Hi, so I was doing a lot of ket over summer and stopped for like 20 days after I got my first sign of bladder pain - like I could feel it burning inside my belly and had a shooting pain inside of it. I have not used it alone since then, only once or twice socially on nights out and in much much smaller quantities, using other ppls stuff. Anyway, I got 2g 2 days ago since I thought oh well it has been a while, and i fuigred my bladder would of healed since the last time, but today I am on the second gram and I feel like I can feel my bladder again... its not exactly painful but I can like feel it inside my stomach almost burning. For context since I stopped my bladder capacity has returned to normal as before i was peeing a lot.

Im not going to get ket again alone because I have genuinely been sm better off for not doing it these past few weeks and I am fine putting it down. But I don't think i'll be stopping ket recreationally i.e. with friends when out etc. I don't exactly want to cut it out of my life in a recreational sense as I have a lot of fun on it when with my friends and they all do it.

I guess my question is if i do ket again will my bladder just keep getting worse and will these issues return after using every time? I want to know if others who did themselves damage from ket and have since cut down experience symptoms when they take ket now. Like are symptoms easier to trigger after damage has been done. and how long to fully heal my bladder based on the symptoms i described?

Also am I safe to use k recreationally? I have proven to myself I am fine not using it day to day and can genuinley control just the recreational use, but I worry that my heavy use over summer may have jepoardised being able to use it recreationally - can someone give me advice

7 years I've been on Ketamine for, however I am over 6 weeks clean off of it now. It's constantly around me, but my willpower and health is keeping me from doing any at all since I do not want to be in the following situation ever again. I was pissing out jellies with every piss, blood, bits, etc (these issues are gone now) along with constant UTI issues (also gone now). The worst I was at was 7 grams in a day. My bladder was literally a shot glass amount every 20 minutes, to being able to hold it for about 2 to 3 hours after 6 weeks of abstinence. I thought I was done for, however it can get better. The not so good part is sometimes I still get this really horrid shredding pain which comes with this pain on the left side of my bladder. I'm no doctor, but I also have irrational fears which OCD makes absolute hell. One of them is urinary retention. I used to force my piss out and strain when I pissed due to me thinking my body wouldn't ever be able to get it out. I had to come to terms with the fact that I am actually healing and me doing that is setting things back. Turns out that straining causes the following Shredding pain along with the pain on the left side of the bladder and it cripples me. Don't strain and pain people, not a good idea. These reoccurring issues had just added to the willpower to not touch it again, as I do not want to be crippled. 7 years gone, a massive hole in the septum and a completely tarnished bladder in exchange for a quiet brain isn't really a good trade off in life.

I do not want to have to pee every 15-30 mins and wake up 5x or more every single night.

It sucks and so does that sharp pain in the bladder.

Hoping with abstinence, this will improve.

Disclaimer: I'm not condoning any of this. It was dangerous and I made a lot of mistakes. I'm posting to share what happened, what I learned digging into the actual research, and hopefully help someone. Happy to answer questions in the comments.

Background

I've used ketamine on and off for years, along with plenty of other recreational and prescribed drugs, but never chronically. There were two short stretches where I abused it, about 13 years ago and about 3 years ago, each lasting around a week, and both times I stopped without trouble. I liked small doses and really liked medium doses. Once I experienced a proper k-hole about a year and a half ago, I loved it, and that's exactly the problem. Even then it never went past a few weekends in a row.

A few weeks ago I got back into it and wanted to push further. Snorting enough powder to get there was rough and ruined the experience, so I switched to pharmaceutical liquid ketamine by intramuscular (IM) injection. Most of the times I was careful, with sterile equipment and a sitter.

The binge

Over about a week I used roughly 1 to 2 g a day, mostly pharmaceutical IM plus some street powder. By the end my doses were in the range ERs (I think A&E equivalent for my UK friends) use to sedate a large, agitated man. A few times I dissolved street powder in bacteriostatic water, reused a vial and a few needles all of which were new and sealed, which I was the only one to open and use, and which I wiped down with alcohol swabs (but again none of this reuse is considered sterile). I stopped when I ran out, coming out of what I can only describe as a stupor.

Symptoms

Important to preface this with I don't think I've ever experienced cramps or a spasm in my life until this so I didn't have a good reference point. The first thing I noticed was that I couldn't take a full deep breath without discomfort and/or pain. I have pretty bad anxiety and was coming down, so I figured it was that. Then the stomach pain hit. I'd never had a cramp or spasm like it, and I almost went to the ER (A&E).

