GHB : 1 in 5 Pass out each year (& women are more at risk than men)
Professor Adam R Winstock
Founder & CEO, Global Drug Survey
GHB (and the closely related GBL and 1.4 butane-diol) have been part of the drugs scene in many Western countries since the 1980s. Perceived us being more commonly (but not exclusively) used by gay men, GHB has prosocial (mood elevating and disinhibiting – a bit like alcohol) and sexual promoting and enhancing effects. It’s big on the chemsex scene in many cities.
Whilst the risks of overdose have always been well recognised, in recent years more attention has been paid to its association with sexual assault and the development of dependence that can be associated with life threatening withdrawal.
This year GDS2018 reports on the patterns of use and the risks among both men and women, and the results were surprising. And what we found will surprise you.
What is GHB (and its almost identical pro drug cousins GBL and 1.4 butanediol)?
GHB is a colourless, odourless liquids usually taken orally in doses of between 0.5 and 1.5ml. Many people who use GHB know the risk and are careful about how much they use. But it is a risky drug and dose for dose is probably riskier than other drugs in terms of its potential to leave you unconscious (and therefore also vulnerable to sexual assault), and rarely, fatal overdose.
There is a tiny difference (less than 1ml) between the dose that gets people feeling happy and horny, and the dose that leaves them unconscious so we strongly advise to always measure dosage carefully using a syringe. Note that alcohol increases the respiratory depression that you get with GHB, massively increasing the risk of overdose.
Because GHB comes on very quickly after taking it (within 15 minutes) and only last a few hours, taking another dose too soon can increase your risk of overdose so leave a minimum of 2-3 hours between doses. Because GHB can affect your memory we advise people to set a reminder on your phone.
Like all illegal drugs the purity and potency of different batches vary, so we suggest always taking a smaller dose than usual when first testing a new batch for its effect
Whilst GDS is not a general household survey and so shouldn’t be used to determine the general prevalence of drug use, it does provide a comparison between the rates of use among different communities. Typically the rates of drug use among the GDS sample are much higher than found amongst the general population. However even among the GDS sample GHB is a very uncommon drug with only 1.4% of straight and 4.4% of gay men and 0.8% of straight and 1.9% of gay/bisexual women using in the last year.
In our very preliminary findings several things stood out:
- First is that on a population basis it may well be that there are more heterosexual male users of GHB than any other user sexuality group.
- Secondly, among gay men, GHB use is rare and contrary to the media portrayal and my own experience of running a chemsex clinic in London, most gay men who use GHB do so infrequently (mean 15.8 times per year). With only about 5% of gay men reporting use of 50 or more occasions in the last year the stereotype of dependent users is also challenged.
- Also surprising is the small number who report use in conjunction with crystal meth or mephedrone, with MDMA being the most popular drug used in combination with GHB (after alcohol). This suggests that use on the dancefloor may be the most popular environment for taking GHB as opposed to chemsex / house parties. Over 60% report never drinking alcohol when using GHB which is great news, since the combination increases the risk of passing out and overdose, though about 20% report always nearly always drinking when using GHB.
- Highlighting just how easy it is to overdose on GHB, 1 in 4 women and 1 in 6 men report passing out on GHB in the last 12 months. 10% of people using once or twice report passing out, which increases to 1 in 3 who report using it more often. Women are also seeking EMT twice as frequently than men (4% v 2%).
Many people who pass out don’t call emergency services, relying on friends to take care of them. If you have friends with you they should place you in the recovery position (see our videos here to teach you how to do this). If they cannot rouse you they should call the emergency services. If a person’s respiratory rate is less than 8 breaths per minute. always call for help.
The best way to stay safe is to keep an eye on your mates and if using GHB for sexual purposes then use a condom, plenty of lube and ask for consent (not saying no is not the same as saying yes). If you’re not sure what you got up to while you were high or unconscious, then get yourself checked at a sexual health clinic. And of course if you can’t wake someone, then don’t ever be afraid to call for help. Place them in the recovery position, call emergency services and stay with them until help arrives.
For more advice on how to reduce your risks see our YouTube video and harm reduction guide:
The Global Drug Survey Highway Code: https://www.globaldrugsurvey.com/brand/the-highway-code/
Videos on the golden rules for using, safer dosing and our animation There’s More to G than Cock.