Graham Ryall of the Rialto Community Drug Team and Dr Kiran Santlal, a Registrar in Psychiatry of Substance Misuse in the HSE National Drug Treatment Centre, speak about the rise of Crystal Meth and GHB use on the aſterparty scene.

Graham Ryall:

I initially worked with a handful of people between 2012 and 2014 in relation to their GHB use and their attempts to cease their use of the drug. From March 2015, numbers started rising and there has been a year-on-year increase in the amount of individuals accessing the Rialto Community Drug Team in relation to Crystal Meth, GHB/G (Gamma Hydroxybutyrate) and the afterparty scene. Of the 50 plus individuals who have engaged with the RCDT over these chems, 90 percent identify as LGBT+.

Those who would have travelled to London to engage in the scene say that the after party scene in Dublin has risen in the last few years. This would be a very professional group of people, a lot of them would have a third level education and very good jobs. Right across society we are seeing a rise in drug use - I am getting calls from places like Limerick, Galway and Cork. Up until last year, GHB would have been the primary drug in the after party scene but this year, Crystal Meth is the primary drug. This correlates with trends in the UK, Europe and the US.

Physical addiction can come on quite quickly. A couple of weekends of prolonged use can lead to physical addiction. While some addictions need to be satisfied every day, a GHB addiction needs to be satisfied every 90 minutes. If not you can go into withdrawal, and withdrawal in extreme cases can be fatal.

It’s important to point out not all individuals who take GHB or Crystal will develop significant problems or dependency. Some can control their use but this is not the case for all.

It is our job to let people know there are supports and there are services out there that can respond to that on a therapeutic and clinical level. It is about making people aware of what they are taking. We do not want to drive further underground a scene that has been historically underground. It is a really complicated issue. It’s about keeping the conversation going in an honest and respectful fashion and not creating any moral panic.

Dr Kiran Santlal:

I’ve been working in HSE-National Drug Treatment Centre as a Registrar in Psychiatry of Substance Misuse since 2014. It was around that time that we first heard about GHB. At that time, my consultant was Dr Eamon Keenan, who is now the HSE Clinical Lead in Addictions. We’d gotten our first referral for a detoxification then - so there was quite a bit of literature to search, and correspondence with one of the consultants who works in the South London And Maudsley Party Drugs Clinic in London about it. GHB (Gamma Hydroxybutyrate)/GBL (Gamma Butyrolactone) had been quite popular on the clubbing scene for a few years there already. It had taken them a few years to develop this type of clinic, so for us, in Ireland, getting the G Detox Clinic in the pilot stage in the matter of a couple of months was a task in itself.

Between 2014 and 2017, the number of people being referred for a detoxification off GHB/GBL increased by 400 percent. In 2018, we’ve had 49 detoxification episodes. So far, in 2019, there have been 29 referrals in the last five months, for both GHB and Crystal Meth detoxes.

For someone who presents to the Emergency Department with an overdose and the medical complications associated with it (slowed respiratory rate leading to respiratory arrest, slow heart beat, ECG abnormalities, low blood pressure) their assessment should include a standard medical assessment, and urine drug screen as there’s a likelihood of ingesting GHB with other substances like Crystal Meth, Cocaine, Ketamine, Mephedrone, Opiates, Benzodiazepines (like Valium, Xanax, Tranax) or other new psychoactive substances. They may regain consciousness with medical supportive management after two to three hours, but immediately have withdrawals and will need to be treated for this.

Withdrawals from GHB can be very dangerous, because it rapidly progresses if it’s untreated/inadequate treatment is given. Ideally, someone who is taking GHB would have a GHB card on their person (available in Outhouse, GUIDE Clinics, GMHS Baggot Street, and the Club Drugs Clinic, Ireland) which will easily identify what they may have taken to any frontline staff.

If you are affected by this issue, please contact: HSE-National Drug Treatment Centre: 01 648 8600 Rialto Community Drug Team 01-4540021 National Drugs Helpline 1800-459459