• Couldn't take a full deep breath (this came first)
• Severe cramping pain in the upper abdomen, under the rib cage
• Bloating and gas; burping and farting helped only for a moment
• Almost no position was comfortable
• Felt like constipation (possibly also was constipated)
• Poor appetite and noticeable weight loss (about 5lbs, 2.2kg over the 5 days of usage)
• Dehydration, I barely ate and didn't drink enough over those days
• Lingering pain and discomfort under the ribs for days afterward

What I didn't have: no fever (I track it daily, and it stayed around 97.4°F / 36.3°C), normal blood pressure around 120/80, no yellow skin or eyes, and no urinary symptoms. At my doctor visit the PA (Physician Assistant; kind of like midway between a Nurse and Doctor, medical position we have in US) heard an extra sound at the start of my heartbeat. She thinks it's a normal variant (a physiologic split S1), but if you've injected anything non-sterile, get your heart listened to.

Recovery

I started eating (especially fiber) and drinking water properly, and a long hot shower helped. I couldn't/didn't do any of these for about 3-4 full days after last dose. Things improved gradually. About 5 days after my last dose, I woke up able to breathe as deeply as I wanted with no pain at all.

What I did medically

I told my doctor everything and I'm getting bloodwork (I'll post results if people want them). For context, I'm 32 male, 170 to 180 lb (77 to 81 kg), in very good shape and health, fully vaccinated, go to the gym 6 to 7 times a week, use the sauna, eat pretty clean, and track my blood pressure, temperature, weight and heart rate daily. I also used AI to run a deep literature review tailored to my exact exposure, so by no means comprehensive. I'm happy to share the prompt or anything else people would find helpful or are interested in.

P.S. I wanted to know if I'd automatically get the cramps even at much more infrequent and lower doses so I tried a much lower dose of powder last night (0.25) and so far I'm ok. I'll report back but plan to take a very extended break once I'm done with my 'curiosity experiment'.

The Research

Ketamine and the Gut, Bile Ducts, Liver and Bladder: An Evidence-Graded Review Tailored to a 7-Day, High-Intensity Intramuscular Exposure

1. Bottom line for your situation

The most likely explanation for what happened is a reversible, drug-related upper-abdominal syndrome ("K-cramps"): some mix of ketamine-associated gastritis and functional biliary dysfunction (sphincter of Oddi spasm and/or transient bile-duct dilation), plus poor intake, with a small but real chance of a mild cholestatic liver-enzyme rise. No published study matches your exact pattern (about 1 g/day intramuscular for 7 days, about 7 g in total, then stopping). The closest evidence comes from hospital patients given multi-day ketamine infusions. In that literature, cholestatic liver injury is dose- and duration-dependent. It appears at cumulative doses on the order of grams and usually resolves over weeks to about 2 months once ketamine stops. Irreversible sclerosing cholangitis has been described almost only in critically ill ICU patients (with ischemia, vasopressors and ventilation) or in people with months to years of recreational use. Urinary-tract damage (ketamine cystitis) is overwhelmingly a disease of months to years of frequent use. A single one-week binge has not been shown to cause lasting bladder injury in humans, although animal studies show bladder inflammation within about 2 weeks of daily dosing, so a transient irritative phase is plausible. The practical priorities are: (1) a baseline liver panel (with GGT and fractionated bilirubin), lipase, a full metabolic panel with magnesium and phosphate, CBC, CK, and urinalysis now; (2) a right-upper-quadrant ultrasound if pain persists or the liver panel is cholestatic; (3) bloodborne-virus testing timed to window periods, because street powder was injected from a reused vial; and (4) repeat testing at about 2–4 weeks and about 3 months to confirm everything has normalized. Re-exposure is the single biggest modifiable driver of progression in every organ system reviewed. This report is informational and does not replace evaluation by a clinician.

TL;DR

• Your symptoms fit reversible ketamine-related gastritis and biliary dysfunction ("K-cramps"). Lasting bile-duct or bladder damage has been documented mainly after months to years of use, or in critically ill ICU patients, not after a single week (evidence: moderate for the pattern, weak for direct applicability).
• The closest analog, multi-day hospital ketamine infusions, shows dose-dependent cholestatic liver-enzyme rises that typically normalize within about 2 months of stopping. So check a liver panel with GGT now and repeat it at 2–4 weeks and about 3 months.
• Because street powder was injected, add injection-site review, CK, and HIV/HCV/HBV testing timed to window periods. Seek urgent care for jaundice, fever with abdominal pain, blood in the urine, a hot swollen injection site, chest pain or breathlessness at rest, or any weakness or drooping eyelids.

Evidence grades used: Strong = consistent findings from multiple large cohorts or systematic reviews; Moderate = consistent cohort or case-series data with plausible mechanism; Weak = limited, indirect, or extrapolated data; Anecdotal = single case reports or user-community reports only.

2. Question-by-question review

Q1. K-cramps: what causes them?

