduated with distinction for a Masters in Medicine from the University of Cape Town in 2010. His special interests include laparoscopic, pelvic organ prolapse and urinary incontinence surgery. He consults full-time at Life Kingsbury Hospital in Claremont.

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