THERE HAS BEEN a 55% increase in the number of people being referred to Ireland’s only GHB-detoxification clinic.
Seventy-six people were referred to the clinic up to the end of August, compared to 49 for the whole of 2018.
The number of detoxification referrals has jumped from just one in 2014 and five in both 2015 and 2016.
GHB (gamma hydroxybutyrate) or GBL (gamma butyrolactone), both often shortened to G or Gina, are drugs used socially and for the purposes of chemsex.
G comes in a clear liquid or powder form and its potency can vary greatly, increasing the risk of overdose. It reduces inhibitions and can create a euphoric effect, but is also highly addictive.
Many people pass out while using G, and experts have raised concerns about sexual assault and rape happening in such scenarios.
Chemsex is the use of drugs such as G, crystal methamphetamine, ketamine and mephedrone to enhance sexual activity.
The practice is usually associated with men who have sex with men (MSM), but is also becoming more common among others. Slamsex is the term used when the above drugs are injected for a more intense high.
Overdoses
Of the 76 referrals to the clinic this year, people identified as follows:
Four in 10 referrals were people who used both G and crystal meth. One-third said they used G for sex parties only; 80% used for house parties (with or without sex happening); and 1% used for gym/bodybuilding purposes.
Fifty-three were repeat referrals and 23 were new referrals (up from 20 new referrals in 2018, and 19 in 2017). The age range was from 18 to 50 years, with 50% of people aged 26-33, and 37% aged 34-40.
Experts have been raising concerns about the increase in G’s popularity in Ireland for some time. Many people who are trying to get off the drug supplement or replace it with crystal meth. An increasing number of individuals are injecting meth, frontline healthcare and addiction workers have warned.
There have been at least 15 overdoses from G in Ireland, according to HSE figures. However, this only includes day patients and in-patients, not emergency department or outpatient figures, so the number is likely to be higher.
It’s believed a number of people in Ireland have died from using the drug, but this figure is even harder to quantify – G usually only shows up in a person’s system for 12 hours and many toxicology tests don’t screen specifically for the drug.
The drug is often used socially or for pleasure but some people take it for more complex reasons, such as intimacy issues and internalised homophobia, as previously reported by TheJournal.ie.
Sharing needles
Dr Kiran Santlal, Registrar in Psychiatry of Substance Misuse at the National Drug Treatment Centre (NDTC) in Dublin, helped set up the G detoxification clinic.
Santlal said there are a number of reasons for the increase in referrals, including an awareness raising campaign and media coverage.
“We are seeing an increasing trend of presentations with both GHB/GBL and crystal meth, or solely crystal meth, which might indicate that its use is increasing, or people are moving from sole G use towards crystal meth use,” Santlal told TheJournal.ie.
He added that a similar trend was seen in London a few years ago, where G-use is a huge problem. Santlal said the increasing use of crystal meth is “concerning”.
“It can be injected as well as smoked – this in turn creates a population of ‘novel injectors’ and that brings into play a number of medical issues from poor injecting techniques creating abscesses, or clots, to the sharing of needles, and the potential for the viral transmission of HIV and Hepatitis C,” he said.
‘A weapon of rape’
It’s common for people to pass out while taking G, and in some cases people have been sexually assaulted or raped.
A survey of over 2,700 gay men who use G in the UK, which was conducted by Dispatches and BuzzFeed News, recently found that almost half of them had overdosed on G. Over one in four men surveyed said they’d been sexually assaulted while using G, and four in five men said they knew someone else who’d also been assaulted while on G.
A paper, compiled by Dublin-based researchers, published in the International Journal of Drug Policy in 2017 assessed the prevalence of chemsex among attendees at Ireland’s only MSM-specific sexual health clinic over a six-week period in 2016.
The response rate was 90% (510/568). One in four men (27%) reported engaging in chemsex within the previous 12 months, and half had taken two drugs during their last chemsex experience. One in five people (23%) reported that they or their partners had lost consciousness as a result of chemsex.
One in four men (25%) reported that chemsex was impacting negatively on their lives and almost one-third (31%) reported that they would like help or advice about chemsex. More up-to-date research is current being compiled.
“Going under (passing out while on G) is very, very common – most people have at one time or another,” Graham Ryall, Treatment Services Coordinator at the Rialto Community Drug Team (RCDT), said. He added that topics such as consent and sexual assault come up in sessions a lot more than they used to.
“The conversation is happening much more today, in a way that it was not four or five years ago. Even the terminology we use: consent, sexual assault, rape – those are words that were not uttered a couple of years ago, now they’re being talked about.”
Ryall said G is being used as “a weapon of rape”, with some people putting it into lube and using it during sex without the other person’s consent.
Someone may be on it a few hours, on their first or maybe their second dose, then someone puts it in lube and administers that … that’s a weapon of rape or assault, and that’s not right.
“We need to look at that, the community needs to look at that and ask is that the way people want to treat each other?”
About 70 people have sought help from the RCDT for G and crystal meth use since 2015.
In terms of people seeking help for the first time, 17 people sought support from the RCDT for G (seven men and one woman) or crystal meth (nine men) use in the first eight months of this year. They ranged in age from 26 to 41.
In 2018, nine people sought help for the first time – five for G (four men and one woman) and four for crystal meth (all men). The age range last year was 25-40.
Ryall said, at any one time, about one-third of drug users who engage with a support programme are doing really well, one-third are doing okay and one-third are really struggling. He said, in hs experience, the same rule of thumb is true for people who use G and crystal meth.
“Many people find it very hard to [stop using]. We want to tell people that support is there, the services are there. We hope that in time more people will engage,” he said.
Both Ryall and Santlal are members of the Chemsex Working Group, a multi-agency group that meets once a month to discuss how to tackle the problem.
Advice and support
If someone ‘goes under‘ while on G:
Want to talk about G or chemsex? Here are some of the support services available:
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