The drug epidemic that is hitting gay men hard

On Caledonia Road, in the heart of London’s Kings Cross, there is a small shopfront painted bright purple and a discreet sign that confirms that this is the home of London Friend.
This nondescript, unassuming premises is the frontline in an ongoing campaign to educate gay men in Britain’s capital about the risks that they’re taking and the harm that they’re doing to themselves.
I press the small buzzer to the left of the door and I’m soon ushered into a cluttered waiting room. There’s couches, chairs, a lot of community health posters and leaflets, and a kitchen which doubles as a reception desk.
‘It’s all a bit voluntary sector!’ apologises Monty Moncrieff, head of services for London Friend.
Moncrieff is a friendly, bear of a man. Warm and engaging, he’s the kind of person you feel you could talk to about anything. I’m intrigued by his piercings.
Having celebrated its 40th anniversary a few years ago, London Friend is the UK’s oldest LGBT charity, offering a range of services that address the full range of needs that someone may need to call on at vulnerable points of their life — whether that’s coming out, gender identity, relationship support, or drug and alcohol issues.
Antidote is London Friend’s LGBT drug and alcohol service. Antidote aims to increase awareness, reduce harm and enable individuals to make informed choices in their lives — providing harm reduction advice, information and support for people who want to make a change to their drug and alcohol use, whether that’s to reduce use, gain greater control or stop altogether.
Moncrieff explains that people generally start to admit that they have a problem: ‘…when it starts to impact on aspects of their life such as relationships or work, or when it becomes clear that they have developed a physical dependence.’
As someone who has worked in the drug and alcohol field for many years, what’s concerning Moncrieff are some of the current trends in drug use and how these are specifically impacting gay men: ‘We are seeing massive changes in the way that men who have sex with men are using drugs and the problems that they are experiencing as a result. What’s clear is that the drugs and the problems are community specific and we are not seeing these trends in the wider population. It’s particularly apparent in London that men who have sex with men are increasingly using drugs to enhance sex.’
The CODE sexual health clinic in the heart of London’s Soho is targeted specifically at gay men that are into the ‘harder’ sex scene. According to the clinic’s educational information, some gay men are using drugs during sex because they: ‘…dis-inhibit us. They can make us feel more confident, sexier, butcher, friendlier, more active or more passive, more like a porn star and can facilitate encounters that make our fantasies more likely.’
Commonly referred to as ‘chems’, the drugs that are being increasingly used in this sexualised context are Crystal Meth and GHB/GBL.
Crystal Meth (also known as ‘Tina’) is powerfully addictive. Generally injected or smoked, Crystal Meth is a form of methamphetamine and, by triggering a cascading release of dopamine in the brain, increases alertness, concentration, energy, and in high doses, can induce euphoria, enhance self-esteem and increase libido.
GHB (a naturally occurring substance) and GBL (a form of chemical solvent) are similar but different drugs, both generally referred to as ‘G’. Knowing which form you are taking though is important as GBL is more powerful as it is absorbed faster and requires a lower dose. Produced as a clear liquid and generally ingested by diluting in a drink, at low doses G has a euphoric effect and can increase sex drive, however when used excessively (or combined with alcohol), G acts like a sedative and quickly makes the user unconscious.
Research by Antidote and specialist service the Club Drug Clinic is finding that the way that some gay men are using G is leading to significant physical addiction and dependency.
According to Antidote’s Moncrieff, G started out as a party or club drug, used recreationally to create a euphoric high. The shift into highly sexualised environments such as sex parties, saunas and other sex-on-premises venues has become a noticeable trend in recent years. ‘The typical pattern is that guys are using G over a weekend to enhance or facilitate sex but people have got better at getting the dose right and knowing what to taken when, so the effects on the body are lasting longer and people are quickly forming a physical dependence.’
Based on the users that are presenting to services such as Antidote, the Club Drug Clinic and CODE, the physical dependency created by excessive use of G leads to users needing a fix every two hours. It is commonplace for addicted users to report that they have to set their bedside alarm to wake them every two hours during the night so that they can continue to take the drug at regular intervals and avoid withdrawal.
Contrary to the common public perception of drug addicts, someone that is addicted to G is likely to be a gay man in their 20s or 30s, in employment, in stable housing and often in a relationship.
One of the challenges with treating an addiction to G is that the only treatment option is to stop taking the drug. If the user is not able to stabilise and slowly reduce their usage, sudden withdrawal leads to a rapid onset of symptoms such as sweating, agitation, tremor and intense craving. As the symptoms develop, users can experience severe delirium, paranoia, respiratory depression and convulsions and this often results in admission to intensive care or in-patient treatment.
Physical drug dependency is not the only risk associated with using chems in a highly sexualised environment — lower inhibitions combined with an enhanced sex-drive is a killer combination that seems to throw the accepted safe-sex wisdom out the window and is contributing to increasing rates of HIV infection among gay men in London.
Antidote’s Moncrieff is concerned that London’s problems with G addiction are only just beginning: ‘In recent years we have seen a rapid rise in the number of men seeking help from Antidote — we are now helping over 500 men per year and we’re not advertising anywhere, that’s purely from word of mouth or referrals from GPs or sexual health services. There’s something different about G, we’re really just scratching the surface.’