Club Drug... "Special K" Could leave users incontinent...

[Lucinda F. Boyd]

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, is slated to report its finding Sunday in San Francisco at the annual meeting of the American Urological Association.

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 anesthetic 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 percent reported cocaine use, while nearly 40 percent 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.

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.

More information

There’s more on ketamine and other ‘club drugs’ at the U.S. National Institute on Drug Abuse.

SOURCES: Adam Bisaga, M.D., associate professor, psychiatry, Columbia University, and addiction psychiatrist, New York State Psychiatric Institute, New York City; Marc Galanter, M.D., director, division of alcoholism and drug abuse, department of psychiatry, New York University School of Medicine, New York City; May 30, 2010, presentation, American Urological Association annual meeting, San Francisco