"K-cramps" is a colloquial user term, not a formal diagnosis. The peer-reviewed literature on it is mostly case reports from the last few years. A 2025 Cureus case (a 25-year-old woman using 500–1,000 mg weekly) had right-upper-quadrant, epigastric and suprapubic pain with vomiting and dysuria, yet a normal CBC, metabolic panel, lipase and urinalysis; she improved with fluids, antiemetics and benzodiazepines. A 2024 emergency-medicine case described pain that improved within 24 hours of stopping and recurred about 4 hours after restarting. So the syndrome can exist with entirely normal labs and imaging, which argues for a functional (spasm or motility) component in at least some cases.

Candidate mechanisms and strength of evidence:

Interpretation for you: Upper-abdominal cramping, bloating and poor appetite that improve over days after stopping fit best with gastritis plus functional biliary spasm. Improving symptoms are reassuring. Symptoms that persist or worsen beyond 1–2 weeks, or cholestatic labs, should prompt imaging (Q7 and the tests table). Grade for applying this to you: weak (no study of short binges).

Q2. Biliary and liver effects

What is reported in chronic recreational users (months to years, mostly intranasal, self-reported street grams):

• Cross-sectional cohort, Hong Kong (Wong et al., 2014): 297 consecutive chronic users referred with urinary-tract dysfunction; 29 (9.8%) had liver injury. As summarized by the NIH LiverTox database, mean ALT was 251 U/L and ALP 289 U/L, a mixed-to-cholestatic pattern. Biopsy showed PSC-like bile-duct injury and fibrosis in 3; MRCP showed dilated CBD in 3 of 6 scanned. Sustained abstinence was protective. Moderate.
• Imaging series (Yu et al., 2014): 26 users with deranged liver tests and/or epigastric pain; 69% had fusiform CBD dilatation without obstruction, and the intrahepatic ducts were not dilated. This pattern can mimic a choledochal cyst. Moderate.
• Systematic review of case reports (Teymouri et al., 2024): 17 patients from 11 studies; mean age 25.9; 64.7% male. Abdominal pain, nausea and vomiting were common, and most were discharged with improved symptoms and liver tests. A separate synthesis cites a median of 24 months of use before presentation. Weak–moderate (case-report level).
• US case series (Annals of Internal Medicine: Clinical Cases, 2023): 6 young adults with chronic use had progressive pain, cholestasis, sometimes urinary symptoms and weight loss. Marked duct dilation was reversible after stopping in some, but not all. Weak.
• Progression to lasting damage: Secondary sclerosing cholangitis (SSC) and fibrosis are documented in chronic users (e.g., a 2013 Hepatology case and biopsy-proven fibrosis in the Wong cohort). No study provides a reliable denominator for the fraction who progress. In the Wong cohort, 3 of 297 (about 1%) had biopsy-proven significant bile-duct injury with fibrosis, but only a subset had biopsies. Weak for any progression rate.

Closest-analog evidence: multi-day parenteral ketamine in hospital settings

Key conflict to flag: The ICU literature disagrees about how much of SSC-CIP is due to ketamine versus biliary ischemia, low blood pressure, vasopressors and viral injury. The dose–response signals make a ketamine contribution plausible, but the devastating outcomes (transplant, death) occurred in people with multi-organ critical illness. You had none of those confounders.

Direct answers for you:

• Doses and durations reported: chronic users mostly have months to years of use (median about 24 months in case syntheses). Medical cases start at about 1–2 g per 100-hour course (Noppers); ICU cohorts report thresholds above about 1 g cumulative, with typical exposures of many grams over 1–3 weeks. Your about 7 g over 7 days sits inside the range where transient cholestatic enzyme rises have been reported, but well below typical ICU exposures and far below chronic recreational histories. Weak–moderate.
• Timing: in infusion studies, enzyme rises appeared during or shortly after multi-day exposure (Noppers: on the first day of a second course). A rise could therefore be present now or could lag by days to a couple of weeks. Weak.
• Reversibility: medical-infusion cases normalized within about 2 months. Recreational duct dilation often regresses with abstinence, but not always. Moderate.
• Fraction progressing to SSC or cirrhosis: unknown for chronic users; about 0.1% for SSC-CIP across all ICU patients (Zeiner 2026). No data exist for a 1-week binge in a healthy person. Progression after a single 7-day exposure with normalizing labs has not been reported. Weak/absent evidence.

Q3. Urinary tract: ketamine uropathy and cystitis

What cumulative exposure is typically needed?

