tag:theconversation.com,2011:/fr/topics/ghb-3416/articlesGHB – The Conversation2021-05-17T06:00:36Ztag:theconversation.com,2011:article/1605382021-05-17T06:00:36Z2021-05-17T06:00:36ZWhat is drink spiking? How can you know if it’s happened to you, and how can it be prevented?<figure><img src="https://images.theconversation.com/files/399935/original/file-20210511-21-wi5zfe.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C5689%2C3789&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/colorful-cocktail-on-top-bar-italian-276150941">Shutterstock</a></span></figcaption></figure><p><a href="https://www.theage.com.au/national/victoria/it-was-terrifying-police-on-alert-amid-rise-in-reports-of-drink-spiking-20210331-p57fil.html">Recent media reports</a> suggest drink spiking at pubs and clubs may be on the rise.</p>
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<p>“Drink spiking” is when someone puts alcohol or other drugs into another person’s drink without their knowledge.</p>
<p>It can include:</p>
<ul>
<li><p>putting alcohol into a non-alcoholic drink</p></li>
<li><p>adding extra alcohol to an alcoholic drink</p></li>
<li><p>slipping prescription or illegal drugs into an alcoholic or non-alcholic drink.</p></li>
</ul>
<p><a href="https://www.police.nsw.gov.au/__data/assets/pdf_file/0005/81374/fact_sheet_drink_spiking_myths.pdf">Alcohol</a> is actually the drug most commonly used in drink spiking. </p>
<p>The use of other drugs, such as benzodiazepines (like Rohypnol), GHB or ketamine is relatively rare.</p>
<p>These drugs are colourless and odourless so they are less easily detected. They cause drowsiness, and can cause “blackouts” and <a href="https://pubmed.ncbi.nlm.nih.gov/27198055/">memory loss</a> at high doses.</p>
<p>Perpetrators may spike victims’ drinks to commit sexual assault. But <a href="https://www.aic.gov.au/sites/default/files/2020-05/national-project-on-drink-spiking-investigating-the-nature-and-extent-of-drink-spiking-in-australia.pdf">according to the data</a>, the most common type of drink spiking is to “prank” someone or some other non-criminal motive.</p>
<p>So how can you know if your drink has been spiked, and as a society, how can we prevent it?</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/weekly-dose-ghb-a-party-drug-thats-easy-to-overdose-on-but-was-once-used-in-childbirth-73266">Weekly Dose: GHB, a party drug that's easy to overdose on but was once used in childbirth</a>
</strong>
</em>
</p>
<hr>
<h2>How often does it happen?</h2>
<p>We don’t have very good data on how often drink spiking occurs. It’s often not reported to police because victims can’t remember what has happened.</p>
<p>If a perpetrator sexually assaults someone after spiking their drink, there are <a href="https://theconversation.com/almost-90-of-sexual-assault-victims-do-not-go-to-police-this-is-how-we-can-achieve-justice-for-survivors-157601">many complex reasons</a> why victims may not want to report to police.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/almost-90-of-sexual-assault-victims-do-not-go-to-police-this-is-how-we-can-achieve-justice-for-survivors-157601">Almost 90% of sexual assault victims do not go to police — this is how we can achieve justice for survivors</a>
</strong>
</em>
</p>
<hr>
<p><a href="https://www.aic.gov.au/sites/default/files/2020-05/national-project-on-drink-spiking-investigating-the-nature-and-extent-of-drink-spiking-in-australia.pdf">One study</a>, published in 2004, estimated there were about 3,000 to 4,000 suspected drink spiking incidents a year in Australia. It estimated less than 15% of incidents were reported to police.</p>
<p>It found four out of five victims were women. About half were under 24 years old and around one-third aged 25-34. Two-thirds of the suspected incidents occurred in licensed venues like pubs and clubs.</p>
<p>According to an Australian study from 2006, <a href="https://pubmed.ncbi.nlm.nih.gov/16580243/">around 3%</a> of adult sexual assault cases occurred after perpetrators intentionally drugged victims outside of their knowledge.</p>
<p>It’s crucial to note that sexual assault is a moral and legal violation, whether or not the victim was intoxicated and whether or not the victim became intoxicated voluntarily.</p>
<h2>How can you know if it’s happened to you?</h2>
<p>Some of the <a href="https://adf.org.au/insights/drink-spiking/">warning signs</a> your drink might have been spiked include:</p>
<ul>
<li><p>feeling lightheaded, or like you might faint</p></li>
<li><p>feeling quite sick or very tired</p></li>
<li><p>feeling drunk despite only having a very small amount of alcohol</p></li>
<li><p>passing out</p></li>
<li><p>feeling uncomfortable and confused when you wake up, with blanks in your memory about what happened the previous night.</p></li>
</ul>
<p>If you think your drink has been spiked, you should ask someone you trust to get you to a safe place, or talk to venue staff or security if you’re at a licensed venue. If you feel very unwell you should seek medical attention.</p>
<p>If you believe your drink has been spiked or you have been sexually assaulted, contact the police to report the incident.</p>
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<h2>How can drink spiking be prevented?</h2>
<p>Most drink spiking occurs at licensed venues like pubs and clubs. Licensees and people who serve alcohol have a responsibility to provide a safe environment for patrons, and have an important role to play in preventing drink spiking.</p>
<p>This includes having clear procedures in place to ensure staff understand the signs of drink spiking, including with alcohol.</p>
<p>Preventing drink spiking is a collective responsibility, not something to be shouldered by potential victims.</p>
<p>Licensees can take responsible steps including:</p>
<ul>
<li><p>removing unattended glasses</p></li>
<li><p>reporting suspicious behaviour</p></li>
<li><p>declining customer requests to add extra alcohol to a person’s drink</p></li>
<li><p>supplying water taps instead of large water jugs</p></li>
<li><p>promoting responsible consumption of alcohol, including discouraging rapid drinking</p></li>
<li><p>being aware of “red flag” drink requests, such as repeated shots, or double or triple shots, or adding vodka to beer or wine.</p></li>
</ul>
<figure class="align-center ">
<img alt="Bartender pouring drinks" src="https://images.theconversation.com/files/400926/original/file-20210517-17-rfcblw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/400926/original/file-20210517-17-rfcblw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=397&fit=crop&dpr=1 600w, https://images.theconversation.com/files/400926/original/file-20210517-17-rfcblw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=397&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/400926/original/file-20210517-17-rfcblw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=397&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/400926/original/file-20210517-17-rfcblw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=499&fit=crop&dpr=1 754w, https://images.theconversation.com/files/400926/original/file-20210517-17-rfcblw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=499&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/400926/original/file-20210517-17-rfcblw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=499&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Bartenders should be wary of ‘red flag’ drinks requests like people asking for double or triple shots.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<p>A few <a href="https://adf.org.au/insights/drink-spiking/">simple precautions</a> everyone can take to reduce the risk of drink spiking include:</p>
