Spurred by media panic around a so-called “chemsex crimewave,” the United Kingdom’s independent drug policy advisors are recommending that people involved with the highly stigmatized depressant gamma-hydroxybutyrate and related substances (GHB-RS) be subject to harsher criminal penalties.
But the Advisory Council on the Misuse of Drugs (ACMD) did not make its recommendation to escalate punitive responses unanimously. An unspecified number of ACMD experts on the Technical Committee, which deliberated GHB-RS’s change in classification under the Misuse of Drugs Act 1971, objected. They warned that intensifying criminalization will only inflict, not reduce, harm—particularly for queer and trans people.
The ACMD was commissioned by UK Home Secretary Priti Patel to investigate GHB-RS at the beginning of 2020—shortly after the conviction of, and ensuing media fixation on, a gay man of color for committing large-scale sexual violence that was allegedly facilitated by GHB-RS. On November 20, the ACMD published its assessment of the harms of GHB-RS and its recommendations in response.
The maximum penalty for possession would increase from two years in prison to five.
GHB-RS are central nervous-system depressants, most popular in queer scenes and nightlife contexts. In 2006, GHB was considered by the country’s parliament to be far less dangerous than most other common party drugs, including alcohol, ketamine, benzos, amphetamine, cannabis and LSD. It rank was ranked the second-lowest received for physical harm—including chronic and acute harms—in a study commissioned by the House of Commons’ Science and Technology Committee, for which doctors, psychiatrists and epidemiologists assessed the physical harms, dependence and social harms of 20 drugs.
The drug tends to be stigmatized for its branding as “date-rape drugs” and its steep “dose-response curve”—meaning that redosing yields exponentially more intense effects and can lead to passing out. Overdoses can be prevented through harm reduction strategies, like not mixing with other drugs, accurately dosing with a milliliter syringe, and starting and going slow.
The “majority” of the ACMD’s Technical Committee recommended reclassifying GHB—and related substances GBL and 1,4 butanediol (1,4-BD)—from Class C to Class B of the UK’s drug schedule, where it would join other chemsex drugs like mephedrone and ketamine. The maximum penalty for possession would increase from two years in prison to five. The change wouldn’t alter the 14-year maximum sentence for suppliers and producers.
A Minority Dissents
The Technical Committee’s decision was taken despite a minority warning that the reclassification could uniquely criminalize queer and trans people—all while bucking public health research and potentially hurting the very people the change purports to protect
Those against the reclassification noted, the report summarizes, the “unintended impacts of reclassification on those using these compounds—particularly those from the LGBT community and those using these compounds in the Chemsex context specifically. These already vulnerable groups could be disproportionately impacted by any changes to the criminal justice system.”
The change may even harm survivors of sexual violence facilitated by GHB-RS.
They also warned that more punishment is not the key to reducing harms. There is a “lack of evidence to suggest that reclassification alone would be effective in reducing the harms associated with these compounds,” the report notes. “Overwhelmingly, public health experts, like from the World Health Organization, and international governing bodies, like the United Nations, assert punitive laws, like drug criminalization statutes, have ‘been proven to have negative health outcomes and that counter established public health evidence.'”
The change may even harm survivors of sexual violence facilitated by GHB-RS. “Higher offences applicable to the possession of these compounds,” the report states, “could deter recreational users who fell victim to a drug facilitated sexual assault from reporting their assault to the police.” UK queer and trans survivors of hate crimes already have bad experiences with cops; a 2019 survey found that almost half (45 percent) of those reporting such violence “were unsatisfied with how their report was handled.” Commons reasons survivors didn’t report such incidents to police were that “‘it would not be taken seriously enough’ and/or that ‘nothing would happen or change’.”
The Evidence Around GHB-Related Harms
The Technical Committee majority justified its decision based on “a significant body of new evidence of the harms of these compounds emerging since the ACMD’s last review of their classification, particularly in terms of the associated levels of drug-related death and their ‘weaponization’ (use to facilitate robbery and sexual assault).”
