By Tom Geoghegan
BBC News Magazine
An industrial solvent used to clean graffiti has become the potentially lethal drug of choice for some on the gay clubbing scene.
Another Saturday night, another ambulance outside a night club. But this is not the aftermath of a drunken brawl in binge-drinking Britain.
The medics are there to attend to someone overdosed on an industrial cleaner - GBL - and it's a scene which has been repeated a dozen times in one night.
Gamma butyrolactone, to give it its full name, has a similar effect to GHB, the "date-rape" drug made illegal in 2003 and which is equally popular in some gay clubs. They produce a euphoric high or, if too much is taken, nausea and unconsciousness.
"This is vastly more dangerous than ecstasy," says Dr Sean Cummings, who runs a private gay clinic called Freedom Health in central London.
"I personally know of two deaths this year alone and the numbers using it are much smaller than ecstasy. The penetration into the [straight clubbing] mainstream is relatively small at the moment and if it spreads, the number of deaths associated with it is going to increase."
As well as the danger of overdose, there are obvious risks to the stomach, liver and kidneys in ingesting something so toxic, he adds.
The availability of GHB has been reduced by the ban but its more potent version has stepped in to meet the demand.
Either drug, known as "G", can be bought in liquid form over the internet or manufactured at home, which means its strength can vary. The adverse symptoms can be caused by as little as a millilitre over the correct dose or by alcohol which, as another depressant, compounds the effect.
The regular use of G is restricted to a small number of dance clubs, which is a fraction of the total amount of gay venues, and the number of G-related deaths is officially quite low. But the number of people collapsing on dance floors isn't.
Adam Cooper of Knightlife Medical Services says his firm was called out to 16 G overdoses on one Saturday night a few weeks ago, at three gay clubs in London. Four patients needed hospital treatment.
Ecstasy's domination of dance culture has waned
"I can understand people taking ecstasy to get high and dance all night but I can't understand why you would go to a club and make yourself fall asleep," says Mr Cooper, who adds that he's never treated anyone for an ecstasy overdose.
A staff nurse at an intensive care unit in a central London hospital says he sees about one patient a month who is so seriously ill from G that the paramedics and A&E have transferred him to his department for artificial respiration.
Recalling the night he collapsed, banker Sergio, 33, says: "One minute I was dancing, the next I woke up in hospital and the nurse said I had been resuscitated. I got such a shock. My friend told me I had collapsed and security staff at the club were reluctant to call an ambulance.
"But another guy was monitoring my pulse and said it was dropping so my friend called an ambulance himself and I'm forever in his debt that he did. I had taken G before but that night I had drunk alcohol earlier and I think that's what made me overdose. It's a great high but never again."
GHB AND GBL
GHB is found in small amounts in the body
Both are colourless and odourless liquids
Low levels cause euphoria and increased libido
High doses induce nausea, vomiting, dizziness, depressed breathing and unconsciousness
Long-term effects unknown
£150 litre produces 500 shots
GHB is Class C so possession can mean two years' jail
GHB has a long-standing medical use as a general anaesthetic or in the treatment of insomnia. Its use as a date-rape drug has been reported across the UK for several years and the recreational use of GHB and GBL has spread beyond the gay scene and the capital.
In 2002, a girl in Bolton, then aged 25, pulled 18 of her teeth out while hallucinating on GHB at home with her boyfriend. Three years earlier, Ian Hignett, a 27-year-old from Birkenhead, died from an overdose at home with friends.
More recently, a zero-tolerance campaign has been launched by some gay night clubs in an effort to persuade customers not to indulge. On arrival, people with eye drops are sometimes asked to put a few drops in their eyes, to prove it. But there are no plans to outlaw GBL, a Home Office spokeswoman said.
Dr Cummings says G also facilitates sexual activity. "It's euphoric and disinhibiting so people can use it as an aphro-drug," he says.
The implications for sexual health mirror that of methamphetamine, or crystal, which in the UK is also largely confined to the gay clubbing scene. It is Class B but is being reviewed by the Advisory Council on the Misuse of Drugs.
A few years ago there were fears the drug could have the same devastating effect in Britain that it has wreaked in parts of the US and South-East Asia, where addicts suffer from psychosis, paranoia and social dysfunction.