<ul>
<li><p>have your drink close to you, keep an eye on it and don’t leave it unattended</p></li>
<li><p>avoid sharing beverages with other people</p></li>
<li><p>purchase or pour your drinks yourself</p></li>
<li><p>if you’re offered a drink by someone you don’t know well, go to the bar with them and watch the bartender pour your drink</p></li>
<li><p>if you think your drink tastes weird, pour it out</p></li>
<li><p>keep an eye on your friends and their beverages too.</p></li>
</ul>
<h2>What are the consequences for drink spiking in Australia?</h2>
<p>It’s a criminal offence to spike someone’s drink with alcohol or other drugs without their consent in all states and territories.</p>
<p>In some jurisdictions, there are specific drink and food spiking laws. For example, in <a href="http://classic.austlii.edu.au/au/legis/vic/consol_act/soa1966189/s41h.html">Victoria</a>, the punishment is up to two years imprisonment.</p>
<p>In other jurisdictions, such as Tasmania, drink spiking <a href="https://www.legislation.tas.gov.au/view/html/inforce/current/act-1924-069#JS1@GS176@EN">comes under broader offences</a> such as “administering any poison or other noxious thing with intent to injure or annoy”.</p>
<p>Spiking someone’s drink with an intent to commit a serious criminal offence, such as sexual assault, usually comes with very severe penalties. For example, this carries a penalty of up to 14 years imprisonment in <a href="http://www6.austlii.edu.au/cgi-bin/viewdoc/au/legis/qld/consol_act/cc189994/s218.html">Queensland</a>.</p>
<p>There are <a href="https://justice.nt.gov.au/__data/assets/pdf_file/0004/171850/drink-spiking-discussion-paper.pdf">some ambiguities</a> in the criminal law. For example, some laws aren’t clear about whether drink spiking with alcohol is an offence.</p>
<p>However, in all states and territories, if someone is substantially intoxicated with alcohol or other drugs it’s good evidence they <a href="https://www.monash.edu/__data/assets/pdf_file/0003/1092675/05_McNamara.pdf">aren’t able to give consent</a> to sex. Sex with a substantially intoxicated person who’s unable to consent may constitute rape or another sexual assault offence.</p>
<hr>
<p><strong><em>Getting help</em></strong></p>
<p><em>In an emergency, call triple zero (000) or the nearest police station.</em> </p>
<p><em>For information about sexual assault, or for counselling or referral, call 1800RESPECT (1800 737 732).</em></p>
<p><em>If you’ve been a victim of drink spiking and want to talk to someone, the following confidential services can help:</em></p>
<p><em>- Beyond Blue: 1300 22 4636</em></p>
<p><em>- Kids Helpline (5-25 year olds): 1800 55 1800</em></p>
<p><em>- National Alcohol and other Drug Hotline: 1800 250 015.</em></p>
<hr>
<p><em>This article has been amended to remove a reference to blood tests for criminal prosecution which may not be available across Australia.</em></p><img src="https://counter.theconversation.com/content/160538/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Nicole Lee works as a consultant in the alcohol and other drug sector and a psychologist in private practice. She has previously been awarded funding by Australian and state governments, NHMRC and other bodies for evaluation and research into alcohol and other drug prevention and treatment, and currently receives funds from the Australian Government, and several state and territory governments. She is a member of the Australian Government's Australian National Advisory Council on Alcohol and other Drugs, a member of the board of directors of Hello Sunday Morning and volunteers with The Loop Australia.</span></em></p><p class="fine-print"><em><span>Jarryd Bartle works as a consultant in the alcohol and other drug sector.</span></em></p>Preventing drink spiking is a collective responsibility, not something to be shouldered by potential victims.Nicole Lee, Professor at the National Drug Research Institute (Melbourne), Curtin UniversityJarryd Bartle, Sessional Lecturer, RMIT UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1304662020-01-30T06:34:54Z2020-01-30T06:34:54ZWhat is GHB, the liquid ecstasy drug implicated in Reynhard Sinaga’s crimes?<figure><img src="https://images.theconversation.com/files/311533/original/file-20200123-162221-nlr1u4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Overdose involving GHB and alcohol can cause a person to have breathing difficulties, respiratory failure, coma, or death.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/man-hand-holding-woman-vector-illustration-1413808376">TRUNCUS/Shutterstock</a></span></figcaption></figure><p>The case of Reynhard Sinaga, an Indonesian man convicted by a court in Manchester, United Kingdom for <a href="https://www.bbc.com/news/uk-england-manchester-51093692">136 rapes</a>, has shed light on an illegal drug he most likely used to paralyse his victims.</p>
<p>Sinaga reportedly <a href="https://www.telegraph.co.uk/news/2020/01/06/manchester-based-student-reynhard-sinaga-named-britains-worst/">lured drunk men from nearby nightclubs</a> to his apartment with offers of drinks or the opportunity to charge their phones. Sinaga would then spike their drinks, most likely with the drug gamma-hydroxybutyrate (GHB), rendering the men unconscious. He would then <a href="https://www.bbc.com/news/uk-50688975">assault them</a>. </p>
<p><a href="http://www.lowyinterpreter.org/the-interpreter/k-pop-sex-and-drugs-scandal-sweeping-south-korea">GHB was allegedly used</a> in the Burning Sun nightclub case in 2019 in South Korea, which involved K-Pop star Seungri, a member of the legendary group Big Bang.</p>
<p>GHB is <a href="http://www.emcdda.europa.eu/publications/thematic-papers/ghb_en">classified as a controlled drug</a> in most European Union countries, restricting its distribution. But it’s <a href="https://publications.parliament.uk/pa/cm200506/cmselect/cmsctech/1031/1031.pdf">illegal in United Kingdom</a>. </p>
<h2>Anaesthetic in night clubs</h2>
<p>What is GHB?</p>
<p>GHB is known as one of many <em>club drugs</em>. It is often used in night clubs and music festivals to enhance social intimacy and sensory stimulation.</p>
