'GHB is a killer, I know of eight men who died after taking it'

MORE NEEDS TO be done to track sexual assaults and deaths related to chemsex in Ireland, one expert has said.

Noel Sutton of the Gay Health Network (GHN) said he knows of at least eight men who have died after taking G in the last two years, including five in Ireland and three Irish men abroad.

Chemsex is the use of drugs such as GHB/G, crystal methamphetamine, ketamine and mephedrone to enhance and prolong sexual activity. The practice is usually, but not exclusively, associated with men who have sex with men (MSM). 

Experts in Ireland have recently been raising concerns about the use of G in particular – it’s highly addictive and its potency varies wildly, increasing the risk of passing out or overdosing.

It’s very difficult to get an accurate figure of how many people die because of using G; it usually only shows up in a person’s system for a few hours and many toxicology tests don’t screen specifically for the drug.

Deaths that are likely connected to the drug are often listed as ‘death by misadventure’ or as a drug overdose but G is not specifically mentioned. However, people who work in the sector have said they’re aware of a number of men dying after taking G. 

‘This is a killer’ 

Sutton noted that drug use is nothing new across all walks of society, but that G is more dangerous than many other substances.

He said there have always been dangers around taking drugs, for example “with ecstasy you never knew what was in the pills”, but G is riskier. “The problem with this drug is just the danger of it … this is a killer, it’s just undocumented”.

Sutton told TheJournal.ie the number of people coming to the GHN and similar groups for advice about G has increased in recent years, as has the number of those coming for support after a sexual assault or death connected to G.

Sutton said G is “so highly addictive”, cheap (people can get a hit for as little as €1) and easily available, that many people find it hard to stop using despite the risks. Other people use G socially and don’t see any issue with it.

He stated that some people who use G are aware of the dangers but others are simply “riding the wave of having a great time and being young and not realising the consequences of what could happen”.

Sutton said because there are no official statistics on the number of people who die after taking G, unlike some other drugs, it’s “not seen as a problem”.

He said some people may view eight deaths as low but he sees it as eight deaths too many. He said people working in the gay men’s health sector, as well as the wider health sector, think it’s “really important” to try to track these deaths.

“It’s only when we get to that point that we can start to recognise this as a problem, as a national problem. And it’s only then that the government take things seriously and then we can start to work harder.”

A chemsex working group – which comprises representatives from the National Drug Treatment Centre (NDTC), the Gay Men’s Health Service, the Ana Liffey Drug Project, the Rialto Community Drug Team, HIV Ireland, BeLonG To, and St James’ Hospital among others – meets every couple of months to discuss how to address the issue. 

Overdoses 

As well as issues classifying G deaths, it is very difficult to gauge how many people have overdosed from the drug. There are 14 recorded instances of people who overdosed on G being treated as inpatients or day patients in Irish hospitals in 2018, up from eight in 2017 and seven in 2016.

This figure is likely to be a large underestimation as the vast majority of overdose patients present at emergency departments and these numbers are not collated.

One clear increase has been the number of people seeking help at Ireland’s only G-detoxification clinic, which is based at the NDTC in Dublin city centre. About 80 cases were treated there last year, up from 49 cases in 2018.

The majority of people who attended the clinic last year were aged between 26 and 40 years; two-thirds were male; 63% identified as gay and 37% identified as straight. Just over half of the people who presented were using crystal meth as well as G, up from 40% last year.

Dr Kiran Santlal, Registrar in Psychiatry of Substance Misuse at the National Drug Treatment Centre, said patients are “using [G] more in sex scenarios and less for clubbing” over the last 12 months.

Seven in 10 (71%) patients treated in 2019 said they took G in clubs and at parties, down from 83% in 2018. Last year, 36% of people said they used G at sex parties, up from 29% last year.

“If someone has overdosed on G, the only treatment that you can give is medical supportive management – make sure the airways open, make sure that they’re breathing properly, they’re getting enough oxygen, monitor their heart rate, and just keep them medically stable,” Santlal previously explained to TheJournal.ie.

