For years, the most recognized physical risk of chronic ketamine abuse has been bladder damage, but a new clinical puzzle is emerging: severe injury to the liver and bile ducts, known as Ketamine-induced Sclerosing Cholangitis (K-SC). This episode dives into a recent case series detailing patients—including older and female European users—broadening the picture of who is at risk.

Sclerosing cholangitis is a progressive condition where chronic inflammation leads to severe scarring and narrowing of the bile ducts. This obstruction causes bile backup (cholestasis), which, if unchecked, can result in irreversible cirrhosis—often making a liver transplant the only option. We explain why laboratory markers like GGT and ALP are critical red flags for this damage.

How does th ...