Skip to main content

Advertisement

Log in

The Experience and Meaning of Problematic ‘G’ (GHB/GBL) Use in an Irish Context: an Interpretative Phenomenological Analysis

  • Original Article
  • Published:
International Journal of Mental Health and Addiction Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  • 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.

  • BMJ. (2015). The BMJ press release: “chemsex” needs to become a public health priority. BMJ.

  • 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.

    Article  CAS  Google Scholar 

  • Brunt, T., van Amsterdam, J. J. G. C., van den Brink, W., Brunt, T. M., van Amsterdam, J. J. G. C., & van den Brink, W. (2014). GHB, GBL and 1,4-BD addiction. Current Pharmaceutical Design, 20(25), 4076–4085 Journal Article, Review.

    Article  PubMed  CAS  Google 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).

  • Busardo, F. P., & Jones, A. W. (2015). GHB pharmacology and toxicology: acute intoxication, concentrations in blood and urine in forensic cases and treatment of the withdrawal syndrome. Current Neuropharmacology, 13(1), 47–70.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Busardo, F. P., Kyriakou, C., Napoletano, S., Marinelli, E., & Zaami, S. (2015). Clinical applications of sodium oxybate (GHB): from narcolepsy to alcohol withdrawal syndrome. European Review for Medical and Pharmacological Sciences, 19(23), 4654–4663 Journal Article.

    PubMed  CAS  Google Scholar 

  • Cain, M. (2015). The rise of gay “chemsex” parties involving libido-enhancing drugs. The Independent. London.

    Google Scholar 

  • Cochran, S. D., Ackerman, D., Mays, V. M., & Ross, M. W. (2004). Prevalence of non-medical drug use and dependence among homosexually active men and women in the US population. Addiction (Abingdon, England), 99(8), 989–998. https://doi.org/10.1111/j.1360-0443.2004.00759.x.

    Article  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.

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • de Weert-van Oene, G. H., Schellekens, A. F. A., Dijkstra, B. A. G., Kamal, R., & de Jong, C. A. J. (2013). Detoxification of patients with GHB dependence. Tijdschrift voor Psychiatrie, 55(11), 885–890 English Abstract, Journal Article.

    PubMed  Google 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.

    Article  PubMed  CAS  Google 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.

  • Elliott, R., Fischer, C. T., & Rennie, D. L. (1999). Evolving guidelines for publication of qualitative research studies in psychology and related fields. The British Journal of Clinical Psychology, 38, 215–229. https://doi.org/10.1348/014466599162782.

    Article  PubMed  Google Scholar 

  • EMCDDA. (2015). European drug report trends and developments 2015.

  • EMCDDA. (2016). European drug report 2016.

  • EMIS Network. (2013). The European men-who-have-sex-with-men internet survey. Findings from 38 countries (2010). Stockholm.

  • 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).

  • 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 

  • Giorgetti, R., Tagliabracci, A., Schifano, F., Zaami, S., Marinelli, E., & Busardò, F. P. (2017). When “chems” meet sex: a rising phenomenon called “ChemSex”. Current Neuropharmacology, 15(5), 762–770.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Halkitis, P. N., & Palamar, J. J. (2008). Multivariate modeling of club drug use initiation among gay and bisexual men. Substance Use & Misuse, 43(7), 871–879. https://doi.org/10.1080/10826080701801337.

    Article  Google Scholar 

  • Halkitis, P. N., Palamar, J. J., & Mukherjee, P. P. (2007). Poly-club-drug use among gay and bisexual men: a longitudinal analysis. Drug and Alcohol Dependence, 89(2–3), 153–160. https://doi.org/10.1016/j.drugalcdep.2006.12.028.

    Article  PubMed  PubMed Central  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.

  • Hill, J. V., & Leeming, D. (2014). Reconstructing “the alcoholic”: recovering from alcohol addiction and the stigma this entails. International Journal of Mental Health and Addiction, 12(6), 759–771 ELEC.

    Article  Google Scholar 

  • Holt, M. (2014). Sex, drugs and HIV: let’s avoid panic. The Lancet. HIV, 1, e4–e5. https://doi.org/10.1016/S2352-3018(14)70007-4.

