Introduction: Medical and nonmedical ketamine use is increasing in the United States. This will likely lead to an increase in emergency department (ED) visits in individuals experiencing associated side effects. Physicians will need to be able to effectively recognize and manage ketamine-related complications.
\nCase Report: A 31-year-old male with a three-year history of inhalational, intramuscular, and intravenous nonmedical ketamine use presented to the ED twice within a week with symptoms of severe atraumatic back pain, abdominal pain, and dyspepsia. A comprehensive workup, including advanced imaging, was unrevealing for identifiable causes, and the patient was discharged with instructions for primary care follow-up for further evaluation. The patient used information shared on Reddit, an online forum and social network, to identify that the cause of his pain was related to chronic ketamine use. Subsequently, upon discontinuation of ketamine, the pain improved in 24 hours. The patient self-navigated to addiction treatment.
\nConclusion: Emergency physicians should consider sequelae of chronic ketamine use as a possible cause for gastrointestinal and urologic symptoms in the ED. In addition to thorough examination and assessment for other acute medical problems, patients should be offered education, symptomatic treatment, and linkage to harm reduction and substance use disorder treatment services.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"ketamine"},{"word":"case report"},{"word":"Harm reduction"},{"word":"Reddit"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0kj4h9z6","frozenauthors":[{"first_name":"Tucker","middle_name":"","last_name":"Avra","name_suffix":"","institution":"UCLA David Geffen School of Medicine, Los Angeles, California","department":""},{"first_name":"Jesus","middle_name":"","last_name":"Torres","name_suffix":"","institution":"UCLA David Geffen School of Medicine, Department of Emergency Medicine, Los Angeles, California","department":""},{"first_name":"Kumar","middle_name":"Felipe","last_name":"Vasudevan","name_suffix":"","institution":"UCLA David Geffen School of Medicine, Department of Internal Medicine, Los Angeles, California","department":""},{"first_name":"Elizabeth","middle_name":"A.","last_name":"Samuels","name_suffix":"","institution":"UCLA David Geffen School of Medicine, Department of Emergency Medicine, Los Angeles, California","department":""}],"date_submitted":"2024-02-16T18:00:44.677000Z","date_accepted":"2024-04-10T22:30:25.444000Z","date_published":"2024-08-01T13:00:00Z","render_galley":{"label":"Final Article","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/19431/galley/24595/download/"},"galleys":[{"label":"Layout","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/19431/galley/14583/download/"},{"label":"Final Article","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/19431/galley/24595/download/"}]}