Ketamine is Making You Piss Yourself and it Could Get Much Worse

Recreational ketamine use in Aotearoa, New Zealand, is increasing. Unfortunately for Kiwis, this could mean increased bladder disorders. 

Ketamine, sometimes referred to as a “horse tranquiliser,” is a medical drug that has dissociative and hallucinogenic effects. 

While its usage is hard to track, there are indicators that the drug has grown increasingly popular in Aotearoa, and New Zealand Customs Service saw a gigantic increase in ketamine border seizures from 2016 to 2021. 

Drug-checking organisation Know Your Stuff has also reported a significant increase in ketamine testing via their service with only four instances of ketamine reported in 2016-17 and 186 instances reported in 2020-21. 

Based on its wide availability via illegal dealers and its frequent appearances at parties and festivals, it’s fair to say ketamine has become common among young New Zealanders already engaging with illicit substances. 

And this increased use is set to cause some issues for kiwis. 

A new study, published today in the New Zealand Medical Journal from the Canterbury District Health Board, reports on international data showing ketamine use could lead to “irreversible damage to the bladder” such as ketamine-induced cystitis. 

Cases of ketamine bladder syndrome (KBS) were first reported in 2007 and have continued to be documented globally.   

In response to this, surgical procedures like cystectomy (removal of the bladder) and urinary diversion or augmentation cystoplasty (an operation that enlarges the bladder) have been reported as “necessary treatments.” 

So, if you’ve been having nose beers a little too often and are worried you could be headed for this fate, what do you need to look out for?  

Symptoms of KBS commonly affect the lower urinary tract, and according to the report, they include:

• urinary frequency
• urgency and nocturia
• associated dysuria or suprapubic discomfort.
• significant pain 
• urinary incontinence

Ketamine causes this affect on the bladder as it is metabolised in the liver, to eventually be excreted in urine. 

While the specifics of KBS are unknown, researchers hypothesise ketamine metabolites damage the layer of the bladder tissue (urothelial barrier) that prevents toxic substances from being absorbed.

When the barrier is damaged, it is more likely for bladder inflammation to occur. This can lead to an incompliant bladder and eventually chronic kidney failure if not treated. 

Studies on KBS have inferred that the “severity of  the  condition does appear to have a  positive correlation with ketamine exposure.” 

Which means, basically: the more ketamine you do, the worse the condition can get.