hoptis
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Dose of reality
April 22, 2006
No inhibitions … teenagers and people at private parties are the new users of G, which sometimes is sold in plastic soy sauce containers.
Illustration: SMH News Design
The hardcore clubbers might be turning away from the risky party drug G, but it's the dabblers who are dicing with death now. Ruth Pollard and Jano Gibson report.
IN THE 19th century, Russian prisoners were forced to play the game now known as Russian roulette. They would place a bullet in a revolver, spin the cylinder and close it without looking. As legend has it, they would then aim the gun at their head and pull the trigger. If the chamber was empty, they lived; if not, they died.
So it is with the party drug known as "G", except there is no gun or bullet on which to chance your life. The game of chance is in your ability to measure out a safe dose, in the number of doses you take, and in whether you mix it with other drugs or alcohol. These variables determine whether you will experience euphoria or die trying.
The death this week of 24-year-old Matthew Ryan, reportedly after taking G, brings that danger into sharp relief and, if the link is proved, makes it the 11th death attributable to the drug in Australia.
"It's a very intense rush, incredibly pleasant. I guess at times you get very sexual and very frisky … it makes you want to root anything," says David (not his real name), a 38-year-old accountant.
He started taking G five years ago "because ecstasy wasn't giving me the same high any more. [G] plays with my senses. Sounds can go a little bit funny. I dance rather quickly. There's a sensation of exhilaration, amazingness."
First synthesised as a drug in 1960, gamma hydroxybutyrate (GHB) - the original form of G - is a fatty acid that occurs naturally in the body. It has been used either clinically or in trials as a treatment for sleep disorders, as an anaesthetic and as a treatment for withdrawal from alcohol or opioids such as heroin.
Dealers promote it as the drug sniffer dogs cannot detect - and with a promise such as that, what punter could refuse? Combined with feelings of euphoria, heightened sexuality and intense relaxation, the path to a good night out is paved in gold. The downside? Dizziness, nausea, vomiting, weakness, profuse sweating, confusion and agitation, drowsiness, unconsciousness, coma, and, if the bullet is in the chamber, death.
From a little-used clinical drug, it moved to one that was promoted in the late 1980s as helping bodybuilders lose weight and develop muscle.
But by the 1990s, emergency departments in California were reporting the first wave of GHB overdoses. Since then its illicit use has increased considerably. Emergency departments in Australia are reporting a marked rise in the number of overdoses.
GHB, G, grievous bodily harm, fantasy, blue nitro, liquid ecstasy, liquid X, liquid E, cherry meth, Georgia Home Boy, soap, scoop - as with most party drugs, the street names can sound clever and sexy. But it is in those names that a further danger lies.
Some users, particularly those who do not take drugs often, believe they are taking a form of ecstasy. It is only when they regain consciousness in a hospital emergency department, or under the watchful eye of a dance party medic or ambulance officer, that they begin to understand how unlike ecstasy this drug can be.
Add to that the fact GHB is no longer available in Australia due to laws prohibiting its possession. Instead, it is its "precursor" drug, GBL, or gamma butyrolactone - for which a licence is required - that is sold. Another variant on the market is 1,4-Butanediol (1,4-B).
When it is ingested, GBL is converted into GHB, but it is metabolised differently and is slower to "come on", bringing with it a further threat, says Paul Dillon from the National Drug and Alcohol Research Centre.
If people are used to a drug taking effect in 15 minutes - as GHB has been known to - they are likely to take a second dose if the first does not work quickly, not knowing they are putting themselves at real risk of an overdose, he warns.
GBL is used as a solvent, in the production of pesticides, herbicides and plant growth regulators, and is used in paint removers, textile oils and drilling oils. Essentially, users are mixing a small amount of industrial solvent, usually with a soft drink to mask the chemical taste, in the chase for the next big high.
Users tell the Herald that G feels like "a cross between alcohol and ecstasy".
"Everything softens and goes a bit wobbly," says a 34-year-old woman who takes it "at home for lovemaking" and at small parties and clubs.
Another user, a 28-year-old man, says: "You get bodily sensations like relaxing, tingly feelings [that come] in gentle waves."
The new trends in the use of G bring with them the greatest risks, Dillon says.
It is now used more often at home and has moved from being a drug taken by a handful of hardcore partygoers in the gay community to being broadly used on the straight dance scene.
The other key change: many young people at dance parties and music festivals report that they have swapped their drug of choice from ecstasy to G. Why? Because it is sold as a drug sniffer dogs cannot detect, Dillon says. The dogs have been blamed for the increasing use of drugs at home.
"This notion that you are standing in a nightclub and a whole lot of police come in with sniffer dogs, is a scene people want to avoid," he says.
"All drugs are riskier in the home environment, but with G, of course, people are so disinhibited, they tend not to look after each other as they would on other drugs."
BUCK Reed, a first-aid officer who works on many of Sydney's major dance events, outdoor festivals and dance clubs, is seeing new, less experienced users getting into trouble with G. "People who are experimenting do not have a very good understanding about how it works and what the risks are, and they have been getting a lot of misinformation from the people supplying it to them."
