The pain can be so extreme that people need to have their bladders removed.
Scientists at the University of York’s Department of Biology have discovered a startling effect that recreational ketamine abuse has on the bladder.
Using ketamine can damage the lining of the bladder, enabling urine to seep into underlying tissues. This results in inflammation and extreme pain, and in some cases, the pain can be so severe that patients need to have their bladder removed — a procedure called a cystectomy.
Led by postdoctoral research fellow Dr. Simon Baker, the researchers decided to investigate exactly how ketamine has these effects — is this bladder damage caused by direct contact with urinary ketamine or does the drug cause a systemic change in the body that impacts the organ?
In collaboration with clinicians from Middlesbrough and Leeds hospitals, the team looked at a cystectomy case to study the epithelial cells — cells that line hollow organs and help protect or enclose them — around the bladder. They also looked at an urachus, which is an adjacent remnant of the fetal urinary tract that isn’t in contact with urine.
The results revealed that the epithelial cells lining the patient’s bladder were almost completely gone because they’d been killed and swept off into the urine. The epithelial cells from the urachus, on the other hand, were completely healthy.
This led to the revelation that ketamine has these devastating effects on the bladder due to direct contact with urine rather than a systemic change in the body.
In a second study, the researchers used epithelial cells from healthy patients to produce laboratory models and expose the cells to ketamine.
They observed that ketamine overwhelms the cell’s mitochondria, or internal power station, and causes a “catastrophic release of toxins,” as stated in the press release. In order to avoid this “melt-down,” the cells commit apoptosis, which is a controlled form of cell suicide that does not cause toxicity to other cells, in an attempt to protect the remaining tissue.
However, when it comes to ketamine abuse, all epithelial cells are killed.
"These two studies combine to demonstrate that direct contact with urinary ketamine causes significant bladder damage, and shows how this drug causes the death of previously healthy bladder cells,” said Baker in a press release.
“Understanding the full side-effects of ketamine is very important as other researchers are currently investigating the potential for this drug to spawn a new generation of anti-depressants."
Other scientists have raved about ketamine’s ability to treat severe depression, and some experts have gone so far to deem its potential antidepressant effects as the “most significant advance in mental health in more than half a decade.”
However, this study goes to show that there’s a lot more research to be done on the long-term risks of ketamine before it can be used as a potential treatment for depression.
In a concluding warning from the press statement, “Urologists advise anyone who experiences bladder pain when using ketamine to stop taking the drug immediately, as if too many bladder cells are killed there will not be enough remaining to repair the tissue.”