When legendary Montreal after-hours club Stereo went public with their new no-tolerance policy on GHB use this month, owner Tommy Piscardeli hoped that it would inspire a larger conversation about the problems the drug poses to dance music venue owners and event organizers worldwide. "We have to prevent it before something really horrible happens. Let's stop this before someone dies," he told THUMP.
While Stereo's new policy of barring patrons from the club forever if they're caught with GHB may not end up having the impact they're hoping for, other Canadian club owners and promoters aren't exactly stepping up to the plate when it comes to joining the conversation around harm reduction. Several agreed that they were seeing more issues in recent years with GHB (gamma hydroxbutyrate), most were unwilling to talk on the record, citing fears that it would lead to unwanted attention from the authorities.
"They're probably afraid," says veteran Toronto house music promoter Richard Brooks. "They don't want anyone to think there's even a possibility of that stuff happening at their club or event. The problem is, you can't control it. You can only search so much. I think it's amazing that Stereo did that. I actually wanted to put a 'no GHB' thing on my promo last year."
How Did GHB Become a Party Drug?
Originally popular among bodybuilders, used after workouts because it was believed to stimulate muscle growth, the drug eventually became popular for recreational use. In the mainstream media, it's commonly referred to as the "date rape drug," due to its effects of putting users into a deep unconscious state and disrupting memories. Generally a clear, salty liquid, it's typically consumed by adding to a beverage, although many dye the drug a colour to prevent accidental ingestion.
While not nearly as commonly used as most other illegal drugs, GHB appears to enjoy sporadic surges of use in specific communities and areas. Studies had suggested a decline in use over the early 2000s, but there's a lag in newer research, so any more recent upswings in popularity are impossible to confirm or refute. According to Toronto's Centre for Addiction and Mental Health, there's little current data in Canada tracking its use. The drug is also difficult to detect in patients who show up in emergency rooms unconscious, further complicating efforts to get dependable numbers on its impact.
Given GHB's reputation for unpredictably knocking users unconscious and the related associations with sexual assault, it can be hard for outsiders to understand its popularity in some scenes. Those who do enjoy the drug argue that it seems healthier to them than other illegal drugs, with no hangovers, and that the high is worth the risk.
"I just found the euphoria with G was much superior to MDMA for me," according to one anonymous user and occasional dealer (let's call him "John"). While he says he's been a regular user for three years, he prefers to use it at home with his partner while having sex as the substance enhances libido. "I've seen people doing it out at parties, and it does get sloppy. For one thing, they're not measuring it correctly, and that's a huge important part of it. If you're an experienced G user, you're going to measure it with a plastic syringe to make sure you're getting the right dose."
John says a big reason for bad reactions to GHB at parties is that people may combine it with alcohol, or forget to make sure they measure out half-size doses after their first of the night. Different batches can also be radically different potencies.
A big part of the appeal is how cheap the drug is to manufacture and buy in Canada, which also makes it attractive to dealers. According to John, the street price on the west coast is around $1 per millilitre, and that goes down dramatically when purchasing larger amounts. The profit margin can be high, especially when selling individual doses at events. But despite John's love for the high, his nervousness over its unpredictability led him to stop selling small amounts, out of fear that a new customer might end up in trouble. He says he'll only sell it in larger amounts to other distributors now, and let them take the risk.
Prohibition, or Harm Reduction?
John points out that daily users may also be dealing with significant withdrawal symptoms, and that those heavy users will always make sure they have a supply on them, regardless of any hardline policies a club like Stereo might take against it. He believes that a better approach would be to focus on harm reduction and information sharing, comparing the situation to safe injection sites for opiate users.
"I don't think banning will be a solution. Supporting proper awareness, education and a culture of safety would be better," agrees Nicholas Boyce, who works with the Ontario HIV and Substance Use Training Program and is a member of the Toronto Research Group on Drug Use. "Montreal has a group called GRIP, which, at a minimum, Stereo could actively link to from their website, they could actively support, and they could allow information and outreach inside and/or outside the club."
"G isn't new, and we've been here many times before over the last couple of decades, so I was somewhat surprised [by Stereo's new policy]. I think most drugs cycle through phases of popularity. They move in and out of social networks as people discover or rediscover them."
Why the Panic Over GHB?
It's the phenomenon of users going into a coma-like state that has venue owners and promoters most concerned. Combining it with alcohol, or simply doing a little too much can completely incapacitate users. It's next to impossible to determine how widespread an issue it is, but Brooks agrees that there appears to be a recent upswing in popularity.
"For sure there's a comeback. This has been happening for about five years here. I've been in this scene long enough that I've seen waves of these things coming in. When it was happening in the late 90s, it was the same kind of fallout back then. People were passed out outside of clubs, ambulances were coming, people were actually shitting their pants."
While involuntary bowel movements are pretty rare, the nature of GHB overdoses do pose particular challenges for anyone trying to help the victim.
"They're crumpling to the floor or slouching one second, then bolt upright and arms flailing the next," says Adam Hobbs, who is part of a Toronto team of volunteer medics called Emergency Medical Responders. "Couple that with the fact that some of these users are into bodybuilding, and the risk to everyone goes up when 200-pound-plus of muscle-laden dude suddenly swings out accidentally or defensively. Things can get out of hand quickly."
Hobbs and his team have worked at events since 2001, and while he agrees that his team is seeing more GHB-related issues in recent years, he also says that it varies greatly depending on the crowd. From his standpoint, it's not so much that there's been a massive surge in use, but rather that the incidents involving it are particularly difficult to deal with.
In most cases, those who become unconscious from a GHB overdose will eventually wake up on their own, but there's no way for medics to accurately determine that. Someone might be sleeping peacefully one moment, and then stop breathing the next. Putting the unconscious patron into the recovery position can help prevent them from choking on their vomit, but that's no guarantee that they won't go into a full seizure at any moment. That uncertainty gives first responders few options.
"If they are unconscious, as in they do not wake up from a person yelling in their ear, or a hard squeeze of the muscle from neck to shoulder, then really, you need medical support," Hobbs says. "They could wake up any minute, or not for hours. People don't want to send their friends to hospital, but if you keep them and something happens, you are personally liable."
Hobbs is particularly concerned with the myth that an unconscious GHB user can be revived by blowing cocaine up their nose. While believers claim that the upper will cancel out the effects of GHB, the reality is much more dangerous.
"While seizing, the person isn't breathing, but cocaine can increase the need for oxygen to the heart or elsewhere. So you are increasing demand for oxygen while breathing has slowed or stopped. Not a great situation."
What's Holding Back Harm Reduction Efforts?
There's nothing to suggest that issues related to GHB use in the dance music scene are anywhere near the emerging crisis in North America around heroin or the synthetic opioid fentanyl, but the latter are far less associated with the club scene. While GHB may have a comparatively low fatality rate, it is very easy to experience an overdose requiring a hospital visit if users aren't extremely careful about dosage and mixing with other substances.
It's those embarrassing, but potentially life-saving ambulance calls that have event organizers nervous, and for good reason. Infamous Toronto after-hours club the Comfort Zone filed a lawsuit against the police for ongoing harassment of their patrons and repeated police raids, following the 2008 GHB-related death of Adam Fazio, who'd attended the club before his overdose.
Reactions like that have created a situation where venue owners and promoters feel so intimidated that they are resistant to embracing harm reduction policies, but equally afraid of the potential repercussions if someone dies in their club. It's a catch-22 that is one of the biggest barriers to harm reduction efforts worldwide, and not just with GHB. There may not be a full-on crisis when it comes to G, but there is when it comes to efforts relating to any drug.
Benjamin Boles is on Twitter.