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Chemsex Study Shows Urgent Need for Education amid Rising GHB Deaths

The results of a study into chemsex in the UK illustrate the need for improved public education on the risks of gamma-hydoxybutyrate (GHB) use.

Chemsex involves people – primarily men who have sex with men – having sex while under the influence of psychoactive drugs. Public health experts state that the most prevalent drugs used during chemsex are GHB, mephedrone, and crystal methamphetamine. Among these, the study states, the most significant driver of acute harm is GHB – as overdosing on it can lead to respiratory depression, apnoea, entering a coma, and even death.

The study, published by Forensic Science International on December 5, was carried out by Imperial College London in response to a dearth of systematic analyses into the potential harms of chemsex and associated GHB use. Its main recommendations are that authorities should provide clearer information to the public on how to reduce the harms of GHB use, and for all cases of unexplained sudden death to involve routine testing for GHB.

Between 2014 and 2015 there was a 119 per cent increase in identified GHB-associated deaths in London. The magnitude of this growth can be demonstrated by comparing it other drug-related deaths; during the same period in London, there was a 25 per cent increase in cocaine-related deaths, and a 10 per cent decrease in MDMA-related deaths.

The rate of GHB-associated deaths is likely to be even higher than reported, the study suggests, as GHB is rarely included in coroners’ routine death analysis.

The study partly attributes the growing GHB-related death rate to the lack of awareness that people have about the drug.

Using alcohol or other psychoactive substances can intensify the risks of GHB use, yet many people continue to do so. Presence of at least one other illegal drug were detected in 72 per cent of all identified GHB-associated deaths between 2011 and 2015, while alcohol was detected in 26 per cent of such deaths. These high figures suggest that many people who use GHB are unaware of how to reduce its potential harms.

DrugWise reports that there is "very little statistical evidence" of how prevalent GHB use is in the UK, as it is often not included in drug use surveys. Anecdotal evidence, they say, suggests that it is not a significant narcotic of choice among “the general drug-taking population”.  

Despite GHB most likely being used by a relatively small proportion of people, the study’s findings indicate it may cause particularly significant harm to specific communities, so its importance should not be overlooked.

Last year, the British Medical Journal published an op-ed noting a sharp rise in the number of men seeking help for problems related to chemsex-specific drugs, including GHB. The piece also describes how those who engage in chemsex may be particularly vulnerable, and that those vulnerabilities must be taken into account by health professionals.

The op-ed’s authors claim that those who engage in chemsex may do so to “manage negative feelings, such as a lack of confidence and self-esteem, internalised homophobia, and stigma about their HIV status”. As such, not only do some chemsex participants face the taboo of drug use, but they may also deal with added barriers to speaking out and seeking help.

Essentially, the study recommends three primary approaches for authorities to combat the harms of GHB use, particularly when related to chemsex: providing clear guidance to the public on how to reduce the harms of their GHB use, ensuring that accurate information measuring GHB use and deaths is collected by relevant authorities, and guaranteeing that appropriate drug treatment services – including those related to mental health – are provided.

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