Amphetamines are synthetic stimulants varying in purity
Methamphetamines are a stronger version, usually powder, crystals or tablets
Effects range from increased confidence to euphoria
Users can party for long periods
Side effects include psychological dependence and psychosis
Depression and lethargy can set in during comedown
Although use remains lower than feared, drug workers remain concerned it may become more widespread.
The rocks, which cost about £40 for a quarter-ounce, are smoked, snorted, swallowed or injected to stimulate the central nervous system and enable three-day parties or sex sessions lasting days.
One occasional user Michael, who lives in London, says: "It's the only drug I know that makes you do things that normally would be against your principles. It's like nothing can affect you when you're on it."
He says that at its peak two years ago, it destroyed the safe-sex message which had prevailed since the onset of HIV/Aids in the 1980s.
And he blames crystal for the suicide of two friends. One built a makeshift ramp in front of the window in his high-rise flat and, believing he could fly, threw himself to his death.
I have had many experiences with GHB and GBL...and that is the reason I refuse it every time. I have seen or been in the company of people that have gone into full and total muscle spasm where every muscle in the body is trying to work against each other. even the muscles in the face move independantly so that it looks like your face is trying to rip itself apart. I have also been there when someone had stopped breating and we had to shake him vigorously to get him breathing again and back into conciousness. Another time the person wet himself because his muscles were so relaxed and he didn't even know what had happened until I pointed it out. GHB is very dangerous and I would not recommend anyone have it...
This needs to be taken in context. Yes there may be deaths which is tragic, but the story could equally be referring to 'alcohol' - for example "...a euphoric high or can be nausea and unconsciousness." Alcohol is socially acceptable or even mandatory, whereas GBL is not.
Ben Rowland, England
I work in a gay night club in Manchester City Centre.. The club where i work has a zero tolerance on GHB and all other drugs.. Hearing about a new drug like this that is proving so fatal makes me think that it is time that higher restrictions should be in place in clubs & bars, and bigger penalties should be imposed on people who are caught dealing these drugs or even carrying them. Time Tony Blair spent more time concentrating on what is happening on his own door step than all over the world!
Lee Botham, UK
The gay scene is a mixed bag. But it does includes a small but hardcore, body beautiful, sex-addicted gay clubber type whose life is an endless circle of gym, clubs, drugs and sex. Often late 20s-40s, many are heavily into extreme sexual interests or fetishes (which the drugs facilitate), take steroids to acquire the required bodyshape and live a life revolving round weekend sex/drugs binges. These men rarely bother with condoms, and take risks with a whole coctail of illegal and legal drugs or "chems" to "get off": coke, crystal, ghb, ecstasy, ketamine, poppers.
I have been using GHB for about 10 years now without any problems whatsoever. Taken in the correct dosages it produces a euphoric high like ecstasy. There will always be people who have problems with certain substances. Interestingly, if GHB was such a toxic, deadly substance as some of your commentators are making out, how is that it was licensed a couple of years ago in the US for the treatment of narcolepsy under the brand name Xyrem?
Gavin Patterson, UK
I've taken G a few times and it's always put me straight to sleep or made me vomit. Not good for when you're hoping to have fun! The major downside from my experience is it causes you to lose your inhibitions. I had unprotected sex with someone while high on GHB and was infected with HIV. Never taken it since.
RF, London, UK
These people are not falling "asleep" but falling "unconscious". Suggesting people fall asleep indicates that it is reasonably safe to do so. If they were sleeping, it could not be used as a date rape drug.
I work for the ambulance service and am a gay man. I object to the claims that most gay clubs misuse drugs. The BBC is sensationalising a story which needn't be. Yes you can report the drug, which is in everyone's interest to know. But please do not stigmatise a community which is equally responsible for the drug misuse as every other community.
Nicholas Dalby, Leeds, UK
Perhaps we should start the US idea of "friends don't let friends...". It sounds a bit over the top, but we should help our friends to stay safe.
It is misleading and sensational to say that GBL is the drug of choice on the gay scene. For most it's alcohol and tobacco, followed by amyl nitrite, marijuana, ecstasy etc. The responsible zero tolerance scheme run amongst London gay clubs, the educational and harm minimisation approach by the police, health promoters and gay media and good sense has kept its regular use to a tiny proportion of gay men.
David Reid, UK
The whole reason these dangerous gamma butyrates are being used in clubs now is because of ecstasy crackdowns. Former ecstasy users are substituting more dangerous and more available drugs. When the government bans all the relatively safe ways to have fun, what's left? Drinking industrial solvents is left.
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