<p>American researcher and physician <a href="https://web.a.ebscohost.com/abstract?direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=0002838X&AN=13275596&h=tSMzkpkan6NI%2fm1rNosX1YEjvUGCuUp3fg1l6fMybEK%2fAUDVqHm4G9N%2bc%2fo65e1TYIdPxWyLu3W0wlL%2b5F5KCw%3d%3d&crl=c&resultNs=AdminWebAuth&resultLocal=ErrCrlNotAuth&crlhashurl=login.aspx%3fdirect%3dtrue%26profile%3dehost%26scope%3dsite%26authtype%3dcrawler%26jrnl%3d0002838X%26AN%3d13275596">Paul M. Gahlinger lists</a> four popular club drugs: </p>
<ul>
<li><p>MDMA (3,4-Methylenedioxymethamphetamine)</p></li>
<li><p>GHB (gamma-hydroxybutyrate)</p></li>
<li><p>Rohypnol (flunitrazepam) </p></li>
<li><p>Ketalar (ketamine). </p></li>
</ul>
<p>MDMA is commonly known as ecstasy or molly, while <a href="https://www.who.int/medicines/areas/quality_safety/4.1GHBcritical_review.pdf">GHB is on the street</a> known as liquid ecstasy, G, liquid X, get-her-to-bed, salty water, soap and many more.</p>
<p>GHB induces euphoria and works as a relaxant, sedating the users. The drug also functions as an aphrodisiac and <a href="http://www.emcdda.europa.eu/publications/thematic-papers/ghb_en">can improve sexual performance</a>.</p>
<p>GHB is <a href="https://www.ncbi.nlm.nih.gov/pubmed/27936427">produced naturally</a> in the body in small quantities and works as a neurotransmitter, regulating the sleep cycle, emotion and memory. </p>
<p>In 1960, French biochemist Henri Laborit <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1111/cns.12337">synthesised the drug</a> as an anaesthetic for surgery. It then gained popularity as a <a href="https://www.telegraph.co.uk/men/the-filter/11942081/Nine-things-you-should-know-about-GHB.html">recreational drug</a> taken by clubbers as well as a nutritional supplement marketed to bodybuilders because it helps <a href="https://www.theguardian.com/society/2018/nov/24/club-drug-ghb-melts-plastic-kill">burn fat</a>. </p>
<p>The United States <a href="https://accesspharmacy.mhmedical.com/content.aspx?bookid=454&sectionid=40199486">banned nonprescription sales</a> for this drug in 1990 due to its side effects. People who take GHB can experience breathing difficulties due to lack of air entering the lungs. People can also experience <a href="https://scholar.google.com/scholar?q=A+tale+of+novel+intoxication%3A+a+review+of+the+effects+of+gamma-hydroxybutyric+acid+with+recommendations+for+management">seizures</a>. </p>
<p>Patients who have taken GHB <a href="https://www.ncbi.nlm.nih.gov/pubmed/9624313">often show</a> changes in behaviour such as aggression.</p>
<p>A <a href="https://www.ncbi.nlm.nih.gov/pubmed/9624313">range of neurological effects</a> can occur from taking GHB – from uncontrolled eye movements, impaired body movements due to problems in the brain, dizziness and decreased consciousness to coma, respiratory depression, cessation of breathing and death.</p>
<h2>Deadly impact</h2>
<p>One of Sinaga’s victims told the jury there was something odd in the drink he offered to him. “The drink looks like water, but there is a solvent in it, almost like salt. It’s not as transparent as water,” <a href="https://www.theguardian.com/uk-news/2020/jan/06/reynhard-sinaga-serial-rapist-posed-good-samaritan-lure-men">the man said while giving evidence via video link</a>. “I think I said to him, ‘what is this? This is not water, is it’, and he said, ‘This is water, you need to drink water’.”</p>
<p>In 2000, around 60 deaths were reported in the US due to GHB overdose, and concern was raised about it being used as a “<a href="https://www.aafp.org/afp/2004/0601/p2619.html">date-rape drug</a>”. </p>
<p><a href="https://www.ncbi.nlm.nih.gov/pubmed/15061684">In 2002</a>, sodium oxybate, a salt compound from GHB, <a href="https://www.ncbi.nlm.nih.gov/pubmed/3704454">was approved</a> as a treatment of narcolepsy (a chronic neurological disorder that causes a patient to fall asleep suddenly) and was listed by the US Food and Drug Administration (FDA) under the trade name <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2766839/">Xyrem®</a>. This drug must be prescribed by a doctor, and it has limited distribution.</p>
<p>The British parliament classify GHB <a href="https://www.bbc.com/indonesia/majalah-51017378">as an illegal drug under class C</a>. This means anyone who supplies or possesses it for consumption can be sentenced to two to 14 years in prison. In London, there were <a href="https://www.ncbi.nlm.nih.gov/pubmed/27936427">61 deaths</a> related to GHB between 2011 and 2015.</p>
<p>In high doses, the drug causes dizziness, hypersalivation, reduced muscle tension and amnesia. The drug usually is dissolved in water. It is sold on the street in the US in small plastic bottles resembling hotel shampoo bottles from <a href="https://www.tandfonline.com/doi/abs/10.1080/10903129908958969?journalCode=ipec20">US $10 to 20</a>.</p>
<p>The bad taste of GHB is usually masked by flavourings or alcoholic drinks. The effect occurs within 15-30 minutes after oral consumption and reaches its <a href="https://doctordeluca.com/Library/DetoxEngage/GHB-Withdrawal-AnnEmerMed37-2-01.pdf">peak in 20-60 minutes</a>, depending on whether it is mixed with food or not. </p>
<p>Vomiting is one of the most <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2766839/">common side effects</a> of mixing alcohol with GHB. A mixture of the two depressants can also cause a calming effect and amnesia. It can lead to a potentially life-threatening overdose. Overdose involving GHB and alcohol can cause a person to have breathing difficulties, respiratory failure, coma or death.</p>
<p>Use of alcohol with this drug is very dangerous because it can result in an increase in the toxic effects of GHB. It should also not be used in combination with sedatives or other anaesthetics.</p><img src="https://counter.theconversation.com/content/130466/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Anshar Saud tidak bekerja, menjadi konsultan, memiliki saham, atau menerima dana dari perusahaan atau organisasi mana pun yang akan mengambil untung dari artikel ini, dan telah mengungkapkan bahwa ia tidak memiliki afiliasi selain yang telah disebut di atas.</span></em></p>The use of alcohol with GHB is very dangerous because it can increase the toxic effects of the drug. It should also not be used in combination with sedatives or other anaesthetics.Anshar Saud, Lecturer and researcher at Faculty of Pharmacy, Universitas HasanuddinLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/907362018-01-26T00:43:57Z2018-01-26T00:43:57ZThe comeback and dangers of the drug GHB<figure><img src="https://images.theconversation.com/files/203476/original/file-20180125-100896-1v5ijhp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The drug GHB gained notoriety during raves decades ago, but it is resurfacing again. </span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/hands-air-rave-smoke-machine-laser-94782199?src=Fzblek3t6VqYJnWlF6IUxA-1-9">Anthony Mooney/Shutterstock.com</a></span></figcaption></figure><p>A highly potent drug called GHB is making a comeback in nightlife scenes, along with overdoses and even death. On Jan. 23, 2018, “Storm Chaser” star Joel Taylor <a href="http://abcnews.go.com/Entertainment/joel-taylor-storm-chasers-died-cruise/story?id=52606692">died</a> on a cruise ship. Celebrity news site TMZ reported that Taylor may have used <a href="https://www.dea.gov/druginfo/drug_data_sheets/GHB.pdf">GHB</a> in the hours before his death. </p>
