Controlling for pleasure and risk: The experiences of sexuality and gender diverse people who use GHB

Jack Freestone; Garrett Prestage; Adam Bourne; Nadine Ezard; Kane Race; Anthony Nedanoski; Joel Murray; Krista J Siefried

doi:10.1016/j.drugpo.2022.103747

Controlling for pleasure and risk: The experiences of sexuality and gender diverse people who use GHB

Int J Drug Policy. 2022 Jul:105:103747. doi: 10.1016/j.drugpo.2022.103747. Epub 2022 May 25.

Authors

Jack Freestone¹, Garrett Prestage², Adam Bourne³, Nadine Ezard⁴, Kane Race⁵, Anthony Nedanoski⁵, Joel Murray⁶, Krista J Siefried⁴

Affiliations

¹ The Kirby Institute, University of New South Wales Sydney, Wallace Wurth Building, High St, Kensington NSW 2052, Australia; ACON, 414 Elizabeth Street, Surry Hills, NSW 2010, Australia; National Centre for Clinical Research on Emerging Drugs, c/o the University of New South Wales, Sydney 2052, Australia. Electronic address: jfreestone@acon.org.au.
² The Kirby Institute, University of New South Wales Sydney, Wallace Wurth Building, High St, Kensington NSW 2052, Australia.
³ The Kirby Institute, University of New South Wales Sydney, Wallace Wurth Building, High St, Kensington NSW 2052, Australia; Australian Research Centre for Sex Health and Society, La Trobe University. Building NR6. Bundoora Victoria 3086, Australia.
⁴ National Centre for Clinical Research on Emerging Drugs, c/o the University of New South Wales, Sydney 2052, Australia; The National Drug and Alcohol Research Centre (NDARC), the University of New South Wales, Sydney 2052, Australia; Alcohol and Drug Service, St Vincent's Hospital Sydney, Darlinghurst 2010, Australia.
⁵ Department of Gender and Cultural Studies, The University of Sydney, Camperdown NSW 2006, Australia.
⁶ ACON, 414 Elizabeth Street, Surry Hills, NSW 2010, Australia.

PMID: 35643047
DOI: 10.1016/j.drugpo.2022.103747

Abstract

Background: GHB is used among some sexuality and gender diverse populations at elevated rates, however little qualitative research has explored GHB use among these populations with regards to diverse contexts, settings, practices, and experiences of use. Internationally, harms relating to GHB overdose appear to be increasing. Research outlining consumers' experiences of GHB-related pleasures and their strategies to reduce harms may inform GHB education and intervention responses.

Methods: N = 31 participants reporting three or more occasions of GHB use within the previous 12 months were recruited via digital advertising and snowball methods. Semi-structured interviews were conducted, data were transcribed and analysed in NVivo using a thematic framework analysis. Emergent themes were charted, and divergences and convergences were considered with regards to the sexuality and gender identities of participants.

Results: Pleasures associated with GHB were described in relation to the sensation of the GHB high and experiences of intimacy, and connection. GHB was used to enhance socialising and sex in domestic, private, and commercial venues. Participants prioritised terminology of 'control' when describing their practices associated with GHB dosing, measuring, timing and peer moderation. Most participants reported personal experience of GHB overdose with loss of consciousness.

Conclusion: Participants' near-ubiquitous experience of GHB overdose highlights ongoing education needs around overdose prevention. Efforts must target people new to GHB use who appeared particularly susceptible to overdose. Inconsistencies in understandings around GHB overdose, the perceived severity of overdose and the differences between GHB and its precursors GBL and 1,4-BD, highlight potential focus areas of future education responses. Further research is required to better understand consumers' experiences of sexual violence in the context of GHB use.

Keywords: GHB sexuality and gender diverse populations; Harm reduction strategies; Overdose; Peer group; Sexual violence.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Drug Overdose* / epidemiology
Drug Overdose* / prevention & control
Gender Identity
Humans
Pleasure
Sexual Behavior
Sexuality
Sodium Oxybate*

Substances

Sodium Oxybate