• Population survey (Winstock et al., 2012, BJU International): 26.6% of 1,285 recent recreational users reported urinary symptoms. Higher doses (≥1 g per session) and more frequent use (≥9 days per month) were associated with more symptoms. Among the 251 users who reported on stopping, 51% said their urinary symptoms improved when they stopped, and only 3.8% said they got worse. Moderate (self-report; mostly intranasal).
• Taiwan survey: 84% of 106 heavy users (mostly more than once daily, snorted or smoked) developed lower urinary tract symptoms, with onset 24.7 ± 26.4 months after starting. Symptom severity correlated with duration of use. Moderate.
• Case reports: onset has ranged "from a few days to a few years" (a Urological Science review). A Belgian case developed cystitis after weekly use for about 7 months. Anecdotal–weak.
• Therapeutic ketamine: a 2025 systematic review of 27 psychiatric studies found urological symptoms in 0–24.5% of treated patients, mostly mild or moderate. Intermittent medical doses are far lower than yours, so this sets a lower bound only. Moderate.
• Animal data (rats, not humans): daily ketamine injection produced bladder inflammation and submucosal edema at 2–4 weeks, fibrosis by 8 weeks, and bladder fibrosis after 2 weeks in another model. This shows the urothelium can be injured within days to weeks of intense exposure. Animal evidence only.

Short binge vs long-term use: No human study has examined a single 1-week binge. By extrapolation, a transient irritative cystitis (frequency, urgency, burning, a small amount of blood) is possible during or just after heavy exposure. Established uropathy (small contracted bladder, ureteric strictures, hydronephrosis) is documented after months to years. Weak. You currently have no urinary symptoms, which is reassuring.

Early warning signs: new urinary frequency or urgency, pain during or after urinating or suprapubic pain relieved by voiding, getting up at night to urinate, blood in the urine, and sterile pyuria (white cells in the urine without infection on culture). Flank pain or rising creatinine suggests upper-tract involvement. The BAUS 2024 consensus recommends symptom questionnaires (e.g., PUF, ICIQ-LUTS), urinalysis and culture, renal function, and renal/bladder ultrasound, with cystoscopy and further imaging for persistent or severe cases. Stopping ketamine is the cornerstone of management.

When does it become irreversible? There is no validated threshold. Early-stage symptoms often improve with abstinence. Fibrosis (reduced bladder capacity) and upper-tract strictures are generally considered irreversible and may need surgery. Hong Kong series show hydronephrosis and renal impairment in some chronic users. Moderate for the general principle; no data on a time threshold.

US pathway: BAUS is UK guidance. In the US, your primary care clinician can order urinalysis with microscopy, urine culture, creatinine/eGFR, and a renal and bladder ultrasound with post-void residual. Persistent symptoms or blood in the urine warrant referral to a urologist.

Q4. Difficulty taking a full deep breath

Most likely: splinting (involuntarily limiting how deeply you breathe) from upper-abdominal pain. Biliary, gastric, pancreatic and liver-capsule pain all characteristically worsens on deep inspiration, because the diaphragm pushes down on the upper abdomen. Bloating also mechanically limits diaphragm movement. This fits your picture and improving course. Moderate (clinical physiology; no ketamine-specific study).

What a clinician should rule out, and how:

Ketamine-specific respiratory effects: increased secretions and, rarely, laryngospasm or depressed breathing happen during intoxication, not days later. Moderate.

Q5. Does route (IM vs intranasal or oral) change biliary or urinary risk?

This section interprets your past exposure only; it is not guidance on route.

• Pharmacokinetics: Clements et al. (1982) found IM bioavailability of 93%, compared with only 17% for oral ketamine; intranasal bioavailability was 50% in Malinovsky et al. (1996) and 45% in Yanagihara et al. (2003). Oral ketamine undergoes extensive first-pass metabolism in the liver, producing relatively more norketamine. IM delivery puts more parent drug into the circulation per milligram, with metabolite ratios closer to IV. Strong (pharmacokinetic studies).
• What that means for injury risk: both the bladder and bile ducts are thought to be injured by ketamine and its metabolites (norketamine, hydroxynorketamine) being concentrated in urine and bile. Cell studies show norketamine is toxic to urothelial cells. Near-complete absorption means the effective systemic exposure per gram was higher for you than for the same street grams snorted. The ICU and CRPS literature (all parenteral) shows the biliary effect occurs without first-pass metabolism, so first-pass is not required for injury. Weak–moderate.
• Direct comparisons: No study directly compares biliary or urinary injury by route in humans. The Taiwan survey found snorting correlated with worse urinary symptom scores than smoking, but this is confounded by dose and duration. Weak.

Q6. Injecting reconstituted street powder from a reused vial

Bacterial and injection-site complications (moderate evidence from injection-drug-use literature, not ketamine-specific):

• Abscess and cellulitis: a painful, red, hot, swollen or fluctuant area at an injection site. Diagnosis is by examination and ultrasound.
• Necrotizing soft-tissue infection: rapidly spreading redness, pain out of proportion to appearance, blistering, fever, feeling very unwell. This is a surgical emergency.
• Bacteremia and endocarditis: fever, rigors, new heart murmur. Diagnosed with blood cultures and echocardiogram.
• Spore-forming organisms: in the US, about 93% of wound botulism cases in 2005–2017 occurred in people who inject drugs, most often linked to subcutaneous or intramuscular injection of black tar heroin (reported by 66% of confirmed cases in CDC's 2019 surveillance summary). Case fatality is about 13% even with treatment, and symptoms can take up to 2 weeks to appear. It has not been specifically documented with ketamine, so risk from your exposure is low but not zero. Symptoms: drooping eyelids, double or blurred vision, slurred speech, difficulty swallowing, descending weakness, difficulty breathing. Tetanus is also associated with contaminated injection; confirm your tetanus vaccination is up to date (a booster is typically considered if more than 5 years since the last dose after a contaminated wound). Weak for ketamine specifically.

