TOO LITTLE, TOO LATE

Dr Graham Bloor, whose son, Paddy, died after taking GHB, reflects on what the most recent review of the drug means and why it doesn’t go far enough

Paddy, I think, would be amused to see what has happened. GHB was just another drug to him; if a little of drug X works then more drug X is better and so, almost three years ago in Brighton, he died. He would have been 24 years old now and no doubt still partying.

The campaign started with a simple article in Gscene back in June 2018. I needed to talk about Paddy and I thought that writing about him would be cathartic. It was nowhere near enough. The response to describing him and our pain when it was so raw, was incredible. Unlike me, Paddy loved being the centre of attention. I wonder what he’d think of what followed? He was the central feature of a Channel 4 documentary, Buzzfeed and various newspaper articles. Even the BBC and Sky News included him. Just as important though, was a Sheffield University drugs awareness video and various projects by university students as part of their nursing, media studies and journalism courses. And it all started with Gscene’s editor James Ledward who sadly passed away last year; thank you so much James.

Paddy

Through Paddy’s story, I have met wonderful people who truly care about the issues: Patrick Strudwick (journalist), Brian Paddick (retired police officer and member of the House of Lords), and Monty Moncrieff (chief executive of London Friend). Others have shared their personal stories and agonies when a young person dies. It’s heartbreaking and some, years later, have yet to come to terms with it. Please remember this before choosing to take GHB.

So, Paddy’s story is out there and still being talked about. GHB is now a class B drug, there is increased awareness of its dangers and toxicology screening is improving. For me, it’s all too little, too late, but this is tempered by understanding that GHB use is only one part of a much bigger problem and, as such, there is no quick fix.

First though, the good news. In response to a request by the home secretary, the Advisory Council on the Misuse of Drugs published a review of GHB on the November 20, 2020. Thankfully, rather than simply blaming users, it focused on the need to recognise the unique dangers of GHB and the need to improve awareness. Also, it specified that coroners now must explain why GHB was not tested for. It’s a start; monitoring systems are in place to improve testing and support. We should now be able to report more accurately just how many deaths in the UK are linked to GHB use.

Until we recognise GHB’s role in acute emergency medicine, we will not appreciate its insidious effect on people early enough in the drug-use cycle to avoid longer-term problems

Less impressive, and as a doctor personally frustrating, is that the message was aimed at sexual and mental health clinics but not A&E departments nor intensive care units.

Clearly the devastating long-term mental, sexual and social effects of GHB abuse were addressed and hopefully support for users will improve. However, until we recognise GHB’s role in acute emergency medicine, we will not appreciate its insidious effect on people early enough in the drug-use cycle to avoid longer-term problems. At first, GHB use was, in the main, unrecognised by most doctors, toxicologists, coroners and politicians. The horse has already bolted for some but there are many who remain at risk. A&E workload is an early indicator of future morbidity and it is for these patients that advice and support will best reduce future morbidity and hopefully mortality.

Looking at wider issues, GHB is mainly but not uniquely an LBGTQ+ problem. Yes, the Reynhard Sinaga multiple rapes were predominantly, although not exclusively, of gay men. However, the black-cab rapist John Worboys attacked young women. Murders such as those in the Stephen Port case have, to date, been limited to gay men, however.

It seems to me that there is a wider problem relating to safety and reasons for taking drugs in the first place.

Recreational drugs should be decriminalised and, from that, quality controlled and advice for harm reduction provided at source. (While we have classification, of course GHB should be included and I believe increased to class A.)

Behaviour can change. We’ve had to accept social distancing in response to Covid-19 so why not raise awareness of the risk of drinks being spiked? Keep an eye on your drinks at all times, and don’t accept a drink unless you’ve seen it being poured. Likewise, if you must use recreational drugs, then take them as safely as you can with full knowledge of the risks. With GHB, have a “designated driver”. Some will be old enough to remember LSD parties where one person stayed sober to help with a bad trip. Better still, avoid GHB altogether. There are other, safer euphorics out there. We’re never going to totally prevent drug deaths but with understanding of risk comes harm reduction.

I haven’t talked about the long-term effects of GHB abuse but they are multiple and frightening. GHB addiction is incredibly damaging, difficult to treat and withdrawal needs medical supervision. Paddy never got that far but I think he would have.

Finally, a personal plea. If someone taking G starts snoring, don’t ignore it. It is a medical emergency; call for an ambulance. That person is losing his airway and has respiratory depression. He is choking and without urgent treatment, oxygen delivery to his brain will stop and brain damage, cardiac arrest and death will inevitably follow. This was Paddy’s final story.

Dry January anyone? Whatever you decide, be safe.

Love, Graham