It costs little and is easy to find, even on social media, but it can wreak havoc on the bodies of very young people. The latest health emergency shaking the United Kingdom concerns the use of ketamine among minors, a phenomenon that has forced doctors at the Alder Hey hospital in Liverpool to set up the country’s first multidisciplinary clinic for boys and girls under 16.
The “Ketamine Bladder”
The objective is to cure the damage of the so-called “ketamine bladder”, a serious pathology that affects the urinary tract with effects that doctors have defined as “devastating”. As shown by the data collected by the pediatric hospital after the first year of the clinic’s activity, the excessive and continuous use of ketamine causes very serious biological damage. Ketamine and its metabolites remain inside the bladder for a long time, where they corrode and destroy the internal lining and muscle tissue, causing deep ulceration and fibrosis. The symptoms of this pathology are totally disabling, as they include a continuous urge to urinate, loss of control and the presence of blood in the urine. In severe cases, young people are forced to use incontinence pads and diapers and urinate in buckets placed next to the bed at night because they cannot reach the bathroom in time.
Alder Hey hospital data
The results were analyzed by Dr Harriet Corbett, a pediatric urologist at Alder Hey, and Professor Rachel Isba, a specialist in pediatric public health medicine. The data, which concerns approximately 60 minor patients treated in the facility, were also published in the journal Archives of Disease in Childhood of the British Medical Journal group. The medical team also identified some recurring patterns. In fact, 70% of the children and young people cared for come from the most socioeconomically disadvantaged communities in England; furthermore, 72% had traumatic childhood experiences, while 20% grew up or are in foster homes.
First contact at 13 years old
The data on the precociousness of the phenomenon are shocking: the average age of the first report is around 14 and a half years, but the first contact with ketamine often occurs earlier, around 13 years of age. The early intervention, as underlined in the study, immediately showed its effects: 12 patients in the sample have already been discharged and, after completely stopping taking ketamine, they found a clear and progressive improvement in their urological symptoms.
“Devastating damage”
A worrying phenomenon, which must be countered in time, as underlined by Dr Harriet Corbett, consultant pediatric urologist at Alder Hey: “Ketamine-induced uropathy is a very serious bladder problem associated with the chronic use of this substance. It can cause significant pain and long-term health consequences. This first year of analysis has highlighted the importance of understanding the young person beyond the diagnosis. By examining factors such as age, place of residence, context and life experiences, we can begin to build a picture much clearer about who is affected and how we can best support them.”
“The damage caused by ketamine can be devastating,” added Corbett. “It can affect the bladder wall, causing ulceration and fibrosis, and the effects can be irreversible. Young people can suffer from chronic bladder pain and incontinence and, in severe cases, may need major surgery or dialysis. But this problem is preventable. Better understanding the young people who come to us is an important step in preventing further damage.”
The big picture
As Professor Rachel Isba, consultant in pediatric medicine, explained, it is crucial to know the big picture: “It is one of the most important aspects of this work. Ketamine use does not happen in isolation and our analysis is helping us to explore the different factors that may be associated with the development of serious health problems in young people. We looked at characteristics such as age, geographical background and experiences such as childhood trauma. These findings give us a much better understanding of the young people attending the clinic and raise important questions about how we can intervene early and develop services Our approach is free of prejudice. We want to offer young people a safe space to talk about what is happening in their lives and work with them to develop a plan to help them stop using ketamine and prevent further harm.”
In their conclusions, the research team from Alder Hey hospital highlighted the need to consider ketamine-related bladder damage no longer as a simple and isolated urological problem, but as the alarm bell of a profound and dramatic social and psychological distress that requires an adequate healthcare response.