Protecting ourselves, protecting each other: The current reality of GHB in the PnP scene and solutions to keep our friends alive

Warning: this blog post describes a fatal overdose. This content will be upsetting to some of our readers. For support around grief and loss, please contact Healing Hearts Canada.

 

Connor shouldn’t have died alone in his room. Left by his hookup, face down on his bed after passing out, he choked on his own vomit. His death was preventable: putting him in the recovery position and staying with him could have saved his life. Connor was the first in a series of recent deaths in Toronto’s party and play (PnP) scene attributed to GHB and its substitutes, GBL and BDO. Instead of sounding alarm bells, there has been silence and confusion about how to respond to these deaths, whether they were isolated incidents or part of a frightening new chapter in Canada’s toxic drug crisis.

To prevent more needless deaths, harm reduction advocates, guys who PnP and our allies must push for safer supply, increased access to drug testing that is amenable to gay, bisexual and other men who have sex with men (GBMSM), community education on responding to GHB-related emergencies, as well as ending drug criminalization and stigma. But before diving into solutions, let me provide some basic information about this misunderstood recreational drug.

All about GHB

GHB (Gamma-hydroxybutyrate) is a depressant used for its alcohol-like effects, inducing mild euphoria. Sold as a clear liquid, often called “G” or “water”, GHB is used by some GBMSM to enhance sexual encounters. Its narrow dosage margin between euphoria and unconsciousness makes its effects unpredictable. This is further exacerbated by factors like sleep, food intake, potency and combined use with other depressants like benzodiazepines or alcohol.

If someone takes too much G, they may slide into a deep sleep-like state called “G’ing out”, more akin to a coma than a power nap. Death can occur due to dangerously slowed breathing and heart rate, leading to respiratory failure or choking on vomit.

BDO (1,4-Butanediol) is suspected to have been involved in Connor’s death. Relatively new to the Toronto scene, this drug emerged when GHB became scarce and expensive during the pandemic. BDO and GBL (Gamma-butyrolactone) metabolize into GHB when consumed, with a faster onset and an increased potency. All three drugs look similar, taste noxious and are currently circulating in local drug markets, often falsely labeled as GHB, putting people who use GHB at risk.

What’s in your vial?

National data on the prevalence of BDO and GBL across Canada is lacking, though they’ve shown up in Toronto and Montreal markets. Dealers are often unaware which of the three substances—GHB, BDO or GBL—they are selling. Drug testing is not common in the PnP scene, making it difficult for people to identify substances. The decriminalization and regulation of GHB (also known as safer supply) would allow people who use these drugs to be more aware of what they are taking, because there would be content packaging and labelling guides like those found on cannabis and alcohol products; however, until then, improving access to drug testing is crucial for harm reduction.

Access to drug testing

To deal with the current crisis, drug testing infrastructure must adapt to the PnP community’s needs. Mainstream harm reduction services struggle to test GHB quickly. Extensive recalibration of mass spectrometry machines used to determine the composition of drugs is needed for definitive results. Despite plans to address drug testing infrastructure, there is still a lack of PnP and GHB information circulating among harm reduction workers, hindering effective responses. Resources and supports for drug testing need to be accessible to everyone. That means including GBMSM in drug testing discussions, as well as promoting queer representation in adaptive drug testing and advocacy at all levels.

Improving community responses to GHB emergencies

My focus has been on changes needed at a systems level. Yet, individuals in the PnP community can also play an important role by protecting friends and fellow partiers, as well as responding appropriately to GHB emergencies. Research shows most instances of GHB overdose are not attended to by emergency medical services, due to a misconception among people who PnP that “G’ing out” isn’t harmful. Recent incidents contradict this belief, emphasizing the need for community education on recognizing and responding to overdoses. Empowering community members to respond appropriately can mitigate risks while we strive for an end to criminalization and stigma.

Criminalization and stigma

Criminalization and stigma breed fear, profoundly impacting the choices of people who use drugs. The consequences of being identified as a person who engages in PnP—job loss, strained relationships and societal judgment—can drive an individual into secrecy, often with tragic outcomes. These fears can even deter bystanders from offering life-saving assistance, as seen in Connor’s story. Sensationalized media narratives have intensified stigma surrounding GHB, linking it to sexual violence and even murder, overshadowing the reality that most users prioritize consent.

Criminalizing & banning GHB based on the actions of a small minority of individuals who would seek to harm others, will only push people who use the drug towards riskier alternatives, increasing the likelihood of overdose and death. People who use GHB aren’t criminals, and exceptional cases don’t justify laws that heighten overdose risks for all recreational users.

 

In conclusion, the PnP community must be included in discussions on Canada’s toxic drug supply. Decriminalization, legalization and comprehensive harm reduction are essential to prevent further tragedies. As part of this community, I urge GBMSM to advocate for themselves and demand inclusion in the national dialogue on drug rights. Our recent losses are a stark reminder of the broader drug crisis engulfing our country—we can no longer ignore our vulnerability. We must stand up in solidarity with other communities who use drugs.

To harm reduction advocates, let’s collaborate with GBMSM health allies to enhance access to services and support. We can look to the work of The Outreach Network at CATIE who are currently collaborating with the Gay Men’s Sexual Health Alliance to include PnP in their education and training for frontline harm reduction workers in Ontario as an example. The time for action is now. Let these deaths not be in vain.

Rest in power, Connor, Frederick, Mirek, Max, Sam, Jacob and all those taken too soon.

 

Jordan Bond-Gorr is the PnP/chemsex initiatives coordinator at the Gay Men’s Sexual Health Alliance. They help produce content, research and resources for service providers about the realities of chemsex and crystal meth use among queer men. Jordan believes that shame and stigma are the root of most of the harms we attribute to drugs. His passion is to create spaces for judgement free conversations about chemsex that empower GBMSM to take back control of their own narratives and lives.