The Experience and Meaning of Problematic ‘G’ (GHB/GBL) Use in an Irish Context: an Interpretative Phenomenological Analysis
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The problematic use of psychoactive substances has adverse consequences for people’s lives and requires on-going investigation of experiences of onset, course and resolution in order to better inform theoretical understanding, particularly with regard to the use of club drugs and novel psychoactive substances. In turn, this may influence treatment approaches. GHB/GBL, frequently termed ‘G’, is one such substance, with problematic use resulting in increased presentations at A&E departments and at substance dependence clinics across Europe. The aim of the present study was to explore problematic G use as experienced by people who had presented for treatment, in Ireland, using interpretative phenomenological analysis (IPA). IPA was selected in recognition of the lack of previous research on the experience of problematic use of G and in the context of an evolving understanding of what constitutes problematic substance use. A purposive and homogenous sample of seven people, five gay males and two straight females, who had presented for treatment for ‘G’ substance use disorder to a community-based drug team, participated in semi-structured interviews. Three superordinate themes reflecting the participants chronological development of problematic ‘G’ use and early recovery were fully developed and presented—(1) early use: “I was part of that gang that took G”; (2) daily use: “It’s like insidious; it just weaves into your everyday life”; and (3) early recovery: “my priorities are changing”. This study supports the interactive role of community, self-identity, personal vulnerability and substance effects in the development, maintenance and recovery from problematic G use. Findings are discussed in the context of gay community health, the role of chemsex in problematic substance use and the need for public health providers to engage with novel psychoactive substance use and the health and well-being effects of chemsex.
KeywordsAddiction Problematic substance use GHB GBL Interpretative phenomenological analysis (IPA)
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
- Abdulrahim, D., Bowden-Jones, O., & (on behalf of the Neptune Expert Group). (2015). Guidance on the clinical management of acute and chronic harms of club drugs and novel psychoactive substances. London: Neptune.Google Scholar
- Anderson, P., Rehm, J., & Room, R. (Eds.). (2015). The impact of addictive substances and behaviours on individual and societal well-being (1st ed.). Oxford: Oxford University Press.Google Scholar
- APA. (2013). Diagnostic and statistical manual of mental health disorders (5th ed.). Arlington: American Psychiatric Publishing, Inc.Google Scholar
- Bell, J., & Collins, R. (2011). Gamma-butyrolactone (GBL) dependence and withdrawal. Addiction, 106(2), 442–447.Google Scholar
- BMJ. (2015). The BMJ press release: “chemsex” needs to become a public health priority. BMJ.Google Scholar
- Bourne, A., Reid, D., Hickson, F., Tores Rueda, S., & Weatherburn, P. (2014). The Chemsex study: drug use in sexual settings among gay and bisexual men in Lambeth. London: Southwark & Lewisham.Google Scholar
- Bourne, A., Reid, D., Hickson, F., Torres-Rueda, S., & Weatherburn, P. (2015). Illicit drug use in sexual settings (“chemsex”) and HIV/STI transmission risk behaviour among gay men in South London: findings from a qualitative study. Sexually Transmitted Infections, Online. https://doi.org/10.1136/sextrans-2015-052052.
- Bracchi, M., Stuart, D., Castles, R., Khoo, S., Back, D., & Boffito, M. (2015). Increasing use of “party drugs” in people living with HIV on antiretrovirals: a concern for patient safety. AIDS (London, England), 29(13), 1585–1592. Editorial. https://doi.org/10.1097/QAD.0000000000000786.CrossRefGoogle Scholar
- Buffin, J., Roy, A., Williams, H., & Winter, A. (2011). Part of the picture: lesbian, gay and bisexual people’s alcohol and drug use in England (2009–2011).Google Scholar
- Cain, M. (2015). The rise of gay “chemsex” parties involving libido-enhancing drugs. The Independent. London.Google Scholar
- Corkery, J. M., Loi, B., Claridge, H., Goodair, C., Corazza, O., Elliott, S., & Schifano, F. (2015). Gamma hydroxybutyrate (GHB), gamma butyrolactone (GBL) and 1,4-butanediol (1,4-BD; BDO): a literature review with a focus on UK fatalities related to non-medical use. Neuroscience and Biobehavioral Reviews, 53, 52–78 ELEC.Google Scholar
- Daskalopoulou, M., Rodger, A., Phillips, A. N., Sherr, L., Speakman, A., Collins, S., … Lampe, F. C. (2014a). Recreational drug use, polydrug use, and sexual behaviour in HIV-diagnosed men who have sex with men in the UK: results from the cross-sectional ASTRA study. The Lancet. HIV, 1(1), e22–31. Journal Article. https://doi.org/10.1016/S2352-3018(14)70001-3.
