If You Do Enough Ketamine, You Might Piss Blood

As more Americans party with ketamine, an organization that tests drugs at music festivals is warning that frequent use can damage people’s bladders and even cause them to urinate blood. 

In a recent Twitter thread, harm reduction group Dancesafe said it was concerned about the scale and regularity of ketamine consumption in “various party communities.”

A mainstay of the British rave scene, the dissociative drug ketamine has never reached mainstream popularity in the U.S. But Dancesafe and other experts told VICE News the drug is experiencing a boom in the U.S. festival circuit and beyond, as more people report doing it—and experiencing bladder issues. 

CALLOUT: Are you a frequent ketamine user in the U.S.? We’d like to hear from you. Email manisha.krishnan@vice.com 

“Ketamine bladder cystitis is very real and quite dangerous, and it's possible to start using ket compulsively. Keep these risks in mind as you self-moderate,” the group wrote on Twitter. 

Bladder cystitis refers to chronic bladder problems, which can include frequent and painful urination and blood in the urine. According to a recent VICE World News documentary, ketamine damages the epithelial cells of the bladder lining, which are designed to hold urine. That can scar the inner layer of the bladder walls and reduce its ability to expand. While the bladder can repair itself, prolonged and frequent ketamine use can create permanent damage, and in some cases, people need their bladders removed, the documentary found. 

Five years ago, Dancesafe’s drug checking tents at festivals would see one or two people turn up a day with ketamine to test—“now it’s dozens,” Sferios said. 

“It’s crazy that so many people are using it as often as they are,” he added. 

Medically, ketamine is used as an anesthetic for both animals and humans, though more recently it's being used to treat a variety of mental health conditions.

But there’s a lot more discussion about the different types of ketamine online. Sferios believes the dark web, the surge in popularity of synthetic drugs and the ease with which people can make them, and the mainstreaming of ketamine-assisted therapy, are all contributing to its increased popularity.

But ketamine use remains rare in the U.S., with less than 1 percent of the general population using it in the last year, according to Joseph Palamar, an associate professor of population health at New York University’s Grossman School of Medicine. His study, published in the Journal of Public Health, however, has found that among nightclub and festival attendees in New York, the number of people who reported using ketamine in the previous year went from 5.9 percent to 15.3 percent between 2016 and 2019. 

Ketamine seizures by law enforcement also went up, the study found, suggesting more of it is around. Palamar said his new research found an 81 percent increase in calls to poison control over ketamine between 2019 and 2021, though he said reports of ketamine poisonings are still rare. 

“I’m now hearing mainstream songs with lyrics about ketamine use and K-holes and I’m seeing scenes in teen movies with groups of people sniffing bumps of K,” Palamar said. “To me, this means ketamine use today is no longer limited to club scenes.” 

People like K for a bunch of reasons, according to Sferios —it can be introspective, there’s no comedown, and people don’t get physical withdrawal symptoms. And even when users experience bladder issues, more ketamine will take the pain away. They may not even realize the drug is causing their bladder discomfort, he added.  

“You don’t experience repercussions right away,” he said. 

But even without physical withdrawal, people can develop problematic use of ketamine. 

Sferios said one of his acquaintances recently went into recovery after years of using a couple grams of ketamine daily. He was told he could lose his bladder if he kept up at that pace. 

Jack, one of the subjects in the VICE World News documentary, said he’s been using two to three grams of ketamine a day for the last 14 years. 

“I’ve been pissing white cells, red cells, due to horrendous ketamine abuse,” he said, noting that some of his friends now have urostomy bags, which collect urine outside of a person’s body once their bladder has been removed. 

Sferios said people should remember that bladders can regenerate but it takes time for them to heal.

“If someone does start experiencing lower urinary tract symptoms and is using ketamine a lot, the most important thing to do is quit the ketamine or seriously reduce your use.” 

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