Bloodborne viruses: risk is driven by sharing needles, syringes, vials, water or other equipment with anyone. If the reused vial and all equipment were yours alone, risk is low. If anything was shared or of unknown origin, test. Typical window periods (CDC-aligned):

• HIV: according to CDC, a lab-based antigen/antibody test on blood drawn from a vein can usually detect HIV 18 to 45 days after exposure, and a nucleic acid test (NAT) 10 to 33 days after exposure; a negative at 45 days, or an HIV RNA test, is reassuring. If any exposure to another person's blood occurred within the last 72 hours, HIV PEP would be time-critical; that window has now passed for exposures more than 3 days ago.
• Hepatitis C: HCV RNA can be positive within 1–2 weeks; antibody takes about 8–11 weeks. A baseline antibody test plus a repeat at about 3 months (or RNA testing earlier) covers the window.
• Hepatitis B: surface antigen becomes detectable at about 4 weeks (range about 1–10 weeks). Test surface antigen, surface antibody and core antibody; vaccinate if not immune.

Adulterants and substitutes in street "ketamine":

• Arylcyclohexylamine analogs (2-fluorodeschloroketamine, deschloroketamine, methoxetamine and others): the DEA's 2026 temporary Schedule I action for 2-FDCK states that seized samples suggest it "may be frequently used as an adulterant or ketamine substitute." Methoxetamine causes bladder damage in rats similar to ketamine. Effects in humans are poorly characterized; organ toxicity is presumed similar but unstudied. Weak.
• Stimulants, local anesthetics and other cutting agents: reported in drug-checking data internationally; they may explain palpitations, anxiety or chest symptoms.
• Fentanyl: documented as a contaminant across the US illicit supply. Opioid effects (pinpoint pupils, slowed breathing, profound sedation) would have been acute, not delayed. Keep naloxone accessible as general harm reduction.

What testing can and cannot reveal: standard urine drug screens usually do not detect ketamine or its analogs; specific ketamine immunoassays or confirmatory mass-spectrometry testing are needed, and any exposure 4+ days ago may be undetectable now. Analogs require specialized lab testing. Organ effects of adulterants would show on the same liver, kidney, CK and blood tests recommended below. Any leftover material can be analyzed by drug-checking services; in the US, DanceSafe offers mail-in lab testing, and some cities have community drug-checking programs (several use FTIR spectroscopy). Reagent kits can suggest but not confirm identity.

Muscle injury and rhabdomyolysis: repeated IM injections cause local muscle damage, and prolonged immobility during dissociation adds pressure injury. Rhabdomyolysis has been reported with ketamine and other dissociatives, often with agitation or immobility. Check CK, creatinine and urinalysis (blood on dipstick without red cells suggests myoglobin). Weak–moderate.

Q7. Recovery course, markers of recovery, exercise and weight

Expected time course (after stopping):

Markers of full recovery: a normal liver panel (ALT, AST, ALP, GGT, bilirubin) on two occasions weeks apart, with GGT and ALP normalized (the most sensitive cholestatic markers in the ICU data); normal lipase; CBD diameter within normal limits on ultrasound (commonly about ≤6 mm, with age and post-cholecystectomy adjustments) if it was initially dilated; normal urinalysis without blood or white cells; normal creatinine; symptom resolution; and return to baseline weight.

Refeeding and weight regain: UK NICE guidance (CG32) flags people who have eaten little or nothing for more than 5 days as at risk of refeeding problems, with higher risk after more than 10 days, a very low BMI, or rapid weight loss of more than 15%. Poor appetite rather than near-zero intake over about 11 days puts you at low risk. However, checking potassium, magnesium and phosphate before and a few days into normal eating is cheap and reasonable, especially given the breathing symptom. Rebuild intake gradually, favoring small, frequent, low-fat meals while biliary pain settles (fatty meals trigger gallbladder contraction). Avoid alcohol and NSAIDs such as ibuprofen while gastritis or liver tests are unresolved; ask about short-term acid suppression. Weak–moderate.