- Daskalopoulou, M., Rodger, A., Thornton, A., Phillips, A., Sherr, L., Gilson, R., et al. (2014b). Sexual behaviour, recreational drug use and hepatitis C co-infection in HIV-diagnosed men who have sex with men in the United Kingdom: results from the ASTRA study. Journal of the International AIDS Society, 17(4 Suppl 3), 19630 Journal Article.CrossRefPubMedPubMedCentralGoogle Scholar
- Dines, A. A. M., Wood, D. M. D. M., Yates, C., Heyerdahl, F., Hovda, K. E. K. E., Giraudon, I., et al. (2015). Acute recreational drug and new psychoactive substance toxicity in Europe: 12 months data collection from the European Drug Emergencies Network (Euro-DEN). Clinical Toxicology, 53(9), 893–900. JOUR. https://doi.org/10.3109/15563650.2015.1088157.CrossRefPubMedGoogle Scholar
- Durgahee, S., Allen, G., & Williams, H. (2014). The “G” men: A profile of GBL/GHB users in an area of high drug-related mortality. Irish Journal of Psychological Medicine, 31(4), 275–280.Google Scholar
- EMCDDA. (2015). European drug report trends and developments 2015.Google Scholar
- EMCDDA. (2016). European drug report 2016.Google Scholar
- EMIS Network. (2013). The European men-who-have-sex-with-men internet survey. Findings from 38 countries (2010). Stockholm.Google Scholar
- Gell, L., Holmes, J., Bühringer, G., Allamani, A., Anderson, P., Stirling, K., … Behrendt. (2014). Determinants of harmful substance use and harmful gambling: an interdisciplinary review. (ALICE RAP WA3: WP8).Google Scholar
- Gell, L., Bühringer, G., McLeod, J., Forberger, S., Holmes, J., Lingford-Hughes, A., & Meier, P. (Eds.). (2016). What determines harm from addictive substances and behaviours (1st ed.). Oxford: Oxford University Press.Google Scholar
- Hennessy, M. (2015). London “chemsex” parties face gay club scene with HIV fears. Dublin: The Irish Times.Google Scholar
- Herman, J. L. (2001). Trauma and recovery. From domestic abuse to political terror. London: Pandora.Google Scholar
- Higgins, A., Doyle, L., Downes, C., Murphy, R., Sharek, D., DeVries, J., … Smyth, S. (2016). The LGBT Ireland report: national study of the mental health and wellbeing of lesbian, gay, bisexual, transgender and intersex people in Ireland. Dublin.Google Scholar
- Jackson-Roe, K., Murray, C., & Brown, G. (2015). Understanding young offenders’ experiences of drinking alcohol: an interpretative phenomenological analysis. Drugs: Education, Prevention & Policy, 22(1), 77–85 ELEC.Google Scholar
- Knapton, S. (2015). Chemsex: the alarming new trend of 72 hour drug-fuelled sex sessions. London: The Telegraph.Google Scholar
- Lea, T., Prestage, G., Mao, L., Zablotska, I., de Wit, J., Holt, M., … (2013). Trends in drug use among gay and bisexual men in Sydney, Melbourne and Queensland, Australia. Drug and Alcohol Review, 32(1), 39–46. JOUR. https://doi.org/10.1111/j.1465-3362.2012.00494.x.
