Drugs This article is more than 13 years oldThis article is more than 13 years oldAs the government prepares to classify mephedrone as a class B drug, Dina Rickman uncovers the dangers of young people's current drug of choice; KetamineThree teenagers are huddled over a CD case in the corner of a Brighton squat. Rave music blares from the soundsystem as they cut lines of white powder from a crumpled wrap. Emily, the youngest of the group at 17, uses a £5 note to snort the largest line. She laughs, coughs a little, then passes the CD case to her friend. "This is just like Skins" she shouts, her voice barely audible over the pounding bassline. It could be any party, in any town in the UK. The powder is ketamine, a Class C dissociative anaesthetic which is also used as a horse tranquilliser. When taken, it causes euphoria and powerful hallucinations, with users reporting out-of-body experiences and conversations with god.
In 2008 the British Crime Survey revealed it was the fastest growing "party drug" among 16-24 year olds, leading it to be dubbed the "new ecstasy." It now boasts an estimated 125,000 users in the UK and more users among young people in England and Wales than heroin and crack cocaine combined.
But as the number of users rise, serious side effects are beginning to emerge. On internet forums for clubbers the stories all started the same. After about three months of regular use people were experiencing strange side effects; incontinence, blood in their urine and urine infections that did not respond to treatment.
By May 2008, doctors from the Bristol Urological Institute (BUI) became concerned. They published a letter in the British Medical Journal reporting they had seen nine patients with severe urological symptoms associated with ketamine use over the last two years. The letter warned that these cases were "the tip of the iceberg." It was right. Since then, 15-20 people in the area have been put forward for bladder stretching, a surgical procedure performed under anaesthesia. Two users in their 20s had to have their bladders removed because they had incurred so much damage from the drug.
Daniel, a 21-year-old heavy user from Brighton knows his body is beyond repair. Doctors have told him that drug abuse has given him the bladder of an 80-year-old, and he needs to have it surgically stretched, but he cannot stop taking Ketamine.
"I've got a fixation, I just think 'one more line.' I'll go for a piss it will literally be a tablespoon's worth of urine. I'll piss out slugs of blood, like congealed jelly and the pain is horrific. It feels like a ball with loads of spikes just bouncing on your bladder. During a bad week I will go to the toilet every five minutes. I was in the job centre once having an interview and I had to stop halfway through because I was sitting there bursting."
Also known as K, special K and wonk, can sell as cheaply as £6 per gram in the South West. But few of its users will have heeded the warning on the government's drug website, Frank, of "serious bladder and related problems found in ketamine users."
Jess was 18 when she began taking ketamine. Two years later, she was wandering the streets of Bristol, high and covered in her own blood: Now 21, her health is a constant reminder of her drug use. She regularly suffers from cystitis because of the damage done to her bladder, and was hospitalised three times from kidney infections during her time on the drug. She also suffered from "k cramps", severe stomach pains associated with ketamine use. She says that the only cure for the cramps was talking more ketamine – trapping her in a vicious cycle of drug abuse and self harm:
"It started off as very small amounts, when you start using K it's very attractive, it's cheap and the effects are strong."
A leaflet circulated by the Bristol Drugs Project (BDP) and the BUI to GPs in the south west warns: "the symptoms can be severe enough to require hospitalisation... and can result in irreversible bladder and renal damage. Although commoner among those who use ketamine daily or at high doses, it can also occur with lower dose recreational ketamine use."
The possibilities worry Jess, especially as she knows of 14 and 15 year olds injecting the drug:
"It's really, really scary. One of my friends got really wasted on ketamine and walked into the sea and drowned themself. It can have a massive effect on your mental state. When I was a heavy ketamine user I spent most of my time in my room on my own self harming. I tried to give up many, many, many times. The only way I managed to do it was to get out of the country."
Dr Rachel Ayres, from the BDP, said urinary symptoms associated with ketamine use were becoming more widely known in the medical community as more people are abusing it:
"These problems are not due to contamination of ketamine, and they still develop even when you inject it rather than snort it. Some users think that damage is due to contaminated drugs but we think these problems are due to ketamine itself." Ayres emphasises that the users who had to have their bladders removed or stretched were at the severe end of the scale: "You have to be really bad to be referred to a urologist, and not everybody is."
Nate, 24 from Milton Keynes didn't go to see a doctor, even when he couldn't sleep through the night because he had to use the toilet so frequently. Charlie, 24, a student from Brighton also didn't seek help when he had the same problem. He says there needs to more preventative education about ketamine's effects:
"It's such a massive epidemic, it's something that you can get on any street corner. When ecstasy came onto the party scene there was a furore but there hasn't been for ketamine even though young people are destroying their bodies."
Young people like Emily, the 17-year-old at the squat party in Brighton who snorted the largest line. She's notorious on the Brighton party scene now - not for her hedonism or youthful charm, but for being incontinent.
*Some names have been changed
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