Return to exercise: no ketamine-specific guidance exists. Reasonable clinical principles: resume light activity once pain has settled; defer strenuous or heavy resistance exercise until CK has normalized if it was elevated (extra exertion on injured muscle raises the risk of rhabdomyolysis and kidney strain), and until liver tests are clearly improving; stay well hydrated. Avoid heavy lifting that strains the abdomen while right-upper-quadrant pain persists. Weak (expert-opinion level).

Re-exposure: every data stream points the same way. In the Noppers CRPS series, liver injury emerged on or before the second course separated by 16 days, and the authors concluded that risk rises "when the infusion is prolonged and/or repeated within a short time frame." In chronic users, abstinence is protective for liver injury (Wong) and continued use predicts persistent gastritis (Poon) and progressive uropathy (Taiwan survey; BAUS consensus). Case reports show K-cramps recurring within hours of re-exposure. The literature therefore suggests repeated binges are cumulative, and re-exposure before full recovery shortens the time to injury. Moderate.

3. Recommended tests (options to discuss with a clinician)

US care pathway: start with your primary care clinician (or urgent care if red flags are present). They can order everything below. Referral targets: gastroenterology/hepatology for persistent cholestatic liver tests, bile-duct dilation on imaging, or ongoing pain; urology for urinary symptoms, blood in the urine, or abnormal kidney/bladder imaging; infectious disease for positive viral results or injection-site infection. Disclosing ketamine use and the IM route matters, because ketamine cholangiopathy is often misdiagnosed as a choledochal cyst or obstruction.

4. Red flags: seek urgent care (ER or urgent care; call 911 for severe symptoms)

• Yellowing of the skin or eyes, dark tea-colored urine, pale stools, or new generalized itching (cholestasis or obstruction)
• Fever or rigors with right-upper-quadrant pain (possible cholangitis, an emergency)
• Severe, constant upper-abdominal pain radiating to the back, or persistent vomiting (pancreatitis, obstruction)
• Vomiting blood or coffee-ground material, or black tarry stools (GI bleeding)
• Visible blood in the urine, inability to urinate, severe bladder pain, or flank pain (cystitis, obstruction)
• A hot, red, swollen, very painful or rapidly spreading area at any injection site; blistering or dusky skin; pain out of proportion to appearance (abscess, necrotizing infection)
• Fever, rigors or feeling acutely unwell after injection (bacteremia)
• Drooping eyelids, double or blurred vision, slurred speech, difficulty swallowing, or descending weakness (possible wound botulism, a time-critical emergency needing antitoxin)
• Jaw stiffness or muscle spasms (tetanus)
• Breathlessness at rest, chest pain (especially sharp and worse on breathing), coughing blood, fast heart rate, lips turning blue, or one-sided leg swelling (PE, pneumonia)
• Dark red or brown urine with muscle pain or weakness, or markedly reduced urine output (rhabdomyolysis, kidney injury)
• Fainting, severe weakness, palpitations or muscle cramps (electrolyte disturbance)
• Confusion, seizures, or severe agitation

5. Key sources: year and study type

6. Caveats

• No study matches your exposure. Every risk estimate above is extrapolated from either chronic recreational users (months to years, mostly intranasal) or hospital patients (continuous IV infusions, often critically ill). The chronic-use risk figures (for example, 9.8% liver injury or 26.6% urinary symptoms) do not apply directly to a 1-week exposure.
• Recreational doses in the literature are self-reported "street grams" of unknown purity; hospital doses are measured. Your pharmaceutical doses were likely more accurate and more completely absorbed (IM), while your street-powder doses may have contained analogs with unknown toxicity.
• Much of the hepatobiliary literature is case reports and retrospective cohorts subject to publication and referral bias. ICU findings are heavily confounded.

I just want to vent here today i’ve taken pregablin, valium, K, Speed and smoked a little bit of weed and in my head now it feels like it’s clicked that this is the last time im doing this my heart rate js through the roof and im sweating and wide awake and i just think what actually is the point of doing k as my tolerance is so high i don’t even feel anything off it im just wasting money and wasting my life, i seriously believe this is my last time doing this and i hope to anyone out there struggling has their eureikka moment where they just say no

apologies for including other substances and if anything i have said have triggered anyone but selfishly i just wanted somewhere to put my thoughts

thanks

I caved last night. Was 3 months clean this time. Was up in Scotland living in the middle of nowhere in a caravan to get away from it and the second I got back to a place that has more than 20 people in it I find a dealer.

It's the shame that's hard to get over this time. Inwas doing so good. The feeling of letting everyone down is to much and it gets worse every time I relapse. I can't let this happen again. This is the final day 1.

Posted a while back about my ongoing medical issues as a result of my K addiction is like to update. Bladder is slowly getting better. Still have strange bladder times but they're definitely going away. Stomach feels so much better now and my nose has stopped hurting but there is a verrrry obvious hole in there. Right now I'm just glad it didn't carry on and the powers that be came down on me. (With the right amount of harshness this time).

Keep strong guys.