<p>GHB, or gamma-hydroxybutyrate, has been referred to as a “date rape drug” by the media for decades, as it has been involved in instances of sexual predators spiking unsuspecting womens’ drinks to take advantage of them while unconscious. However, much of the public is unaware that most of use of this highly potent drug is actually intentional. </p>
<p>I am a public health researcher who studies party drug use in the nightclub scene. I have learned a great deal through my research and through what I have witnessed firsthand in my years in this scene. Use of this drug largely disappeared from the scene, but it appears to be emerging again in popularity. </p>
<h2>Initially, a sleep aid</h2>
<p>GHB gained popularity in the 1990s, when it was sold over-the-counter in vitamin supplement stores as a sleep aid and growth hormone enhancer. In <a href="https://www.cdc.gov/mmwr/preview/mmwrhtml/00001847.htm">1990</a>, at least 100 people were reportedly poisoned using GHB, and the Food Drug Administration banned sales of the substance. However, availability continued, as did <a href="https://www.cdc.gov/mmwr/preview/mmwrhtml/00047106.htm">outbreaks</a> of poisonings. </p>
<p>Use can lead to a <a href="https://www.cdc.gov/mmwr/preview/mmwrhtml/00001847.htm">range</a> of adverse effects ranging from nausea and vomiting to seizures, repressed breathing, and even death. Despite the ban, GHB use increased throughout the 1990s, and the drug was made <a href="http://www.projectghb.org/content/gamma-hydroxy-butyrate-ghb">illegal to possess </a>in March 2000. Recreational use eventually decreased, but there appears to be a recent uptick in use — especially in the <a href="https://www.vice.com/en_us/article/8x5kbp/heres-how-queer-nightlife-is-addressing-a-rise-in-ghb-use">gay</a> party scene. </p>
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<p>While GHB induces sleep, the drug causes users to feel high before falling unconscious. Therefore, in my observation, most users of GHB attempt to take small doses in order to experience the high without falling unconscious. This practice of using GHB to get high began in the 1990s and led to GHB’s popularity in nightclubs. </p>
<p>However, doses of GHB are difficult to calibrate as it is highly potent with a steep dose-response curve, and co-using GHB with alcohol increases its effects. Higher than intended doses or combining it with drugs like alcohol can easily render someone unconscious. </p>
<h2>The party scene</h2>
<p>What is particularly unique about GHB is that onset of unconsciousness can occur quickly. A user can be dancing and talking with friends, yet a few seconds later fall on the floor unconscious and temporarily unwakeable. In fact, <a href="https://www.ncbi.nlm.nih.gov/pubmed/12534425">most</a> users expect to “overdose” at some point and fall unconscious. </p>
<p>Witnessing the problems associated with GHB use so often in nightclubs was the main reason I became a drug researcher. I was deeply immersed in the after-hours New York City nightclub scene in the late 1990s and early 2000s, when GHB popularity was at its peak. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/203475/original/file-20180125-100912-1a651gi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/203475/original/file-20180125-100912-1a651gi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=398&fit=crop&dpr=1 600w, https://images.theconversation.com/files/203475/original/file-20180125-100912-1a651gi.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=398&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/203475/original/file-20180125-100912-1a651gi.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=398&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/203475/original/file-20180125-100912-1a651gi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/203475/original/file-20180125-100912-1a651gi.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/203475/original/file-20180125-100912-1a651gi.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">GHB was especially popular in dance clubs, where dancers could get a quick high.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-p…">KK Tan/Shutterstock.com</a></span>
</figcaption>
</figure>
<p>By 2001, almost every week I witnessed multiple overdoses. I’ve helped carry unconscious bodies from dance floors, I’ve had good friends of mine die after using GHB, and I had even witnessed some of the infamous hidden <a href="http://www.nydailynews.com/archives/news/detail-chilling-dance-death-night-twilo-ends-er-article-1.913461">rooms</a> in some nightclubs that held bodies of unconscious users where nightclub staff waited for them to gain consciousness hours later. Some New York City nightclubs even had their own private <a href="http://www.nytimes.com/2001/05/07/nyregion/city-closes-dance-club-over-problems-with-permits.html">ambulance</a> services in order to not alert authorities about the GHB problem in their venues. </p>
<p>GHB use declined in response to the abundance of overdoses and increased <a href="http://www.ijdp.org/article/S0955-3959(05)00183-0/fulltext">stigma</a> toward use. In New York City, some <a href="http://www.nytimes.com/2001/05/07/nyregion/city-closes-dance-club-over-problems-with-permits.html">major venues</a> closed, largely in response to so many GHB overdoses. </p>
<h2>The popularity of GHB</h2>
<p>GHB is by no means a popular drug in the general population. Only about 3 out of 1,000 young adults (age 18-25) in the U.S. are <a href="https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs-2015/NSDUH-DetTabs-2015/NSDUH-DetTabs-2015.htm#tab7-22a">estimated</a> to have ever knowingly used the drug. </p>
<p>But things are much different in the nightclub scene. My colleagues and I, for example, found that among electronic dance music attendees in New York City in <a href="http://www.tandfonline.com/doi/full/10.1080/10826084.2016.1219373">2015</a>, nearly 1 out of 10 attendees reported ever using GHB. However, most of the individuals we surveyed identified as heterosexual. </p>
<p>Use is more prevalent among gay men and men who have sex with men (MSM) in party scenes. For example, a recent <a href="https://www.ncbi.nlm.nih.gov/pubmed/26440912">study</a> of MSM nightclub attendees in South London found that more than half reported GHB use in the past year. </p>
<p>But GHB is not only popular in the nightclub scene for dancing and socializing; it is a leading “ChemSex” drug — meaning it is often used intentionally to intensify sex. This is particularly prevalent among <a href="https://www.ncbi.nlm.nih.gov/pubmed/29268075">MSM</a>.</p>
<h2>What can be done to prevent more deaths?</h2>
