Youth drug abuse problem in North District showed signs of improvement in the past three years. According to the Central Registry of Drug Abuse of Narcotics Division, Security Bureau of HKSAR, the number of first reported drug addicts under the age of 21 in North District significantly decreased from a peak of 261 to 161 in the past three years. Since 2009, a team of multi-disciplinary volunteer health professionals has been set up in North District Hospital. They hosted outreach clinic in collaboration with local social workers to screen youth with a history of ketamine abuse. The body screening results were used to let the abusers to understand the detrimental effect of drug abuse. This approach helps to motivate young drug abusers to quit. 

The Division of Urology of the Department of Surgery at The Chinese University of Hong Kong (CUHK) further analysed the urinary system data and found that the majority of young people with history of ketamine abuse had urinary bladder problems. The study results were presented in the American Urological Association Annual Meeting, San Francisco, California in May 2010 and published in the August 2011 issue of the Journal of Urology. 

(from left) Mr. Keith Ming Chak LUK, Registered Social Worker, Tai Po District Youth Outreaching Social Work Team, Hong Kong Children & Youth Services; Prof. Sidney Kam Hung YIP, Head of Division, Division of Urology, Department of Surgery, CUHK; Dr. Siu King MAK, Honorary Clinical Assistant Professor, Division of Urology, Department of Surgery, CUHK; and Ms. Meow Fung Lin WONG, Registered Social Worker, Youth Outreaching Social Work Team, The Evangelical Lutheran Church of Hong Kong.

The study analysed 66 young people with history of ketamine abuse. Lower urinary tract function was evaluated using the Pelvic Pain, Urgency and Frequency questionnaire, uroflowmetry and ultrasonography.  Their average age was 18(76% males, 24% females). Most of them lived with their family members. 56% of the subjects were self-supported financially while 35% relied on their families. Use of multiple drugs was reported by 81% of the subjects.   

'The normal urinary bladder capacity is 400-500ml. In ketamine users who were taking 3 doses weekly, 4 doses weekly and more than 5 doses weekly, the urinary bladder volume were 203.2ml, 199.6ml and 189.5ml respectively. Small bladder capacity can lead to urinary urgency, frequency, pelvic pain and urinary incontinence symptoms,' said Dr. Mak Siu King, principal investigator and CUHK Honorary Clinical Assistant Professor of Division of Urology. 

The study also found that the bladder capacity of young people who had quitted taking ketamine for more than one year is larger than those who began to quit (387ml vs 243ml), showing the recovery potential of the urinary bladder. However, there is no guarantee that every damaged urinary bladder can recover completely. 

The Pelvic Pain, Urgency and Frequency (PUF) patient symptom scale is a non-invasive diagnostic tool for screening patients with chronic pelvic pain. The PUF patient symptom scale consists of eight self-report items and takes approximately five minutes to complete, helping to evaluate the presence and severity of chronic pelvis pain and lower urinary tract symptoms.When quitting time is categorized into less than three months, three months, six months and one year, the symptoms scores decrease progressively. This reveals that quitting drugs will have a positive impact on relieving the patients' suffering and symptoms of a small diseased urinary bladder. 

This is the first-ever report proving the inverse relationship of drug abuse dosage and bladder functions, which can help people to understand the detrimental effects of drug abuse and enhance the motivation of the youth to quit drugs.