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Deaths in the Lesbian, Gay, Bisexual and Transgender United Kingdom communities associated with GHB and precursors.

Corkery, JM; Loi, B; Claridge, H; Goodair, C; Schifano, F (2017) Deaths in the Lesbian, Gay, Bisexual and Transgender United Kingdom communities associated with GHB and precursors. Curr Drug Metab, 19 (13). pp. 1073-1086. ISSN 1875-5453
SGUL Authors: Goodair, Christine M

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Background Misuse of gammahydroxybutrate (GHB) and its prodrugs gammabutyrolactone (GBL) and 1,4 butanediol (1,4-BD) has increased greatly since the early 1990s, particularly amongst lesbian, gay, bisexual and transgender (LGBT) individuals in recreational and sexual settings, e.g. 'chemsex'. Objective and method This paper presents an overview of GHB pharmacotoxicology and provides analyses of cases in the LGBT population associated with use of these substances extracted from the UK's National Programme on Substance Abuse Deaths database, to which notification is voluntary. Results From 1995 to September 2013, 21 GHB/GBL-associated fatalities were reported. None involved 1,4-BD. Typical victims were: Male (100%); White (67%), young (mean age 34 years); employed (90%); with a drug misuse history (81%). Most deaths were accidental (67%) or related to recreational drug use (19%), the remaining (potential) suicides. The majority of fatalities (83%) occurred in private residences, typically following recreational use; others occurred in specific 'gay'-oriented locales including clubs and saunas. Three London boroughs accounted for 62% of all notified deaths, reflecting the concentration of both resident and visiting 'gay' individuals. However, this may be an artefact of the voluntary nature of the data submission procedure in particular areas. GHB/GBL alone was implicated in 10% of fatalities. The following substances were implicated either alone or in combination in the remaining cases (percentages may add to more than 100%): cocaine (38%); alcohol (33%); amphetamines (29%); ecstasy (29%); diazepam (24%); ketamine (24%); mephedrone (24%). Post-mortem blood levels: mean 660 (range 22 - 2335; S.D. 726) mg/L. Conclusions Significant caution is needed when ingesting GHB/GBL, particularly with alcohol, benzodiazepines, stimulants, and ketamine. Risk of death is increased due to their CNS-depressant properties. Of these, 'chemsex' drugs such as cocaine, mephedrone and ketamine are of note. More awareness is needed in the 'gay' community about risks associated with the consumption of such substances.

Item Type: Article
Additional Information: The published manuscript is available at EurekaSelect via
Keywords: Deaths, GBL, GHB, LGBT community, Toxicity, United Kingdom (UK), Deaths, GBL, GHB, LGBT community, Toxicity, United Kingdom (UK), Pharmacology & Pharmacy, 1115 Pharmacology And Pharmaceutical Sciences, 0801 Artificial Intelligence And Image Processing
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: Curr Drug Metab
ISSN: 1875-5453
Language: eng
8 November 2017Published
8 October 2017Accepted
Publisher License: Publisher's own licence
PubMed ID: 29119924
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