The epidemiological study of GHB-RS harms is sparse in comparison to the public health monitoring of other drugs. Of the data that do exist, GHB-RS harms appear to be concentrated in urban queer scenes.
Compared to deaths related to other drugs, reported GHB-RS fatalities are uncommon.
Emergency department cases of GHB-RS-related health emergencies seem to be mostly presenting in London hospitals, particularly those located near popular LGBTQ nightlife scenes. Between autumn 2013 and 2014, two such hospitals, Guy’s and St Thomas’s, saw more GHB/GBL overdoses (293) than they did for heroin (111) and cocaine (171) combined.
That’s alarming—but it can’t be presumed to be the case across the UK. In fact, the ACMD report noted that a hospital that saw zero GHB/GBL overdoses in that year-long period “may be more representative of the picture nationally,” though adding that “this is difficult to determine without data from other UK hospitals being included.”
Compared to deaths related to other drugs, reported GHB-RS fatalities are uncommon. That doesn’t mean more aren’t occurring; the chemical is rapidly metabolized by and cleared from the body, posing challenges for postmortem detection.
The ACDM report presents a spotty statistical picture. Between 1995 and 2012, researchers recorded 159 cases where GHB was listed to have caused death across England and Wales—or 0.5 percent of all drug-related deaths in that 17-year period, according to the ACMD report. More recent numbers from London, a GHB-RS hotspot, between 2011 and 2015 show a slightly higher fraction of 0.92 percent (61 deaths out of 6,633). But the figures aren’t even comparable: The London numbers capture all deaths where “GHB was present in some form,” as the ACMD explains.
The “strong new evidence of significant criminal harm” is, in fact, slim.
On the other hand, the “strong new evidence of significant criminal harm” from GHB-RS that the ACMD describes is, in fact, slim. For alleged GHB-RS-facilitated sexual assaults, the report cites a single case: that of Reynhard Sinaga, who was convicted of assaulting 48 queer men. For murders allegedly associated with GHB-RS, again the report only points to two high-profile cases: those of Stephen Port and Gerald Matovu. All three cases have been the subject of sensationalized news media accounts.
The tactic of invoking a few notorious cases is straight from the United States’ playbook for criminalizing GHB-RS. In the 1990s, lawmakers framed their political battle to criminalize GHB-RS as a so-called date-rape drug” around the death of a teenage girl, Hillory Farias, who was framed as a sexual assault victim (despite no indication of such violence) and likely did not even take the drug, much less die from it.
The ACMD’s call to up penalties is also, plainly, pro-cop—amid growing calls by the UK public to defund the police. The report authors explain that the reclassification would allow for “providing law enforcement agencies with additional tools to tackle offences associated with these compounds.” The UK has seen similar Uprisings against police terror and calls for police defunding or abolition to those that have radically shaped 2020 in the United States.
The Technical Committee overall identified “unintended consequences” of its recommendation. Similar to how some people who once used prescription opioids then shifted to unregulated fentanyl-adulterated heroin, current-GHB-RS users, the Committee warns, may “shift to increased use of GHV/GVL,” two GHB-related that are not controlled.
The tendency for UK residents to adopt previously little-used substances in the wake of supply-side crackdowns has precedent. After GHB was deemed a Class C drug in 2003—right around when the US was criminalizing it—GBL and 1,4-BD seemed to increasingly be used, attracting the ACMD’s attention and resulting in those substances’ Class C classification in 2009.
The Technical Committee also noted that the reclassification “may force current GHB users to withdraw from the drug in an uncontrolled way with consequent impacts on their physical and mental health.” GHB-RS withdrawal can have serious health consequences, like insomnia, anxiety, tremors, sweating, increased heart rate and blood pressure, and psychosis.
The report additionally called for expanding data collection and education on, as well as toxicological testing and behavioral health services for, GHB-RS use.
Image adapted from a 2006 Acon educational guide via Archives of Sexuality and Gender