<p>GHB, due to its high likelihood of leading to overdose, is one of the most deleterious drugs to ever reach the party scene. Stigma toward users was a leading method of reducing prevalence in the early 2000s, and anti-GHB campaigns in the nightclub scene have already begun in <a href="https://thump.vice.com/en_ca/article/bma7xm/canada-clubs-ghb-guide">Canada</a> in response to recent overdoses. However, while stigma might prevent some people from using, this will lead others to resort to hiding their use. And hidden use is riskier. </p>
<p>The new generation of partiers needs to learn from the past. Yes, there are plenty of partiers who use GHB “safely,” and harm reduction techniques should be used among those who insist on using. But GHB commonly results in overdoses, and as is shown by the death of Joel Taylor who is suspected of taking GHB, sometimes use can lead to fatal outcomes.</p><img src="https://counter.theconversation.com/content/90736/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Joseph Palamar receives funding from the National Institutes of Health (grant K01DA038800)</span></em></p>The recent death of ‘Storm Chaser’ star Joel Taylor, reportedly because of his use of the GHB, is a tragic reminder of the drug’s dangerous impact.Joseph Palamar, Associate Professor of Population Health, New York UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/763032017-06-21T20:02:00Z2017-06-21T20:02:00ZFeeling euphoric on a low-carb diet? The effect on your brain is similar to an illicit drug<figure><img src="https://images.theconversation.com/files/174868/original/file-20170621-8977-mfwsk1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A very low-carb diet can prompt changes in your brain similar to that caused by the illicit drug GHB.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/387499906?src=n7Jb-vNzt4zt5Cdcn5AsCA-1-0&size=medium_jpg">from www.shutterstock.com</a></span></figcaption></figure><p>Some people on very low-carb diets say they feel <a href="https://www.paleohacks.com/ketosis/does-ketosis-and-or-intermittent-fasting-cause-euphoria-35565">euphoric</a>, <a href="http://lowcarbediem.com/have-more-energy-sleep-less-and-get-more-done">have clear minds</a> and lose their appetite.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"455930671148453889"}"></div></p>
<p>Going low-carb might even mimic the effects of <a href="https://theconversation.com/weekly-dose-ghb-a-party-drug-thats-easy-to-overdose-on-but-was-once-used-in-childbirth-73266">GHB</a> – the recreational drug better known as fantasy, liquid ecstasy or grievous bodily harm – on the brain.</p>
<p>To understand why we need to look at how the body processes a very low-carb diet, one that typically limits carbohydrates to no more than <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2359752/pdf/1743-7075-5-9.pdf">50 grams a day</a>. That’s one cup of rice, two slices of bread or roughly 10% of your total daily energy needs.</p>
<h2>Your body thinks it’s starving</h2>
<p>A very low-carb diet flips your metabolic switch from burning more carbs than fat, to more fat than carbs. This usually takes a few days in a process known as ketosis.</p>
<p>During this time, your body thinks it’s starving. Once it uses up most of your glucose (carb) reserves, the body stimulates the breakdown of stored fat into fatty acids and releases them into the blood.</p>
<p>When fatty acids reach the liver they’re converted into acetoacetate, an excellent metabolic fuel that belongs to a family of chemicals called ketones. That’s why very low-carb diets are sometimes called “ketogenic” diets.</p>
<p>Acetoacetate decomposes to carbon dioxide and acetone, the smelly solvent best known for its ability to remove nail polish. This is why very low-carb dieters and people who are fasting often have sweet smelling breath. </p>
<p>A healthy liver minimises the acetone lost via the lungs by converting most of the acetoacetate it produces to a more stable substance, called beta-hydroxybutyrate or BHB. And this is where those euphoric feelings could come from.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/4fw9E32bhoc?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">The molecule BHB, which your body produces during a very low-carb diet, is very similar to GHB, the recreational drug with psychoactive effects.</span></figcaption>
</figure>
<p><a href="https://www.ncbi.nlm.nih.gov/pubmed/17011713">BHB is almost identical to GHB</a>, the naturally occurring neurotransmitter, called gamma-hydroxybutyrate, that in synthetic form is used as a <a href="https://theconversation.com/weekly-dose-ghb-a-party-drug-thats-easy-to-overdose-on-but-was-once-used-in-childbirth-73266">recreational drug</a>.</p>
<p>BHB and GHB have exactly the same chemical formula. Both consist of just 15 atoms, with the only difference being the position of one hydrogen and oxygen atom. It’s not too surprising, therefore, the two molecules share the <a href="https://www.ncbi.nlm.nih.gov/pubmed/15173314?dopt=Abstract">same carrier</a> across the <a href="https://theconversation.com/explainer-what-is-the-blood-brain-barrier-and-how-can-we-overcome-it-75454">blood-brain-barrier</a>, the impermeable tissue that protects the brain. </p>
<p>During ketosis, BHB can reach high levels <a href="http://journals.sagepub.com/doi/pdf/10.1097/00004647-200010000-00012">in the brain</a>, where it can bind to the same anxiety-reducing <a href="https://www.karger.com/Article/FullText/443173">receptors as GHB</a>. They bind with <a href="https://www.ncbi.nlm.nih.gov/pubmed/7070203">sufficient affinity</a> that they may have <a href="https://www.ncbi.nlm.nih.gov/pubmed/17011713">similar effects</a>.</p>
<p>There are no reports of <a href="https://www.ncbi.nlm.nih.gov/pubmed/26893218">BHB supplements</a> or low-carb diets causing any of GHB’s adverse effects, like loss of consciousness, seizures and death.</p>
<p>So, apart from the similar-sounding name, what evidence is there that BHB produced by the liver by people on a very low-carb diet has euphoric, GHB-like effects in the brain?</p>
<h2>Fasting for the original ‘natural high’</h2>
<p>The first case of euphoria directly attributed to ketosis was reported by Walter Bloom, who pioneered therapeutic fasts for obesity <a href="https://www.ncbi.nlm.nih.gov/pubmed/13656492?dopt=Abstract">in the 1950s</a>. After several days without food, his patients lost their appetite, felt remarkably well, and experienced a mild intoxication:</p>
<blockquote>
<p>not dissimilar to the effects of ethanol.</p>
</blockquote>
<p>Bloom speculated that acetoacetate had caused the inexplicable jubilation.</p>
<p>Other people have observed similar effects, including three Scottish doctors whose patients fasted for <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(66)92925-4/abstract">up to 249 days</a> in the 1960s. After several days without food, their appetites subsided and all patients felt an increased sense of well-being which:</p>
<blockquote>
<p>in some amounted to frank euphoria.</p>
</blockquote>
<p>Unfortunately, no studies of the euphoria reported by low-carb dieters have been conducted, as far as we know.</p>