    Article  PubMed  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 

  • Kirby, T., & Thornber-Dunwell, M. (2013). High-risk drug practices tighten grip on London gay scene. The Lancet, 381(9861), 101–102 JOUR.

    Article  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.

    Article  PubMed  Google 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.

    Article  PubMed  PubMed Central  Google 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.

    Article  Google 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.

  • Miller, W. R., & Rollnick, S. (2002). Motivational interviewing. Preparing people for change (2nd ed.). New York: Guilford.

    Google Scholar 

  • Moos, R. H. (2007). Theory-based active ingredients of effective treatments for substance use disorders. Drug Alcohol Dependency, 88(2–3), 109–121.

    Article  Google Scholar 

  • Nutt, D. J., King, L. A., & Phillips, L. D. (2010). Drug harms in the UK: a multicriteria decision analysis. The Lancet, 376(9752), 1558–1565. https://doi.org/10.1016/S0140-6736(10)61462-6.

    Article  Google Scholar 

  • Orford, J. (2008). Asking the right questions in the right way: the need for a shift in research on psychological treatments for addiction. Addiction, 103(6), 875–885. https://doi.org/10.1111/j.1360-0443.2007.02092.x.

    Article  PubMed  Google Scholar 

  • Rodriguez, L., & Smith, J. A. (2014). “Finding your own place”: an interpretative phenomenological analysis of young men’s experience of early recovery from addiction. International Journal of Mental Health and Addiction, 12(4), 477–490 ELEC.

    Article  Google Scholar 

  • Rosenberg, H., & Davis, A. K. (2014). Differences in the acceptability of non-abstinence goals by type of drug among American substance abuse clinicians. Journal of Substance Abuse Treatment, 46(2), 214–218. https://doi.org/10.1016/j.jsat.2013.07.005.

    Article  PubMed  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 

  • Schep, L. J., Knudsen, K., Slaughter, R. J., Vale, J. A., & Megarbane, B. (2012). The clinical toxicology of gamma-hydroxybutyrate, gamma-butyrolactone and 1,4-butanediol. Clinical Toxicology, 50(6), 458–470. JOUR. https://doi.org/10.3109/15563650.2012.702218.

    Article  PubMed  CAS  Google Scholar 

  • Shinebourne, P., & Smith, J. A. (2009). Alcohol and the self: an interpretative phenomenological analysis of the experience of addiction and its impact on the sense of self and identity. Addiction Research & Theory, 17(2), 152–167 ELEC.

    Article  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.

  • 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.

    Article  CAS  Google Scholar 

  • Van Amsterdam, J., Nutt, D., Phillips, L., & Van Den Brink, W. (2015b). European rating of drug harms. Journal of Psychopharmacology, 29(6), 655–660 JOUR.

    Article  PubMed  Google Scholar 

  • Vangeli, E., & West, R. (2012). Transition towards a “non-smoker” identity following smoking cessation: an interpretative phenomenological analysis. British Journal of Health Psychology, 17(1), 171–184. https://doi.org/10.1111/j.2044-8287.2011.02031.x.

    Article  PubMed  Google Scholar 

  • Watson, L., & Parke, A. (2011). Experience of recovery for female heroin addicts: an interpretative phenomenological analysis. International Journal of Mental Health and Addiction, 9(1), 102–117.

    Article  Google Scholar 

  • West, R., & Brown, J. (2013). Theory of addiction (2nd ed.). Chichester: Wiley.

    Book  Google 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.

  • Winstock, A. R., & Mitcheson, L. (2012). New recreational drugs and the primary care approach to patients who use them. BMJ, 344(e288), 1–10. https://doi.org/10.1136/bmj.e288.

    Article  CAS  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.

  • Yardley, L. (2000). Dilemmas in qualitative health research. Psychology and Health, 15(2), 215–228. https://doi.org/10.1080/08870440008400302.

    Article  Google Scholar 

  • 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.

Download references

Author information

Authors and Affiliations

Authors

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Joyce, N., MacNeela, P., Sarma, K. et al. The Experience and Meaning of Problematic ‘G’ (GHB/GBL) Use in an Irish Context: an Interpretative Phenomenological Analysis. Int J Ment Health Addiction 16, 1033–1054 (2018). https://doi.org/10.1007/s11469-017-9851-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11469-017-9851-y

Keywords

Navigation