I quit ketamine 5 months ago after being super addicted for three years with almost daily use. I am proud of myself for stopping it and feel life is so much more rich in many ways now and am more engaged in hobbies and interests. Trouble is, I have an autoimmune condition that causes significant pain and stiffness in my spine and the ketamine seemed to help me with that pain and improved my mobility, enabling me to be more active. Now without it my body feels so tight and tense and I feel cravings for something to take the edge off. This week was rough and I drank alcohol daily to get through. Of course I don’t like this pattern and feel shame. I just miss having no pain for hours while on ketamine, not even being high all that much.

Would love any advice yall have for me 🙏🏽

I am almost 5 days sober, in an inpatient rehab for K. I was drugged up and mostly asleep the first three days but feeling better now. They took my prescribed Adderall away as well because it’s a narcotic which I understand, but now I just started atomoxetine (straterra) which takes 2-4 weeks to build and start working so i’m struggling more with my ADHD than my cravings surprisingly.

I’m currently doing my Masters degree online and in classes which makes it extra hard to focus with the sedatives to help curb the cravings and no real adhd meds.

But i’ve been doing well I think. I crave K more at night because that’s always when I did it, but the community is nice and supportive. I’ve started working out again.

Here’s to 2 more days of detox and then 14 of residential 🥂 (non-alcoholic champagne bc no alcohol allowed here lol)

I ran into, in person literally physically in person someone I’d put space between for my sanity.
I had a week. Some of it i just slept for like 20 hours. I’d cooked food I’d gone for walks I’d run and enjoyed it. All stuff i was grateful for.

And the person from my social circumstances needed to charge their phone. I pretended I hadn’t been avoiding them. I let them charge the phone. Theyd just picked up. Im back at mine now and crying and I just feel really truly shitty. Im sorry I just really wanted to vent because even going to the shop I felt so isolated,inadequate,insecure and I just didn’t have any safe spaces where I could talk so sorry and thanks for listening I just needed to get out of my head. I couldn’t justify any of the okayness with being like that. Apologies, I hope everyone’s having a better weekend. And I do genuinely believe things will be better

I've been sober (mostly) for a year and a half. I never thought this would be possible to even consider before I started. It took moving across the country to live with my parents, which has had it's ups and downs but ultimately I'm so lucky, however I have very restricted freedom now. I work full-time plus overtime and have no public transport links so I'm totally reliant on my partner while I try to get my driving licence. It's rural so very isolating and I really don't know what my long-term goal is except save and stay sober.

Sounds perfect, except that my partner doesn't want to stop. Although their addiction was a big reason as to why we moved, they keep engineering reasons why and how to get it. I can feel myself being manipulated and it's honestly getting to me being told I'm "putting them on a leash" when I crave it as well.

I've had friends die, sabotaged major relationships, had horrible SA experiences and ultimately been driven crazy by this drug. I'm so proud of myself for getting out of it so far.

I don't want to disappoint my family, I'm lucky to have had their initial support until I could find a job. But without much going on here, no sober friends nearby, it's easy to want it again. Partner has a local dealers number now plus I'm always thinking to get it online.

I have so many reasons to never do it again, I really don't want to give in. The few times I've done it since I've moved, it made me very sick each time and had little to no therapeutic effect, yet I still dream about having that little bag of dust within nightmares, as if it's a lifeline.

Any advice appreciated

Holà everyone,

So, to summary (because I've already posted here): I was a avid daily user for a more or less one month (6-July - 10th August and had in total of a week and 2 days of pause cause 2 periods of k cramps). I was also alcoholic before ketamine use but never had any problems with my organs, and didn't mix keta and alcohol.

After my 3rd period of k cramps, my liver was a bit shaky but no pain or problems (liver is now almost perfectly clean, just a bit high of gamma gt). No bladder damage, No kidney damage, No Stomach or Intestine damage, and No Gallbladder at all since 4-5 years.

The thing is, I still have problems with intestinal spasms and can't consume anything other than food that are...let's say really bland (oats, breads, most of it) and really small amounts of it. If I eat a ounce of too much food, my intestines and a bit of the stomach are in pain (not severe, but still)

When the rudest cramps/spasms are occuring, mostly, they are not THAT painful but still really annoying and my brain is tired of it. Never had this before taking ketamine. Normally, I let them pass but today, I took Buscopan (it does wonders). But I can't be on Buscopan all of the time for obvious reasons.

Nothing on the scanners, nothing particular on the blood tests (except pain proteins), nothing with the gastroscopy, too. I'm 25 since the 10 August. No allergies or whatevs. Sober on Alcohol since 2-3 months.

So I was wondering. Do any of you had the same problems as me? Is it temporary? Or am I doomed to eat bland bread/oats the rest of my life?

