The Incidence of Urological Symptoms in Ketamine Drug Users.

1. Usage Information

Have you used, or are you using, ketamine?? Peeing blood? Can't sleep through the night without running to the restroom? Ketamine has a powerful, damaging effect on the bladder and kidneys. The purpose of this survey is to gather some baseline data about ketamine use and the incidence and/or awareness of bladder symptoms that may develop with ketamine use. Please help us learn more about this! No personal identifying information is required or will be collected other than your country and/or region of origin.

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* 1. How did you first learn about ketamine?

At a party

From a friend

From a drug dealer

From a family member

At school

On Facebook Or Other Social Networking Sites

Other

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* 2. How old were you when you first tried ketamine?

Under 10

11-15

16-20

21-25

26-30

31-40

41-50

Over 50

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* 3. How long did you use ketamine?

Less than a year

1 year

2 years

3 years

4 years

More than four years

Still using

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* 4. Where did you or do you normally get ketamine from? Check all that apply!

At parties/raves

From friends

From family

From dealers

From kids at school

Buy it off the internet

Other

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* 5. Ketamine is often cut into ecstasy for use at raves. Have you ever used ecstasy?

Yes

Don't know

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* 6. Are you still using ketamine?

Yes - daily

Yes - occasionally

Yes - rarely

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* 7. Was quitting ketamine difficult?

Yes, very difficult. I required treatment.

Yes, but I was able to do it on my own