Sutton said G is easy to access and carry around – it usually comes in a clear liquid or powder form. “It’s a liquid, somebody would have a water bottle, nobody’s going to suspect it,” he added.

Sutton noted that many people who are addicted to G are “highly functioning” and often affluent.

“If they’re turning up to work and they’re functioning, there’s no reason to suspect them,” he said, noting that many people only seek help when their addiction is at “crisis” point.

“Even after going through a treatment, many just went back into that cycle again,” he said. Almost seven in 10 (68%) of people had attended the G-detox clinic last year were repeat referrals.

‘Wide open to sexual assault’

As passing out on G is so common, there are growing concerns about sexual assault.

Sutton said three men have come to him for support after being sexually assaulted while on G. In one of these cases, a man was raped. He said allegations of assaults are causing waves among the gay community, which he described as “a small community” where people typically look after each other. 

“I think that over the last while that has imploded on itself, and there are a lot of people who are scared,” Sutton told us. 

The use of drugs for a sexual high is nothing new. It’s been there since the dawn of man.

“It’s just the type of drug [they're] using which is quite dangerous and because of the fact that people can ‘go under ‘ or end up going into a semi-vegetative state because of the amount that they’ve ingested, it leaves them vulnerable and wide open to sexual assault.”

He said many people who have been sexually assaulted are reluctant to come forward, as those who do are sometimes blamed or not believed. When chemsex is involved, that level of victim blaming is heightened.  

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Sutton said some people who were assaulted while at chemsex parties “don’t want to say anything because of the fact that it was their friends that they were there with or it was people they trusted and, you know, the stigma that might bring about”.

He stated that some people who are at chemsex parties believe certain things are “fair game”, adding: “Everybody has come back here with the thought of having sex, so if I see somebody who’s lying there, it’s okay. And of course, we know that it’s not okay.”

Sutton said “huge work” needs to be done informing people in general about consent. 

“I had a recent case where one of the guys started to talk about the fact that he felt abused – and they were his words. And it wasn’t until the third conversation that we had that he actually started talking about sexual assault.

“And then we got to a point where he could actually talk about the fact that he was raped, and certainly it was rape in his case, but it was just that whole guilt thing of ‘Did I do something wrong? How did I leave myself so vulnerable? It’s my fault’, and the shame that brings about.”

Register 

Sutton said he and others who work in the gay health sector are considering setting up an informal register, where people could anonymously register assaults that take place at chemsex parties. 

“We’re hearing so many of these stories, and because we know so many of the people and for a lot of them they won’t go to the police, they won’t report these cases. Or [if they do] it’s too late for a sexual assault units for get involved. And because it’s not documented in seen as though it’s not happening,” he explained. 

It’s time that we actually started some kind of a register where people come to us confidentially and we can just log it because I think we are starting to reach crisis on this.

Sutton said chemsex is seen by some people as only a gay issue, but that’s not the reality and the practice is becoming more common in general.

He said members of the LGBTI+ community often have to explore their sexuality “more so than a heterosexual person might, because that’s the norm and it’s accepted that’s the way you’re going to be”. However, he said gay men in particular are often unfairly labelled as promiscuous but they are “just as vulnerable as anybody else” when it comes to sexual assault.

Straight people go to sex parties too, he noted, and their very attendance does not mean they have given up their right to consent.

Recalling how the gay social scene has changed in recent years, Sutton noted: “About four or five years ago, we started to notice the difference where you go back to a house party, half the room went into one room and the others were kind of sitting there drinking and listening to music and having a bit of fun, but the other half would, you know, head off in a different direction.

“I’m loathe to use the word ‘divide’, but you suddenly realise, ‘Okay, that’s not the kind of party I want to go back to’, and then more and more you can see some of your friends are heading in one direction while you’d be heading a different direction.”

Advice and support

If someone ‘goes under‘ while on G: 

• don’t leave them unattended
• make sure they’re breathing, and continue to check their breathing until they wake up
• put them in the recovery position (lie them on their side)
• call 999 if they’re unconscious and unresponsive

Want to talk about G or chemsex? Here are some of the support services available: