Ketamine: effects, bladder risks and harm reduction

What is ketamine?

Ketamine (“K”) is an anaesthetic used in human and veterinary medicine. Used recreationally, it’s mostly snorted. At low doses it gives a drunk, floaty feeling; at higher doses a dissociative state (feeling outside your body), the famous “K-hole”. It’s found at parties and, increasingly, in chemsex, sometimes combined with GHB or stimulants.

Immediate risks

According to Drogues Info Service:

• racing heart, high blood pressure, raising the risk of stroke or heart attack;
• blurred vision, headaches, hallucinations;
• muscle stiffness, body numbness, temporary paralysis: you can get hurt without feeling it, fall, drown in a bath;
• nausea and vomiting, dangerous if the person is semi-conscious.

During sex, numbness and dissociation stop you feeling injuries (fisting, long penetration) and from giving informed consent.

The bladder: the overlooked risk

This is the most insidious danger of regular use. Drogues Info Service and the French medicines agency (ANSM) describe severe urinary damage:

• ulcerative cystitis (serious bladder inflammation);
• very frequent, painful need to pee, blood in urine;
• incontinence, a shrinking bladder;
• kidney and liver damage with prolonged or high-dose use.

This damage can become irreversible if not treated early. If you use often and get burning or urgent peeing, stop and see a doctor: it isn’t necessarily a urinary infection.

Mixes to avoid

Ketamine with alcohol, GHB/GBL, opioids or benzodiazepines raises the risk of passing out, vomiting and respiratory depression (dangerous combinations).

Reducing the risks

According to Drogues Info Service:

• don’t share your straw (hepatitis C risk);
• never share a syringe;
• small, spaced-out amounts, sitting or lying down, somewhere safe;
• never alone, with someone sober; no baths or driving;
• limit frequency to protect your bladder;
• if someone passes out: recovery position and call emergency services (15 or 112 in France).

To talk about your use in France: Drogues Info Service, 0 800 23 13 13 (other resources).