He says a "reasonable number of G overdoses" do not even know they are using the drug. "They think they are on fantasy or liquid ecstasy, which they perceive to be an amphetamine - the reality is very different.
"The dealers in the suburban areas, which is where a lot of the new users are coming from … say it is going to make them feel nice, like pills do, and that it is nice and safe."
People are very surprised when their friends end up in the back of an ambulance. They are "stunned that this whole series of events is occurring", Reed says.
Apart from overdosing, the danger with G is taking it with alcohol, another depressant that multiplies the effects.
The other misconception is that G users simply fall asleep. They can become drowsy and slip into unconsciousness, leading to potentially fatal complications with breathing.
"Essentially, this has led to all the G-related deaths in Australia - they have been left unattended, their mates think they are going to sleep, their airways become obstructed, and they die," Reed says.
He has seen about 25 G overdoses since the new year, compared with only a handful before that.
"The hardcore clubbers seem to have grown out of it … it is people who go to parties at people's places in the suburbs, or very large parties, that are getting into trouble."
David Caldicott is the Emergency Research Fellow at Royal Adelaide Hospital. His studies suggest that G is widely viewed by the dance community as "more trouble than it's worth".
"It brings with it an unhealthy interest of outsiders, it reflects badly on the dance community and the harm that is associated with the drug is likely to lead to more criticism," he says.
The roller-coaster of popularity that a new drug rides often ends with widespread use - take ecstasy as an example. But with G there was a clear spike in people's curiosity, then as they discovered the problems with safety - that the cons outweighed the pros - most moved on to the tried and true or the new and exciting, he says.
"There are a stubborn few who continue to use it. Our concern is that until that drug is removed from the scene completely, there is always a risk that a new generation will land upon it for a range of reasons - for example, the sniffer dogs."
Suddenly, a drug widely seen as too dangerous to bother with becomes popular again. "This is one of the arguments I have put forward against sniffer dogs … you may encourage patrons to increase the use of more dangerous drugs in order to avoid detection," Caldicott says.
G is not a widely used drug in Australia - in the 2004 National Drug Household Survey, 1 per cent of people reported having used it. Only 0.05 per cent said they had used it in the past year.
But the overdose rate is extraordinary. A 2003 study from the National Drug and Alcohol Research Centre found half of all G users in the sample had overdosed at least once (being unconscious and unable to be woken) and a third had overdosed more than three times. The most common place for an overdose to occur was someone's house (40 per cent), a major dance party (25 per cent) or a club (20 per cent).
St Vincent's in Darlinghurst is one of the few hospitals in Australia to keep figures on G overdoses. A spokesman for the hospital provided the statistics, without comment, showing a doubling of G overdoses from 25 in 2001 to 51 in 2002, then leaping to 136 in 2003 and peaking at 205 in 2004, before plateauing last year at 195.
CALDICOTT also points to the dangers of home use, saying most dance parties, raves and big clubs have good security, medical support, a low tolerance for overdoses, and are very quick to call for help. "Much of the medical support at events is really excellent … if you are at home you have none of that."
He points to a drift towards use by teenagers - for underage users, it is easier to acquire than alcohol, and markedly cheaper.
In Adelaide, it is sold by the capful, Caldicott says, measured in a bottle top from a water bottle, for between $2 and $5.
With a licence to acquire GBL, people can import a 208-litre drum for a few hundred dollars - the mark-up is phenomenal, he says.
Kate Leslie, an associate professor and counsellor of the Australian and New Zealand College of Anaesthetists, describes GHB as a very dangerous drug that produces rapid unconsciousness.
"Small increases in the dose of this drug cause a big increase in effect, so you only need to take a little bit more and you get much more than you bargained for.
"If you combine GHB with alcohol, you don't just get an added effect, you can get a synergistic, or multiplied, effect - you might get three or four times the effect."
The danger also comes from the speed with which the drug moves from the disinhibiting stage - the reason people take it - to the unconscious phase, or overdose, she says.
G is not used clinically in Australia because it causes vomiting and lasts longer than other anaesthetics, Leslie says. Anaesthetists prefer safer, shorter-acting drugs.
"We are medical specialists who have trained for at least 13 years at university and hospitals to do this properly. We use drugs that are manufactured by pharmaceutical companies.
"The drugs are pure and the dose is accurate. With G, the concentration of the drug and its purity can vary a lot."
There are usually six medical and health professionals in a room when an anaesthetic is administered, she says. If an overdose occurs, experts are on hand. Not so with an illicit drug such as G.
DAVID says he takes small liquid doses of the drug about once a fortnight, at clubs and at private gay parties.
He has twice "fallen asleep" while on it, six of his friends have been hospitalised after using it and another died in circumstances linked to it.
He, and the other users, say they are meticulous about the dosages they consume and ensure they don't drink alcohol when using.
"If you are going to use the drug you need to be aware of the risks and minimise the harm that can be done, [but] I don't think you can ever be 100 per cent sure with this drug," David says.
From Sydney Morning Herald
(completely figuratively speaking...)