<p>So, researchers don’t know the exact cause of these feelings. Acetoacetate, acetone and BHB, or any of their metabolites, may all be involved, as well as the effects of low blood sugar, which can cause <a href="https://www.diabetesselfmanagement.com/managing-diabetes/blood-glucose-management/understanding-hypoglycemia/">euphoria and giddiness</a>.</p>
<p>A good place to start might be to image brain activity in people on a very low-carb diet and compare activity with people on a normal, non-calorie restricted diet. The aim would be to see if brain imaging of people on a very low-carb diet has similar effects on brain activity seen when <a href="https://www.nature.com/npp/journal/vaop/naam/abs/npp2017110a.html">people take GHB</a>.</p>
<p>And if you’re thinking of going on a very low-carb diet to get that high, beware. Side effects include <a href="https://www.ncbi.nlm.nih.gov/pubmed/19064531">loss of calcium from bones</a>, increased risk of <a href="https://www.ncbi.nlm.nih.gov/pubmed/19596731">kidney stones</a> and <a href="http://onlinelibrary.wiley.com/doi/10.1111/dmcn.12462/full">growth retardation</a>.</p>
<hr>
<p><em>Special thanks to PhD candidate Ruben Meerman for his input, including his animation of BHB versus GHB.</em></p><img src="https://counter.theconversation.com/content/76303/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Andrew Brown does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Some people on very low-carb diets say they feel euphoric, have clear minds and lose their appetite. Here’s why.Andrew Brown, Professor and Head, School of Biotechnology and Biomolecular Sciences, UNSW SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/732662017-02-26T19:04:40Z2017-02-26T19:04:40ZWeekly Dose: GHB, a party drug that’s easy to overdose on but was once used in childbirth<figure><img src="https://images.theconversation.com/files/157830/original/image-20170222-1340-1uyzyjt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">People who take GHB at dance parties say it makes them feel euphoric and less inhibited. But the drug is easy to overdose on.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/573004459?src=HX483FdrXw1-JTtOy5jcIg-1-11&size=medium_jpg">from www.shutterstock.com</a></span></figcaption></figure><p><a href="http://www.drugwise.org.uk/ghb/">GHB</a> stands for gamma-hydroxybutyric acid (also known as 4-hydroxybutanoic acid) and is a naturally occurring neurotransmitter. It’s also a recreational drug.</p>
<p>People take it at dance parties and to enhance sex. Although it’s a depressant, like alcohol, in small doses people find it stimulates them.</p>
<p>It’s in the news in Australia because <a href="http://www.abc.net.au/news/2017-02-19/electric-parade-festival-more-than-20-overdose-hospital/8283828">at least 20 people</a> were taken to hospital recently with suspected GHB overdoses after attending a recent music festival in Melbourne.</p>
<p>Overdoses can happen easily because people do not know the strength of the drug they are taking. Also, the amount needed for the desired effect is not much less than the amount that <a href="http://europepmc.org/abstract/med/10869868">can cause an overdose</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/158238/original/image-20170224-32729-126myhq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/158238/original/image-20170224-32729-126myhq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/158238/original/image-20170224-32729-126myhq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=717&fit=crop&dpr=1 600w, https://images.theconversation.com/files/158238/original/image-20170224-32729-126myhq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=717&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/158238/original/image-20170224-32729-126myhq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=717&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/158238/original/image-20170224-32729-126myhq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=901&fit=crop&dpr=1 754w, https://images.theconversation.com/files/158238/original/image-20170224-32729-126myhq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=901&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/158238/original/image-20170224-32729-126myhq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=901&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<h2>How is it used?</h2>
<p>GHB has many street or slang names including G, fantasy, grievous bodily harm (GBH), juice, liquid ecstasy, liquid E, liquid X, Georgia Home Boy, soap, scoop, cherry meth and blue nitro. It is also called fishies because it is sometimes sold in the small fish-shaped soy sauce containers sold with sushi.</p>
<p>It’s generally made in small batches in people’s homes rather than <a href="http://europepmc.org/abstract/med/10869868">illicit drug labs</a> and <a href="http://www.australiandoctor.com.au/cmspages/getfile.aspx?guid=9be78a1b-dc64-4f9e-a191-15aeb295ba78">comes as a clear liquid</a> with no smell that often <a href="http://europepmc.org/abstract/med/10869868">tastes salty</a>. </p>
<p>It’s often sold in a small plastic container, or sometimes as a white powder, for about A$10 a dose. People usually swallow it, but can inject it or insert it anally.</p>
<h2>Who uses it</h2>
<p>A major 2013 drug survey found only <a href="http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129549848">0.1% or 24,000</a> Australians aged over 14 had used GHB in the past year.</p>
<p>People most likely to use GHB usually use other drugs as well. GHB use has recently increased among regular ecstasy and methamphetamine users but is still infrequent. Of those who reported using it in 2016, most said they had used it <a href="https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/EDRS%20October%202016_FINAL.pdf">two or three times</a> that year.</p>
<h2>What are its effects?</h2>
<p>No-one is certain what naturally-occurring GHB does in the body. But we do know it increases levels of <a href="http://www.who.int/medicines/areas/quality_safety/4.1GHBcritical_review.pdf">dopamine in the brain</a>, a neurotransmitter that helps control the brain’s reward and pleasure centres.</p>
<p>Its effects on the body start within five to 20 minutes of taking the drug and last three to four hours. GHB causes a loss of inhibition, relaxes people, boosts their sex drive and promotes feelings of euphoria.</p>
<p>But side-effects include memory lapses, drowsiness, clumsiness, dizziness or headache, lowered temperature, tremors, nausea and diarrhoea.</p>
<p>The effects of the drug vary according to how much people take (usually 0.5-3g), their body weight, if they are used to taking it, and if they have taken other drugs, including alcohol.</p>
<p><a href="http://www.ajemjournal.com/article/S0735-6757(09)00553-1/abstract">Symptoms of a GHB overdose</a> include vomiting, sweating, shallow breathing, confusion, agitation, hallucinations, seizures, blackouts and unconsciousness for several hours.</p>
<p>Some people have died from GHB because they appear to have gone to sleep but are actually unconscious and have stopped breathing.</p>