- Lea, T., de Wit, J., & Reynolds, R. (2014). Minority stress in lesbian, gay, and bisexual young adults in Australia: associations with psychological distress, suicidality, and substance use. Archives of Sexual Behavior, 43(8), 1571–1578. https://doi.org/10.1007/s10508-014-0266-6.CrossRefPubMedGoogle Scholar
- Marlatt, G., Larimer, M., & Witkiewitz, K. (2012). Harm reduction: pragmatic strategies for managing high-risk behaviors (2nd ed.). New York: Guilford.Google Scholar
- Marshal, M. P., Friedman, M. S., Stall, R., King, K. M., Miles, J., Gold, M. A., et al. (2008). Sexual orientation and adolescent substance use: a meta-analysis and methodological review. Addiction, 103(4), 546–556. https://doi.org/10.1111/j.1360-0443.2008.02149.x.CrossRefPubMedPubMedCentralGoogle Scholar
- McCown, D., & Reibel, D. (2010). Mindfulness and mindfulness-based stress reduction. In D. A. Monti & B. D. Beitman (Eds.), Integrative psychiatry (pp. 289–238). New York: Oxford.Google Scholar
- Measham, F., Wood, D., Dargan, P., & Moore, K. (2011). The rise in legal highs: prevalence and patterns in the use of illegal drugs and first and second generation “legal highs” in south London gay dance clubs. Journal of Substance Use, 16(4), 263–272. https://doi.org/10.3109/14659891.2011.594704.CrossRefGoogle Scholar
- Merikangas, K. R., Mehta, R. L., Molnar, B. E., Walters, E. E., Swendsen, J. D., Aguilar Gaziola, S., … Kessler, R. C. (1998). Comorbidity of substance use disorders with mood and anxiety disorders: results of the International Consortium in Psychiatric Epidemiology. Addictive Behaviours, 23(6), 893–907.Google Scholar
- Miller, W. R., & Rollnick, S. (2002). Motivational interviewing. Preparing people for change (2nd ed.). New York: Guilford.Google Scholar
- Sarma, K. (2007). Recreational drug taking among LGBT young adults in Ireland results of an exploratory study. Youth Studies Ireland, 2(2), 35–49 http://www.youthworkireland.ie/youth-work-centre/vol.-2-no.-2.Google Scholar
- Smith, J (2011). Evaluating the contribution of interpretative phenomenological analysis. Health Psychology Review, 5(1), 9–27. https://doi.org/10.1080/17437199.2010.510659.
- Smith, J., Flowers, P., & Larkin, M. (2009). Interpretative phenomenological analysis. Theory, method and research. London: Sage.Google Scholar
- Stoll, L., & Anderson, P. (2015). Well-being as a framework for understanding addictive substances. In P. Anderson, J. Rehm, & R. Room (Eds.), The impact of addictive substances and behaviours on individual and societal well-being (1st ed.). Oxford: Oxford University Press.Google Scholar
- Stuart, D. (2013). Sexualised drug use by MSM: background, current status and response. HIV Nursing, (Spring), 6–10.Google Scholar
- Thombs, D. L. (2006). Introduction to addictive behaviours (3rd ed.). New York: Guilford.Google Scholar
- van Amsterdam, J., Brunt, T., Pennings, E., van den Brink, W., Pennings, E., & van den Brink, W. (2015a). Risk assessment of GBL as a substitute for the illicit drug GHB in the Netherlands. A comparison of the risks of GBL versus GHB. Regulatory Toxicology and Pharmacology, 70(2), 507–513. JOUR. https://doi.org/10.1016/j.yrtph.2014.08.014.CrossRefGoogle Scholar
- WHO. (1992). The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines (10th ed.). Geneva: World Health Organisation.Google Scholar
- Winstock, A. (2015). New health promotion for chemsex and gamma-hydroxybutyrate (GHB). BMJ (Clinical Research Ed.). Letter, England.Google Scholar
- Wood, D. M., Warren-Gash, C., Ashraf, T., Greene, S. I., Shather, Z., Trivedy, C., … Dargan, P. I. (2008). Medical and legal confusion surrounding gamma-hydroxybutyrate (GHB) and its precursors gamma-butyrolactone (GBL) and 1,4-butanediol (1,4BD). QJM: Monthly Journal of the Association of Physicians, 101(1), 23–29. https://doi.org/10.1093/qjmed/hcm117.
- Zvosec, D. L., Smith, S. W., Porrata, T., Strobl, a. Q., & Dyer, J. E. (2011). Case series of 226 Gammahydroxybutyrate-associated deaths: Lethal toxicity and trauma. American Journal of Emergency Medicine, 29(3), 319–332. http://doi.org/10.1016/j.ajem.2009.11.008.