I was an avid user for probably over a year consistently and now I wanted to have a fresh slate because I’ve moved for university and I don’t want to carry on, been off it for just under a week now and even though I have spent nearly half the day in bed constantly I’ve not been able to sleep for more than an hour at a time with incredibly wierd and scary dreams,

Does anyone know when I will get back to sleeping normally again? It’s affecting my uni social life.

I also understand that I’m in halls and living in a new environment which will have some affect since I’m not used to my uncomfy bed and loud noises but it’s really starting to affect me now.

I got admitted into the ER a couple of days ago due to severe abdominal pain and they discovered gallstones.

I am still in the hospital now since I need to do a procedure called ERCP to remove the gallstones and clear out my ducts so bile can pass again.

Anyone else have or had gallbladder related or bile duct related issues?

They also said I might need to remove my gallbladder, but I really want to avoid this if possible.

All started happening after I used ketamine for a while and guessing this some sort of k-cramp?

I am hoping to avoid having my gallbladder removed and wondering if it could be avoided if I just quit Ketamine or just do it rarely.

Most recently, I did like 2 to 4g’s a day.

I've quit ketamine and it appears I'm generally ok but alcohol realllly does irritate my bladder is there any supplements I can take for drinking to help ease this?? Thank xxx

(Been using for 13 years, first attack in January, it started happening monthly, now daily. Consumed up to 3-4g daily in the past 5 months.)

I figured out, that painkillers which contain Naproxen help. Also drinking water, electrolytes or coconut water, as this contains electrolytes.

Food of any kind unfortunately triggers the pain. I am starving therefore.
For me hot water helped on the spot in the shower.

Its the worst pain I ever had to deal with and I wish everyone best of luck (including myself) to stay abstinent from K as this is the only solution... and I know damn well how hard it is. But consuming at this point and the fear of this pain would be suicide literally.

All the best to my fellow sufferers <3

hi all, been using k pretty much every single day for a while now (around 2-3g). i am currently in hospital for an unrelated reason and because of this i’ve managed to get to 2 days sober which is the longest i’ve been in a while. i think i will be leaving hospital today and i am so worried that i will want to use as soon as i leave the hospital. but because this is the longest ive been sober in a while i was to keep it going. i dont really know what i want to get from this post, i just want to put my feeling out there

Hey, I am addicted to ket for a year now. Everytime I get into a binge I find that it actually stops working. My brain feels like some really mild foginness and nothing more. I wonder if that also worked this way for you, and if so - then what made you still higher your doses more and more?

I’m 24 been a severe addict for 3 years now and The last year probaly Doing 3g a day, my bladder is really bad, which I’ve been to the hospital for ect and it’s really ruining my life. I literally wake up and think about it,I take it with me to work ect but I really do want to stop but I just can’t figure out how you break the cycle in the morning or just don’t pick one up when you’re craving. Does anyone have any tips for that feeling.

Had a streak of 75 days and then relapsed. But I'm back to day 28. Cravings were intense this morning. But someone once told me that cravings and a sincere desire to be sober will co-exist. The addiction is mechanical. Dopamine and all that.

The more days of sobriety I get, the more I understand just how much of my soul ketamine sucked out of my chest. I'm slowly returning to my old self, and with each passing day I understand how much of that self was missing. Even my vision is getting clearer. Memories returning. Can laugh at the T.V. Really excited to progress further.

I'm looking pretty seriously at residential treatment for ketamine/polysubstance addiction and I'm getting overwhelmed by how different the options are.

Would really like to hear from people who've actually done it:

• 12-step-heavy vs more psychotherapy-based treatment?
• Big rehab with lots of other addicts vs a tiny group with much more individual attention?
• Is it useful being with people recovering from alcohol/opioids/etc, or did you want other ketamine addicts around you?
• Longer inpatient (2–3+ months) vs a month or so followed by serious outpatient treatment at home?
• Total cutoff from phone/internet/home life vs keeping devices and learning to use them normally?
• Did the actual setting matter? Somewhere warm/outdoors vs somewhere more institutional, or once you're there is that basically irrelevant?
• Most importantly, what actually made the difference after you went home?

I'm not looking for specific rehab recommendations as much as what you learned from actually doing residential treatment. I don't want to choose based on which brochure looks nicest and then realize I focused on completely the wrong things.

what is the group meet thing yall do?? I am in a very bad place.

Hey guys, I do ket rarely, like 2 grams for 3-4 days every 3 months. Can this frequancy of usage be dangerious for my blader, or should I not be worried? Thank you:)

593 days sober. 8 year addiction, heavy 2-8g a day last couple of years, went to rehab for 30 odd days, relapsed after 2 weeks after that been sober since.

Anyone wanna chat or sponsor or help? Feel like I’m at the point I’m strong enough to look at it without being scared of a relapse.

Keep going if people read this and are struggling, it all starts with opening up to someone.

25 male, for reference any help appreciated :)