<p>Children have also <a href="http://www.theage.com.au/news/national/recall-for-toy-that-turns-into-drug/2007/11/06/1194329225773.html">accidentally overdosed</a> on GHB after swallowing beads from a children’s toy called Bindeez. In 2007, three children were hospitalised after swallowing the beads, made using an incorrect chemical, which turned into GHB in the stomach.</p>
<h2>The date rape drug?</h2>
<p>GHB has been linked to drink spiking and sexual assault. This was the case for <a href="http://www.smh.com.au/national/three-face-charges-over-brimble-cruiseship-death-20080911-4ekv.html">Dianne Brimble</a>, who died on a cruise ship in 2002 after being given GHB and alcohol. So GHB is sometimes called the date rape drug.</p>
<p>Some campaigns about the dangers of drink spiking reported GHB makes people unable to <a href="https://web.archive.org/web/20120510151441/http://www.justice.gov/dea//ongoing/daterapep.html">resist sexual advances</a>.</p>
<p>GHB can only be detected in urine samples for <a href="https://pdfs.semanticscholar.org/a4a3/d2fce99c40bf3e3d3acb5632eac7c3bc7914.pdf">four hours</a> after the drug has been taken. This suggests GHB could have been used when people were drugged and sexually assaulted but it would have left their system by the time they sought help.</p>
<p>But more recent studies <a href="http://www.sciencedirect.com/science/article/pii/S1353113106000393">in Australia</a>, <a href="http://www.24housing.co.uk/news/no-evidence-to-suggest-widespread-date-rape-drug-use/">Netherlands</a> and elsewhere show alcohol is the drug most common in drink spiking, not GHB or other sedatives.</p>
<h2>Is GHB illegal?</h2>
<p>GHB is a chemical that occurs naturally in the body and helps messages travel to the brain. You can also find GHB in some <a href="http://europepmc.org/abstract/med/15939164">meats, fruit and wine</a>.</p>
<p>But as a synthesised chemical, its classification in Australia changed in 2014 from a prohibited drug to a controlled drug (a schedule 8 drug).</p>
<p>This is so doctors could prescribe it for the sleeping disorder <a href="https://theconversation.com/the-big-sleep-science-is-waking-up-to-the-curious-story-of-narcolepsy-45040">narcolepsy</a> under the brand name <a href="http://sleephub.com.au/xyrem-in-australia/">Xyrem</a>. Doctors can only access the drug by special request to the <a href="https://www.tga.gov.au/">Therapeutic Goods Administration</a>.</p>
<h2>An interesting history</h2>
<p>GHB has an <a href="http://www.who.int/medicines/areas/quality_safety/4.1GHBcritical_review.pdf">interesting history</a>.
Russian chemist Alexander Zaytsev synthesised it in 1874 but there are no reports about how it was used at the time. </p>
<p>It was not until 1964 when French doctor Dr Henri Laborit used GHB to drop people’s temperature during surgery, trying to reverse the symptoms of shock caused by their injuries and the operation.</p>
<p>GHB was widely used in Europe for several decades as an anaesthetic in childbirth because it helped the cervix dilate. It was also used to help people sleep. But the development of newer drugs has superseded it.</p>
<p>Reports of GHB use and overdose have been recorded internationally by the <a href="http://www.who.int/medicines/areas/quality_safety/4.1GHBcritical_review.pdf">World Health Organization</a> since 1990. Most reports are from the USA, western Europe and Australia, with spikes at different time periods indicating changes in availability.</p>
<p>Low price, easy administration and limited information about the risks of GHB can cause serious problems for people who try it.</p><img src="https://counter.theconversation.com/content/73266/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Julaine Allan has received funding from the NHMRC, ARC, RIRDC, NSW Health and the Ian Potter Foundation to undertake research related to drug and alcohol use.</span></em></p>It’s easy to overdose on the recreational drug GHB, as recent cases in Melbourne show.Julaine Allan, Senior Research Fellow, Charles Sturt UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/565412016-04-12T11:21:56Z2016-04-12T11:21:56ZChemsex: why is gay sex causing straight panic?<figure><img src="https://images.theconversation.com/files/117100/original/image-20160401-6809-mfb8be.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">1500, BFI Flare: London LGBT Film Festival</span></span></figcaption></figure><p>Since last year’s release of <a href="http://www.theguardian.com/film/2015/dec/03/chemsex-review-scary-but-valuable-documentary">Chemsex</a>, described by the Guardian as a “scary but valuable documentary”, the drug-fuelled sexual practices of some gay men have increasingly become a matter of heated debate, both within the gay community and in the national press. Most recently, papers have picked up on the story of barrister Henry Hendron, whose partner died last year after <a href="http://www.bbc.co.uk/programmes/p03q8tcz">overdosing on GHB at the couple’s London flat</a>. </p>
<p>But unfortunately neither last year’s documentary nor most news stories since have managed to suspend moral judgement when addressing the topic. “Chemsex” is not receiving the depth of critical analysis it badly needs. According to most accounts, including the one put forward by the documentary, gay men are driven to long sessions of “chemsex” because they are lonely and suffer from internalised homophobia. It is for those reasons, the narrative goes, that some of us end up pursuing human contact through “inauthentic” and “dangerous” means: “inauthentic” because intimacy is catalysed by drugs, and “dangerous” because it often involves unprotected sex.</p>
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<p>The <a href="http://www.theguardian.com/film/2015/dec/03/chemsex-review-scary-but-valuable-documentary">Chemsex</a> documentary is a textbook exercise in how straight culture is still obsessed with gay sex. It includes all the telling elements of a 1980s <a href="https://youtu.be/zPO5wausim8">sensationalist exposé on gay sex and AIDS</a>. There’s the crass and objectifying voyeurism: gratuitous sexual scenes punctuate confession-style interviews, the lives of those involved reduced to the kind of sex they do. There are the interviewers, never caught on camera and their questions never heard, so as not to trouble the “truth” granted by a disembodied “birds-eye” view of “reality”. There are the health specialists who voice the “actual truth” of the matter beyond the narratives put forward by participants themselves. </p>
<p>Further evidence of the ideology sustaining the film were the comments made by one of its (straight) directors. <a href="https://youtu.be/DILsNmmnyAE?t=18">During an interview</a> filmed at the 2015 BFI Film Festival, William Fairman unashamedly told the journalist how important it had been for them, the film directors, to “get in there and be the ones to uncover it”. This is a comment that sounds too much like a straight man “<a href="http://www.npr.org/sections/codeswitch/2014/07/06/328466757/columbusing-the-art-of-discovering-something-that-is-not-new">columbusing</a>” – “discovering” something that is not new – a small part of gay culture, one which the gay community was already trying to address before the film’s supposed “reveal”. </p>
