Many deaths involving GHB, a depressant that’s popular in raves and chemsex scenes, in Australia might have been possibly prevented through a few easy-to-do harm reduction practices, found a February 18 study in the journal Clinical Toxicology.
Over the past two decades, 74 Australians died of GHB-related causes, as recorded by coroners. Most of these deaths (79 percent) were from drug toxicity, while others were related to trauma from motor vehicle crashes and suicide. Researchers at the National Drug and Alcohol Research Centre in Sydney found that many of them could potentially have been stopped through first aid—or avoided by the person sticking to one drug, instead of mixing G, as it’s colloquially known, with other substances.
Many of the deaths (30 percent), were caused by the inhalation of vomit. For one of the study’s authors, this highlights the importance of bystanders’ interventions and the provision of emergency medical attention.
“Many of the deaths involving inhaling vomit (aspiration) could possibly have been avoided by placing the person in a recovery position,” said psychologist Shane Darke in a press release. “Vomiting and aspiration are common with GHB overdose. The maintenance of adequate respiration, clearing the airway, and calling an ambulance are crucial.”
Bystanders, he recommends, should take action when they “see anyone with key signs of overdose like vomiting, shallow breathing, loud snoring, or have passed out.” This important peer intervention could be limited by bans on GHB in US-American and European clubs, some harm reductionists have have warned. In the Australian cases reviewed by Darke, though, most (84 percent) occurred in a home environment.
Almost all of the cases (92 percent) involved use of G in combination with at least one other drug—a practice Darke described as being “incredibly dangerous.” It is well established that mixing drugs is the “norm, not the exception” of use, as Harm Reduction Coalition’s Dr. Kim Sue once characterized it to Filter, and is playing a major role in the opioid-involved overdose crisis in North America.
In the Australian cases, the most common substances mixed with G were psychostimulants (64 percent), like methamphetamine; “hypnosedatives” (28 percent), like ketamine; and alcohol (20 percent). Meth can boost wakefulness, thereby offsetting the sleepiness caused by G. A person using both may then underestimate their level of intoxication and take an additional dose they’d otherwise not. “Downers” such as ketamine and alcohol themselves slow down breathing, and mixing them with G can fatally exacerbate that.
Darke rejects any benign characterizations of G. “The idea that this is some type of safe party drug is completely wrong,” he said.
But while G’s harms can be deadly, it is not necessarily exceptional. In fact, G was considered to be far less dangerous than comparatively less-stigmatized drugs like alcohol and cannabis and other popular club drugs, like cocaine and ketamine, by the parliament of the United Kingdom in 2006.
GHB-related fatalities are not destined. How a person uses and how their peers respond are what can determine fatal outcomes—not the mere fact of taking the drug itself.