All drug use comes with potential risks and side effects. Even seemingly harmless drugs like ibuprofen and Advil come with a list of possible outcomes to be aware of before use. Psychedelic drugs are no different, so it’s essential to understand all potential consequences to be as prepared as possible for a safe and pleasant experience. Ketamine is becoming increasingly popular as both a party drug and for use in clinical settings to address various mental health conditions, including treatment-resistant depression. In addition to the psychological effect, large quantities can also put a heavy burden on the body when taken consistently for long periods of time. Liver injury, ketamine cystitis, and k-cramps are all potential side effects.
What Is Ketamine?
Originally discovered in 1962, ketamine was first used as an anesthetic during the Vietnam War. Over the last 50 years, ketamine has gone from a surgical drug to a popular veterinary anesthetic, pain reliever and sedative. Presently, doctors are using ketamine to combat treatment-resistant depression in humans. Ketamine belongs to a class of drugs called dissociative anesthetics. This family of drugs includes PCP and DXM, which along with ketamine, can produce mind-altering effects when taken in large doses. Ketamine has several nicknames, including Special K, Vitamin K, and Kitty.
When used in a clinical setting, intravenous injection is the most common route of administration, however, a nasal spray was recently approved for use by the FDA in 2019 to work as a fast-acting antidepressant. People typically consume ketamine intranasally for recreational purposes, where the powdered substance is snorted in “bumps” or “lines” similar to cocaine use.
Ketamine: A Psychedelic Experience
The effects of ketamine can have a wide range of possible outcomes. A microdose can produce only a soft body buzz, but a strong dose can result in a k-hole. When the user enters a k-hole, the likelihood of a more extended comedown period with residual effects may increase. Additionally, the more ketamine one consumes, the greater the possibility of uncomfortable side effects, such as k-cramps.
Ketamine users often refer to a ketamine trip as a “ketty wonderland,” an experience steeped in euphoria and heightened sensations of bliss. As a dissociative, it can alter one’s perception of time and space, producing a trance-like state that may seem like a dream. Feelings of detachment dissipate during the ketamine comedown, and psychological effects vary from person to person. Type of ketamine, dosage and body composition all play a role in the results. No two experiences are the same in effect. However, there are particular side effects commonly reported among frequent users.
What Are K-Cramps?
Long-term ketamine users report occasional, yet severe, stomach pain when using ketamine. These are called k-cramps, and no one is certain what causes this to happen. Up to one in three long-term users report this feeling.
One user reports in an article for The Guardian:
“One day, on a train, I had my first cramp attack; I thought my lung had collapsed. I went to a doctor, who told me to stop taking K or I would die, but then an older user told me not to worry, it was “just K cramps”. He said that they wouldn’t kill me, but I might wish that they would. Apparently they could last for days.”
K-cramps remain largely mysterious, though research is attempting to understand this side effect, its root cause and other complications associated with overusing ketamine.
How Common Are They?
A 100-person study on ketamine’s effects on the liver, bladder, and intestines produced the following results: “Colicky epigastric/abdominal discomfort in ketamine users, known as ‘K-cramps’, has been reported in 33.3% of frequent ketamine users, and is the second-most common symptom of presentation (21%) among ketamine users in the emergency department.”
The study description goes on to say that the underlying causes of the abdominal pain remain poorly understood, and that perhaps persons affected have an intestinal motility disorder, and that ketamine interferes with gastric motility in general. There is also a potential correlation between k-cramps and ketamine-related liver dysfunction, which affects 16% of users. However, no definitive cause is known.
Researchers have studied ketamine’s effects on the liver for patients who undergo ketamine infusion therapy. The results show elevated liver enzymes that return to normal several weeks after stopping the ketamine infusions. However, these results led researchers to consider what, if any, the long-term consequences may be. It’s hard to say for sure what kind of damage prolonged, frequent use of ketamine can do to the liver. Frequent use of ketamine is generally referred to as the nearly daily use of ketamine in high doses — often the outcome of administering ketamine without any professional, medical supervision or guidance.
Another potential complication of overusing ketamine is referred to as ketamine cystitis. The term was coined in 2007 to describe the side effect of ketamine that causes bladder infections. Prolonged use can cause ulcers and, even worse, may shrink and stiffen the walls of the bladder. Some theories suggest that this is the associated pain that results in k-cramps.
“I’ve had issues with K-cramps and have done research into it. It appears that Ketamine associated urinary tract dysfunction (KAUD) can cause hydronephrosis in the kidneys. Hydronephrosis is when excess water builds up in the kidneys due to reduced urine flow from the kidneys to the bladder. This swelling of the kidneys can cause massive pain and is likely the cause of the so called “K-Cramps.”Reddit user Onefourbeedeeoh
Users suffering from ketamine cystitis may experience pressure, pain, incontinence, an urgency to urinate and blood in the urine. If left untreated, this condition may result in irreparable damage to the bladder and kidneys.
Serious medical concerns need to be addressed by a doctor, and in any situations where extreme pain or blood in the urine are present, please seek medical attention. For anecdotal purposes, several ketamine users have offered the following advice for soothing k-cramps:
Drink plenty of fluids, preferably water. This is good advice for anyone using ketamine, as ketamine has the potential to dehydrate the bladder. Stay hydrated with clear liquids and urinate frequently. Avoid carbonated beverages.
Use a Hot Water Bottle
Place a hot water bottle on the stomach and reheat as needed to help calm down cramping and reduce pain. A hot shower or bath may also help, although it is not advised to take a bath while using ketamine. Since ketamine can have a sedative effect, there is a risk of drowning.
Drink Green Tea
Green tea contains EGCG, which acts as an anti-inflammatory and can help empty the bladder. Users also report that a hot beverage, in general, can alleviate stomach discomfort.
Take Magnesium and Potassium
Magnesium and potassium are well-known for helping to prevent cramping. They can be taken in capsule or tablet form, and magnesium is also commercially available in powdered form and may be mixed in to any beverage. Cashews, pumpkin seeds and spinach are also high in magnesium. Bananas, avocados, and potatoes contain high levels of potassium.
Of course, the ultimate recommendation if someone is experiencing harmful and painful side effects — stop using ketamine. Using ketamine medicinally and recreationally is not without risk. Consider personal health above all, and proceed with caution.
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RS Contributing Author: Holly Crawford
Holly is a lover of the written word. She enjoys telling stories about people, products, and ideas. With her roots deeply entrenched in the cannabis industry, she gravitates toward all things psychedelic with open-minded curiosity. If she isn’t musing in one of her journals, you can find her talking to her plants, studying business and spirituality, and performing all kinds of kitchen witchery. Holly lives in Seattle with her husband, stepdaughter, two cats, and a dog named Charlie. You can follow her on Instagram @m_sungreen.