For some people, recreational drug use can spin out of control without them realising it. For Matt (not his real name), 35, his story of using mephedrone then GBL then crystal meth can be an all too familiar one. Once Matt sought help through CNWL and its Club Drug Clinic, he agreed to take part in a trial investigating whether withdrawal symptoms from GHB and GBL can be reduced and outcomes improved by adding the drug baclofen to the more conventional benzodiazepine treatment. We spoke to Matt about his recovery.
At the height of your addiction what were you taking and how often?
I was taking an average of 14 to 15ml of GBL around the clock with dose levels of 1ml. That could be at intervals of sometimes an hour or up to three hours if I was asleep – my body would wake me up with an uncomfortable sensation or unwell feeling and it was because I was due a dose.
When and why did you start taking these substances?
The first time I took GBL was in a club, probably nine years ago when I was 26, in a club on the gay scene in London. I was offered to try it and at the time it was just a club drug. I was not into heavy drugs and this seemed quite clean. It was very simple and very cheap and it gave me a sense of euphoria and confidence. I had a good time back then.
Had you tried anything before that time?
I had tried cocaine, MDMA, maybe one [ecstasy] pill, but nothing caused me a problem and even at that time with GBL it was something I only took every now and then. It was over time that GBL became a problem.
How is it that GBL became a problem for you but the others didn’t?
It was firstly because of my personality. I did try quite a few drugs over a few years and it became my drug of choice – initially it was purely recreational for me and I was in control, not the drug. GBL became a drug of preference because of the cost, because of what I was feeling when I was using it. It was used purely for clubbing and/or sex and it was just fun. I thought it was something I could stop when I wanted to. I would not have any tremendous hangover, come down or withdrawal symptoms so I could continue with my daily life. It was good fun for a little while. I never knew it would cause dependence. I knew it could cause death so I was careful. In fact I was so careful about use that I was able to use it everyday without losing my job, without making a scene or having family freaking out.
Can you recall when you realised you were this addicted user?
Looking back, November 2012 was the last time I had been abstinent for a considerable period of time. When I saw I was using it daily, but not necessarily around the clock, I started to become concerned and approached drug services. This was firstly for information only. I started to become worried because I was seeing people using it around the clock or being taken ill to hospital, so my usage worried me and I wanted to reduce it. I could see how I was struggling and then I realised I was having some withdrawal symptoms that were going as soon as I took a dose. These doses were not in the context of being at a club or a party. In fact three years ago I stopped going to clubs or sex parties where this use was quite common. It crossed the line at some point.
Which drug services did you approach?
I was referred by mental health services because I was already seeing a psychologist within the Trust (CNWL), and they advised me of the Club Drug Clinic – this was three to four years ago. It wasn’t such a problem then but I was worried. The way the Club Drug Clinic was set up – their tools, their knowledge and their staff – was the best I had known.
When and why was the baclofen trial discussed with you?
It was initially mentioned a year and a half ago by Dr Owen Bowden-Jones when I saw him for a consultation. I was also trying detox with other services, which failed in that I tried detox for a period of time – a week/two weeks and then I would relapse and use again, and before I knew usage was increasing again. Dr Bowden-Jones referred me to the trial because he thought that I was a suitable candidate because other attempts had not worked and the Club Drug Clinic was a leading service for dealing with drugs such as GBL.
How has the trial helped you?
As it’s a trial I do not know whether I was taking baclofen or a placebo. It’s combined with diazepam and researchers are assessing the effects of baclofen on withdrawal.
How has withdrawal and life been for you since you’ve been on the trial?
I have never been sober this long in many years. It has been 60 days this week since I started on the trial, which essentially was my first day not using GBL in years. I didn’t know if I could do it, but it’s obviously worked. It doesn’t mean that just the trial was needed for me. There’s aftercare and counselling, but it was a beginning and it was done by the best. So whether I was given baclofen or not, the trial in itself has helped me quit. I also attend Narcotics Anonymous and I continue to attend local services and charities that support people like me who have an addiction they need to continue working on, whatever their issues were before and after.
How difficult was withdrawal for you?
The first few days were very easy mainly because I was sleeping all day. Like most patients, I was on a high dose of diazepam and was assessed continuously. As the dose was lowered I started to feel anxious and have problems with sleep, to have mood changes and to crave the drug. None were unmanageable.
How did you manage work around withdrawal?
I had to take leave – the first 14 days are the minimum you will need off work because it’s impossible to combine anything else. It’s also very important to have someone with you in that first week. You need to be looked after, especially in the first week with that level of sedation. On the third week I went back to my parents and it was mainly walking, sleeping and eating, so I took three weeks of leave.
Who did you tell about your substance abuse issues?
This was something only close friends knew about and who were with me through the withdrawal process – non drug users, but people that knew about the clubs I went to or might have used the drugs. I didn’t tell my parents the whole story.
