Ketamine addiction, and ketamine bladder and induced cystitis

You have been diagnosed with ketamine bladder and ketamine-induced cystitis. This leaflet aims to help explain the following.

• What ketamine and ketamine bladder are.

• What the long- and short-term affects of ketamine use are.

• How ketamine bladder and ketamine-induced cystitis are diagnosed and treated.

• Where you can ask for help.

We hope this leaflet answers some of the questions you may have. If you have any further questions or concerns, please speak to your GP or contact the local addiction services in your area.

Your local drug and alcohol service providers, can offer impartial advice. They are available 24 hours a day, 7 days a week. Local addiction services are listed in the Further information section at the end of this leaflet.

What is ketamine?

Ketamine is a class B drug. It is also known as; Ket, Kit-Kat, horse tranquiliser, Special K, and Super K.

Ketamine is often sold as a grainy white / brown crystalline powder. The powder can be added to drinks or snorted. Users can also take it orally, wrapping the powder in cigarette paper and swallowing it. Some users inject ketamine into a muscle.

Ketamine was known as a 'fringe club drug'. Its use as a horse tranquiliser gave it a dirty or extreme reputation. However, it is now being used more often by the younger generation as a way of chilling out. With more recreational use at home.

Ketamine is considered a very powerful dissociative drug. Dissociative drugs are classified as a subclass of hallucinogens. They can distort the user’s vision and hearing, leading to detachment from reality, the environment, and one’s own body.

Dissociative states often lead the user to experience an out-of-body transient state, also known as “k-holing”. When this happens, the user falls into an endless void of consciousness. This is a state that most users either fear or desire.

What are the side effects of ketamine use?

The risks of frequent “k-holing” can have psychological side effects on episodic and sematic memory.

• Episodic memory is used for every day happenings, time, emotions, location, and any other day-to-day information. For example, episodic memory is the ability to remember how to pick up and stroke a rabbit. When ketamine affects this type of memory, it makes it hard for the user to distinguish between fact and fiction.

• Sematic memory is the knowledge that we learn from our experiences and events. Happenings which inform memories that we can relate to. For example, what a rabbit is.

The short-term effects of ketamine can cause the following symptoms.

• Body tremors.

• Addiction, leading to long-term dependency on the drug.

• Anxiety (feeling worried all the time).

• Numbness, especially to the mouth and tongue.

• Abdominal (stomach) pain, known as k-cramps.

• Nausea (feeling sick).

• Euphoria (intense excitement and happiness), which can lead to aggression.

• Risk of accidental overdose.

• Insomnia (not being able to sleep).

• Respiratory depression (dangerously low breathing), which can lead to respiratory cardiac arrest.

• Urine (pee) incontinence (you wet yourself).

The long-term effects of using ketamine daily include the following.

People who are long-term dependent users of the drug may find withdrawal symptoms incredibly over whelming. They may experience some, if not all of the symptoms listed below.

• Memory impairment / loss.

• Addiction / dependency on the drug.

• Kidney disease (ketamine-induced cystitis, blood in your urine).

• Abdominal (stomach) pain, known as k-cramps.

• Heart palpitations. Feeling a rapid, pounding, fluttering, or irregular heartbeat. Often felt in the chest, throat, or neck.

• Excitotoxicity is where neurons are damaged or killed by excessive stimulation from neurotransmitters. Symptoms include persistent headaches, long-term tiredness, memory loss, and vertigo (feeling dizzy)

• Intensified pain when stopping ketamine use.

• Psychosis (losing contact with reality) and hallucinations (seeing things that are not there).

• Seizures.

• Liver and kidney problems.

• Urgency in needing to urinate (pee) a lot. A greater risk of urine infections.

• Variations in blood pressure.

• Urine incontinence (you wet yourself).

• Pain when you urinate. Wanting to go to the toilet more often than usual.

What increases my risks of getting these side effects?

• Using ketamine daily over a long time.

• Using ketamine in large amounts.

• Using ketamine often.

* Remember if you only use ketamine occasionally, it can still cause bladder problems.

What is ketamine bladder? 

Ketamine bladder is a condition linked with long-term ketamine use. People with the condition:

• need to urinate more often;

• often pass only small amounts of urine (pee), frequently throughout the day; and

• are more at risk of urine infections and incontinence.

Ketamine damages the bladder, causing inflammation (cystitis) and ulceration. This is a similar sensation to the sore ulcers that you may get in your mouth. It happens because ketamine is toxic to the urothelial cells in the urinary system, and will eventually damage them.

Urothelial cells line your urinary tract, bladder, kidneys, ureters, and your urethra. The cells prevent urine from damaging the underlying tissues, and allow the bladder to expand naturally. So, when you drink your bladder allows you to hold your urine in, and not wet yourself. Ketamine damages these cells, leading to ketamine bladder. 

What are the symptoms of ketamine-induced cystitis?

Toxicity from ketamine use over a period of time, can destroy the urothelial cells. If this happens it may lead to irritation, and cause ketamine-induced cystitis. The effect of this may lead to some of the following symptoms.

• Terrible pain in your kidneys and bladder. Pain may also affect other organs / glands within the body.

• Inflammation in your kidneys and bladder.

• Blood in your urine.

• Sensitivity, feeling very uncomfortable, and at times continuous pain.

How is ketamine-induced cystitis diagnosed?

• A physical examination in the Emergency Department.

• Urinalysis (testing your urine) in the Emergency Department.

