Note: For simplicity’s sake, this article uses the term ‘GHB’. Much of the time people think they are taking GHB it is actually the unprocessed version, GBL, which is absorbed faster in the body and seems to have a notably stronger effect.
In January, the Advisory Council for the Misuse of Drugs was commissioned by the government to review GHB, following the extraordinary case of Reynhard Singha, who dosed at least 48 unsuspecting men before sexually assaulting them. Stephen Port was also found guilty of four murders, after meeting young men on the hook up app Grindr, and giving them GHB. The police missed a ‘series of chances’ to catch Stephen, raising serious questions over how well the police deal with GHB-based sexual assault within the LGBTQ community.
While most GHB use within the chemsex scene can be described as recreational, there are certainly some – mostly older men – who intentionally use the drug to make younger boys much more horny or vulnerable. There are plenty of stories of young boys who were on the verge of consciousness, clearly no longer able to consent. The drug is also increasingly popular within more heterosexual clubbing scenes, likely accounting for the ‘steep rise’ in GHB use from 2005 to 2015. Many women who spend their leisure time in bars and clubs have a story about someone they know who was spiked. Unfortunately, these cases are extremely hard to prosecute and drugging can be hard to prove because GHB is cleared from the body very quickly.
The dose response curve of GHB is remarkably steep, and the fiddly nature of measuring a millimetre of liquid makes it very easy to overdose on. With most drugs, taking a bit too much just means you need to lie down – but with GHB it’s a relatively slim margin before the GABA activity in your brain starts to make you pass out, enter a coma or die. An unusual snoring noise should always be taken seriously as a potential sign of overdose.
Despite these dangers, GHB deaths represent a tiny proportion of the wider drugs death picture: GHB was mentioned on 27 death certificates in 2019, most of them likely to be accidental overdose rather than malicious spiking. It is worth remembering that each individual was a real person, whose death should be regarded as a tragedy. The main danger with illicit GHB use is the fact it is completely toxic when combined with alcohol. Most people are drunk when they party and are then disinhibited to the potential danger posed by using more drugs, creating a cocktail for disaster.
It is important to put the GHB press frenzy into perspective. Alcohol is by far the most commonly used date rape drug. GHB is generally touted in the media as a more effective date rape drug than it really is, and other drugs are known to be much more dangerous in this regard. It was pretty obvious when I got spiked with GHB in a bar, because of the salty burn travelling down the back of my throat. I was fine by the way, I got bundled into a taxi by my friends and remained conscious – but learned my lesson not to leave my drink unattended. While I’m recounting war stories, there was another time where I took a nice hefty glug of pure GHB at a friends’ flat, thinking it was water. I don’t know how many millilitres are in a glug, but I’m certainly lucky to be alive. I couldn’t eat for three days.
GHB can also be physically addictive after 2 or so months of regular use. Dependent users may dose every 1 or 2 hours they are awake. The withdrawals are utterly horrible – symptoms include insomnia, tachycardia, vomiting and seizures – and can last for more than a week. It is important to remember that dependent users are in the minority, and the vast majority of GHB use is recreational and consensual. Its relaxed but euphoric high makes it well suited to both clubbing and sessions on the couch.
So – should GHB be reclassified? Certainly, its potential for overdose and addiction are higher than most other Class C drugs (although pregabalin certainly gives it a run for its money). David Nutt et al. rightly classify it as a drug with a high harm potential to users. I wonder if, given greater public awareness of the darker side of its use, they would now rank its ‘harm to others’ higher than they did ten years ago.
Regardless, existing and forthcoming GHB users are unlikely to understand or listen to the fact it has been reclassified, thanks to a general feeling that drug laws make no sense to begin with. GHB is a particularly difficult drug to prohibit, given that it has a plethora of legal uses – including as a paint stripper. Increasing the legal penalties for drugs has no association with reduced use. The move is also unlikely to deter any existing or potential future GHB dealers. Moreover, it is highly doubtful that further criminalisation and stigmatisation will help protect dependent users or spiking victims in any tangible way. Some members of the ACMD voiced concern that reclassification would not reduce any of the harms associated with GHB use, and would not deter people from using the drug. They are also worried that increased criminalisation would disproportionately impact vulnerable groups.
Attempts to make the A, B and C classifications consistent with harms and evidence should certainly be applauded, and this move fits both of those criteria. But the government classification system is problematic from the outset. Rather than waving a bigger stick, the government should be investing in the chemsex services operating on the front lines, investing in rehab and GHB detoxification and investing in ways to meet GHB users where they currently are, rather than in a custody suite.
I can’t help but wonder if this reclassification is a PR move in response to news stories that represent the anomaly, although in fairness the ACMD’s recommendations are very well informed. Instead of demonising GHB for the actions of Singha and Port, perhaps we should see them as they are: a murderer and a rapist who were given easy access to large quantities of a toxic substance – because the GHB market was gifted to criminals.
Josh Torrance is a Drugs Resercher, Tweets @Joshitea