<p>As its way of contributing to the conversation, this year’s <a href="http://www.bfi.org.uk/flare">BFI Flare</a> added a series of shorts to its programme. These were screened together in a session called <a href="https://whatson.bfi.org.uk/flare/Online/default.asp?BOparam::WScontent::loadArticle::permalink=chems">Chems</a>. Despite being filmed by gay directors, most of the shorts presented don’t do much more than replicating the same moralist tropes already present in Chemsex. <a href="https://vimeo.com/132838133">G-o'clock</a> is unable to convey anything about its characters other than their sex and drug habits. And <a href="http://www.chelwest.nhs.uk/services/hiv-sexual-health/clinics/56-dean-street">56 Dean Street</a>’s David Stuart describes chemsex as “a shameful thing” in the short documentary <a href="https://vimeo.com/154076116">Let’s Talk about Gay Sex and Drugs</a>. The majority of the films resort to uncritically reproducing familiar moralist platitudes on both gay sex and drug use.</p>
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<img alt="" src="https://images.theconversation.com/files/118017/original/image-20160408-23642-fqi5v1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/118017/original/image-20160408-23642-fqi5v1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/118017/original/image-20160408-23642-fqi5v1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/118017/original/image-20160408-23642-fqi5v1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/118017/original/image-20160408-23642-fqi5v1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/118017/original/image-20160408-23642-fqi5v1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/118017/original/image-20160408-23642-fqi5v1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Les Meduses.</span>
<span class="attribution"><span class="source">BFI Flare: London LGBT Film Festival</span></span>
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<p>The one notable exception was Marc-Antoine Lemire’s <a href="https://vimeo.com/116894686">Les Meduses</a>, which uses a fragmented, nonlinear narrative style and rich visual metaphors to highlight the complexity of both “chemsex” and the inner lives of those involved in it. </p>
<h2>Why we transgress</h2>
<p>Why are we still gormlessly creating such one-sided and reductive narratives about gay sex? Sexual behaviours and sexualities are inseparable from the wider political landscapes in which they emerge and are enacted. Further, as sociologists, historians and philosophers have argued for a long time, at least since <a href="http://routledgesoc.com/category/profile-tags/powerknowledge">Foucault</a>, power always coexists with resistance, and morality with deviance. Transgression and risk-taking are “normal” in societies that regulate behaviour through social norms. It is <a href="https://books.google.co.uk/books?id=OMRWM0-gSnMC&pg=PA29&dq=foucault+a+preface+to+transgression&hl=en&sa=X&ved=0ahUKEwj6q4jW74jMAhVhJpoKHQ6UBTIQ6AEIHDAA#v=onepage&q=foucault%20a%20preface%20to%20transgression&f=false">through the transgression</a> of limits that individuals affirm their own individuality and are able to become themselves.</p>
<p>Granted, such limit-experiences do flirt with death, even if to different degrees — from acceptable binge-drinking or bungee-jumping to “scandalous” long sessions of drug-taking and unprotected sex. Still, despite flirting with death, they are also life-affirming practices where individuals are able to reassert and know themselves as such.</p>
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<img alt="" src="https://images.theconversation.com/files/117098/original/image-20160401-6270-e77utj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/117098/original/image-20160401-6270-e77utj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/117098/original/image-20160401-6270-e77utj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/117098/original/image-20160401-6270-e77utj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/117098/original/image-20160401-6270-e77utj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/117098/original/image-20160401-6270-e77utj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/117098/original/image-20160401-6270-e77utj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">G o'clock.</span>
<span class="attribution"><span class="source">BFI Flare: London LGBT Film Festival</span></span>
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<p>Given this, some effort must be made to probe the wider social and political landscapes where chemsex takes place, before morals, before summary judgements, before uncritically reproducing older tropes of moral panic. Part of those landscapes must include the current state of the mainstream LGBT movement. Over the last few years, radical political and sexual agendas have been <a href="http://www.huffingtonpost.com/colin-walmsley/the-queers-left-behind-ho_b_7825158.html">“cleaned” out</a> in order to promote the figure of the “righteous gay” as the pathway towards morally-acceptable queer citizenship. In the past, queer politics used queer sex and sexuality to challenge the whole of society and its institutions. <a href="http://www.beacon.org/The-Twilight-of-Equality-P469.aspx">Today</a>, the mainstream LGBT movement seems more concerned with <a href="http://www.hup.harvard.edu/catalog.php?isbn=9780674004412">assimilating into existing institutions</a> such as marriage and the military, rather than challenging their existence. </p>
<p>The flip-side of the politics of <a href="https://www.dukeupress.edu/terrorist-assemblages">this assimilation</a> is that they have been pursued <a href="http://www.bbc.co.uk/news/uk-england-london-33608000">at the expense</a> of a wider variety of queer sexualities, desires, pleasures, identities, and ways of being. </p>
<p>It’s in that context that I think – somewhat controversially – that chemsex emerges as a form of resistance. Chemsex is a way of surviving assimilation. If this “cleaning” of LGBT culture means the destruction of queerness or deviance in one’s identity, then risk-taking can become a way in which this identity can be reaffirmed and new forms of queer belonging rehearsed – even if only temporarily.</p><img src="https://counter.theconversation.com/content/56541/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>João Florêncio does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The drug-fuelled sexual practices of some gay men have increasingly become a matter of heated public debate – but there are problems with the way it is presented.João Florêncio, Lecturer in History of Modern and Contemporary Art and Visual Culture, University of ExeterLicensed as Creative Commons – attribution, no derivatives.