Did you manage to keep your addiction secret from certain friends and/or family?
I combined it with other drugs. This was crystal meth and mephedrone. At the time when I was using GBL and mephedrone together, my GBL usage was not such an issue. I stopped using mephedrone when it became a classified drug and also when I unfortunately tried crystal meth. The drugs cancelled each other’s effect and I became addicted to crystal meth. That’s how I hid it because no one saw me too high on either drug and would not necessarily note something was weird.
In what circumstances would you take GBL?
It started with strangers in a club, then it became a drug you would do with friends in sex parties, and then you end up doing it on your own. The first alarm for me was when I was doing it on my own.
Tell us about the moment when you realised your drug taking was out of your control?
It was about four years ago when I needed it daily. The first time when I woke up to take a dose, that was an alarm. I had heard about people taking it around the clock but it hadn’t happened to me until then. I went to bed at midnight and woke up at 2.30am not feeling too well. I took a dose and went back to sleep. I was fine until 5.30am when I woke up and had to take another dose, and again at 7.30am. I couldn’t get more than three hours of consecutive sleep in my last year of addiction.
I thought it was all going OK until the moment I ran out of GBL. I was shaking, feeling sick and needed it or diazepam to calm myself down, which luckily I had been prescribed and which I would take to help, though it wouldn’t last long. I needed to get hold of GBL within an hour after taking diazepam. By then I had realised I was totally dependent.
I thought I was only taking it whenever I wanted to take it. I thought I was in control. Big mistake. This was one of the worst things I had gone through because the withdrawal was starting. I was panicking because I knew where withdrawal could lead – potentially death, if not managed. I felt physically very unwell. I felt if I didn’t get this dose I would go to A&E and psychologically I was down because I realised I had an issue. It was something I was ashamed to share.
What effects did your addiction have on your body?
I experience sleep deprivation, which made my low self esteem worse – when off the drug it exacerbated this feeling. On it, it masked this feeling. It boosted confidence. It boosted appetite. GBL gave me a boost or self-confidence when I needed it. Instead of just being in a club it became part of my daily life. It’s a lethal drug if people are not keeping an eye on when they are taking it and how much they are taking.
What would you say to people out there who are in the grip of a GHB/GBL addiction and want help?
If there’s a Club Drug Clinic or similar service in your borough, run to it or go online. Look at me. I had a great time years ago. It was something I hadn’t done before. It was in London. I was clubbing. But then it got out of control. It was like that first beer and I like a beer. That first one is refreshing and tasteful. You get to the fourth pint and, in my case because I don’t drink much, I don’t really know what I’m drinking or how I’m going to get home. It’s when it gets out of control that it’s a problem. The message is stop when you can and don’t pick it back up and go and seek help.
How is your health?
I’m HIV positive. I have managed to keep my health in a decent state. I’ve looked after myself as much as I could, considering the damage I was doing to myself. As I was working I needed to keep some degree of efficiency. I used to call myself a functional addict because I needed it to function.
Did the HIV status come about because of the drugs?
In my case the HIV came first. From experience I know it’s more common to hear it the other way around. In my case GBL helped me get over what HIV meant for me. It was obviously a traumatic event for me when I was diagnosed six years ago. This triggered my mental health issues such as anxiety and depression. I could see in my situation that I could go downhill just by using drugs.
How would you sum up your experience of this trial?
It’s been very easy and straightforward. They are a good team of people. You arrive in the morning and leave in the afternoon for the first five days, Monday to Friday. You are maybe there for the whole day. You can sleep there, you can have a friend with you or a family member.
For the second week you may only go for the morning for the medication and check up how you’re doing. They link with local services, your GP and keyworkers. After that, they will call you for the next few weeks to have a chat with you to see how you’re doing. They request you take a diary to note if you’ve taken any drug – alcohol or nicotine, for instance. It might mean you’re not doing well with the trial. I’ve not taken any mood-enhancing drug since the trial.
What are your hopes for the future?
I’ve now got clean time to think whether I’m happy with what I’m doing career-wise. I’m taking it easy so far because the job can be very stressful and I don’t need additional stress at the moment. I need to continue my job and think about what makes me happy. I have not had a partner in the past six years because of my status and then when I became involved with drugs, sex on drugs became a habit. It’s obviously an aspiration to have a partner, but it’s when I’m ready and the first step will be to go on a date. I also want to travel more; it’s one of my passions.
The baclofen trial team is recruiting patients for a 12-month feasibility study. For details on how to take part, email firstname.lastname@example.org, call the Club Drug Clinic on 020 3315 5800, or see clubdrugclinic.cnwl.nhs.uk/ghb-trial.
For more information about club drugs, visit Clubdrugclinic.cnwl.nhs.uk.