drugs: ketamine more dangerous than pot or xtc

http://www.guardian.co.uk/society/2009/nov/22/teenagers-ketamine-health-risk

Teenagers risk kidney failure in drug craze

Ketamine causes irreversible damage, fear GPs

Diane Taylor and Denis Campbell

The Observer

Sunday 22 November 2009

Ketamine, a powerful tranquilliser used on horses, is being taken in growing number by young people in the UK, causing crippling health problems.

Some addicts have needed to have their bladders removed and must now wear catheters. Other users have suffered serious kidney problems, breathing difficulties, addiction, bouts of unconsciousness and trouble with urinating. The drug also involves a heightened risk of heart attack.

Some users also end up with cocaine-style damage to the inside of their nose, because the drug is often snorted in powder form, though it can also be injected, taken as a pill or swallowed as a liquid.

Experts say ketamine is increasing in popularity partly because it is cheaper than cocaine and, as the purity of cocaine falls, gives a more reliable high. It usually sells for about half the price of cocaine, at about £20 per gram, but can be obtained for as little as £5 a gram. "The quality of heroin and cocaine is so poor that people are turning to ketamine, which is cheap and available," said Dr Chris Ford, a GP and the clinical lead for substance misuse management in general practice in the London borough of Brent.

Dr Angela Cottrell, a urologist attached to the Bristol Urological Institute at the city's Southmead Hospital, has studied the health problems caused by ketamine. She saw her first patient with severe bladder problems in mid-2007 and has seen a growing number of cases since. "About one-third of ketamine users develop severe problems with the drug. There's something about the way that it's metabolised that is causing these problems," said Cottrell.

"One of the most alarming things is that the long-term effects on the body are not known. We don't know if things get better over time or whether people will develop kidney failure in the long-term." The damage to vital organs may be irreversible, Cottrell warned.

Ketamine is both a stimulant and an hallucinogenic. In 2007, Professor David Nutt, recently sacked as the chairman of the government's drugs advisory panel, published research in The Lancet which ranked ketamine as the sixth most harmful substance out of 20 studied. It came behind heroin, cocaine, barbituates, street methadone and alcohol, but ahead of cannabis and ecstasy, in 11th and 18th places.

The drug is known as K, Special K and, because of the youth of many users, "kiddie smack". The Addaction specialist drugs service in Lincoln sees about 200 children under 18 every year. In 2007, none said they used ketamine. Between June and November 2008, one teenager said it was their main drug and six said it was their secondary choice, usually behind alcohol or cannabis. But in the same period this year, four 15- to 18-year-olds said it was their preferred way of getting high, and 15 as their next most favourite.

Elliot Elam, of Addaction, said: "It's not an epidemic, but it is an emerging trend. There's a new generation for whom ketamine use is acceptable."

According to the British Crime Survey, only 1.8% of people in England and Wales have ever used ketamine, but that figure is doubled among 16- to 24-year-olds. It estimated that 113,000 people used it at least once in 2007-08. Research published last week in the journal Addiction blamed the drug for memory loss and mild delusions.

A "normal" dose of ketamine is 60mg to 100mg, but some users are taking 5g or 10g a day. Twenty-three people are believed to have died between 1993 and 2006 after walking into traffic and risking other dangers after losing their sense of reality.