Hospitals across England and Wales are witnessing a concerning spike in serious bladder problems among teenagers and young adults, with medical experts linking the condition directly to recreational ketamine use.
Alarming Rise in Hospital Admissions
Urology departments have reported a significant increase in admissions for bladder inflammation among 16 to 24-year-olds. This troubling trend appears to coincide with a wider rise in ketamine abuse, evidenced by a substantial jump in the number of adults and teens entering treatment programmes for ketamine dependency last year compared to just a few years prior.
The symptoms suffered by these young patients are severe and life-altering. They include frequent and painful urination, an urgent and uncontrollable need to pass water, night-time incontinence, leakage, and blood in the urine. In the most severe cases, the damage can be permanent, making daily life extremely difficult.
From Anaesthetic to Recreational 'K'
Ketamine was first approved for human use as an anaesthetic in 1970. More recently, low-dose applications have been studied for potential antidepressant effects. However, its recreational use has grown significantly. The drug is a powerful dissociative, creating feelings of detachment from oneself and one's surroundings, alongside hallucinogenic, stimulant, and pain-relieving effects that typically last one to two hours.
Users commonly snort or smoke powdered ketamine, or inject the liquid form. Snorting tends to produce the strongest and most immediate effects. Regular users can develop a rapid tolerance, often needing to double their dose compared to occasional users to achieve the same high, as the body becomes more efficient at breaking the substance down.
The Devastating Impact on the Bladder
Frequent, high-dose ketamine use inflicts serious and sometimes irreversible damage on the bladder, urinary tract, and kidneys. The first documented cases emerged in Canada in 2007, involving nine recreational users with severe bladder issues. A later, larger study in Hong Kong identified the same problems in 59 people who had used the drug for more than three months.
The harm occurs because ketamine is metabolised and excreted through urine. Its toxic by-products irritate and damage the lining of the urinary tract. The bladder, which stores urine for the longest period, is affected first. Over time, it can shrink and stiffen, while the tubes connecting the kidneys (ureters) can narrow and become misshapen, described by doctors as resembling a "walking stick." This can lead to a dangerous backup of urine into the kidneys, a condition known as hydronephrosis.
Ketamine also increases oxidative stress, killing bladder cells and breaking down the protective lining. This leaves the bladder leaky, overly sensitive, and painfully overactive.
Stages of Damage and Treatment
Medical professionals outline the damage in three progressive stages. In the initial stage, inflammation can often be reversed by stopping ketamine use and taking anti-inflammatory drugs, pain relievers, or medications to heal the bladder lining.
The second stage involves bladder shrinkage or stiffening. Treatment may involve bladder washes, where medication is delivered directly via a catheter to coat and repair the lining, or Botulinum toxin injections to relax the organ and reduce pain. Cessation of the drug remains critical.
In the final stage, permanent damage occurs to the bladder and kidneys. Kidney failure can develop, potentially requiring dialysis or major reconstructive surgery. In the most extreme cases, complete removal of the bladder becomes necessary.
Despite being a Class B drug since 2014, ketamine remains affordable and accessible in parts of the UK, sometimes costing as little as £3 per gram. Health experts stress that raising awareness of these severe and specific health risks is essential to curb this growing public health issue among young people.