• A bladder ultrasound, possibly in the Emergency Department or as an outpatient.

• Urodynamic studies, which are a series of tests. These tests check how well the bladder and urinary system are working. Patients usually have these tests as an outpatient. If needed, the specialist urology doctors and nurses will explain these tests further.

• During a cystoscopy, a small flexible instrument called a cystoscope, is inserted into your urethra. Patients usually have this procedure as an outpatient.

Can ketamine-induced cystitis be treated?

Your healthcare provider can suggest how to help with ketamine-induced cystitis. They will also tell you when a referral to specialist services is needed.

There is no cure for ketamine-induced cystitis. However, you may be able to manage your symptoms and address serious problems as they arise. Below are some treatments or changes that may help.

• Behavioural changes, therapy, and pelvic floor exercises.

• Do not take further ketamine. Speak to a health professional before doing this or ask for a referral to your local community drug service.

• Take painkillers (such as paracetamol) and anticholinergic medications (such as amitriptyline). Do not take these without the advice of a health professional.

• Buscopan (hyoscine) may help with both bladder cramps and pain. You can buy Buscopan over-the-counter at your pharmacy. Please talk to your pharmacist who will tell you if Buscopan is suitable for you.

• Have warm baths or place a warm hot water bottle on your tummy.

• Medications given directly into the urethra can help reduce inflammation and pain. To be advised by a health professional only.

• Hydrodistension is where the bladder is filled with fluid. This stretches the bladder and helps symptoms of ketamine-induced cystitis. To be advised by a health professional only.

• In severe cases, the bladder can be surgically removed (cystectomy). Surgery may be needed to help with your quality of life. To be advised by a health professional only.

You will discuss the above options with your Emergency Department clinician, before any treatment is started. If you have any questions, please ask them.

How can I reduce my risk of ketamine bladder damage?

• The only way to stop many of the health problems linked with ketamine is to stop taking it. However, this is easier said than done. Reducing your ketamine use is the first step to recovery.

  Ketamine rarely causes physical withdrawals, such as tremors, vomiting, or headaches. You may suffer more from psychological withdrawals. These withdrawals include altered moods and perception, and cognitive disfunction. Speak to a health professional about stopping / reducing your ketamine use. Health professionals include your doctor and community drugs services.

• You may need support with psychological and social care. This support can make quitting easier and more successful. Please speak to a health professional for advice.

• Avoid stimulating drinks, such as coffee, alcohol, and high energy drinks. These drinks can dehydrate you, and your withdrawal symptoms may become worse.

• Buddy-up with a friend or relative who can watch over you.

• Avoid over-stimulated environments. Make sure that when you are resting, your room is well-aired and at a comfortable temperature for you.

• Keep yourself hydrated with water, and / or peppermint tea / oil capsules.

When should I ask for medical help?  

Ask for medical advice from your doctor or the Emergency Department, if you:

• feel generally unwell;

• have a high temperature;

• have shortness of breath; or

• you can no longer urinate (pee).

Early help and advice can prevent serious health problems or psychological issues.

Further information

Below are some of the services available to help you quit, based on where you live.

• BeYou
  LGBTQ+ support for young people aged 8 to 25 years, living in Kent and Medway.
  Instagram: @beyoukent
  Email

• Change Grow Live
  Change Grow Live is a health and social care charity. They provide free and confidential treatment, support and information about drug and alcohol use, smoking, homelessness, justice and probation, and employment.

• Forward Trust
  Telephone: 0300 304 8007

• FRANK
  Telephone: 0300 123 6600

• Help 4 Addiction
  Help 4 Addiction’s experienced support team are always on hand to offer you the most personal and cost effective options available for alcohol and drug addiction treatment.
  Telephone: 0203 955 7700
  Email

• Kent and Medway Eating Disorder Service
  Telephone: 0300 300 1980
  Email

• Kooth
  Anonymous online mental health support for young people aged 10 to 25 years. Available 24 hours a day, 7 days a week.

• Release the Pressure
  Text: Kent to 85 25 8
  Telephone: 0800 107 0160 (24 hour helpline)

• Student Nightline
  Listening and emotional support information services, run by students.
  Telephone: 01227 824848 (8pm to 8am, Friday and Saturday)
  Email

• Thanet Safe Haven
  Mental health support for people over 16 years of age.
  Telephone: 07850 655 877 or 07483 918 233 (6pm to 11pm)
  Telephone: 0800 107 0160 (24 hour helpline)

• WithYou
  For under 17’s, also signposting for those under 21 years of age.
  Telephone: 01795 500881

[Web sites last accessed 13 January 2026]

References

• Administrator (2025). Could ketamine be ruining your bladder? [online] Drug Talk.

• Belal M, Downey A, Ali A, et al. British Association of Urological Surgeons Consensus statements on the management of ketamine uropathy. BJU International 2024.

• Beerten SG, Matheï C, Aertgeerts B. Ketamine misuse: an update for primary care. British Journal of General Practice 2023; 73 (727), 87–89.

[Web sites last accessed 11 February 2026]

What do you think of this leaflet?

We welcome feedback, whether positive or negative, as it helps us to improve our care and services.

If you would like to give us feedback about this leaflet, please fill in our short online survey. Either scan the QR code below, or use the web link. We do not record your personal information, unless you provide contact details and would like to talk to us some more.

If you would rather talk to someone instead of filling in a survey, please call the Patient Voice Team.

• Patient Voice Team
  Telephone: 01227 868605
  Email