“A lot of people don’t realize exactly how quickly crystal becomes addictive. The thing that makes crystal so insidious is that, even if you were basically a mentally healthy, well adjusted, happy person beforehand, the first couple of times after you do crystal it manages to convince you that the state you are in when you are high on crystal is the normal, desirable, natural state, and that what happens to you when you are off crystal is the abnormal condition that needs to [be] rectified. That becomes the abnormal state. What do you do when you’re in an abnormal state? You fix it with something. It becomes this chase, you know, ‘If I could just do enough crystal, if I can manage to get enough of it into me, that will fix whatever is wrong.’ I don’t think a lot of people are prepared for how fundamentally it changes the way you think on and off the drug.” [1]

I reflected for a long time after reading the above quote as I recalled an earlier time in my life where I smoked a lot of pot and came to equate euphoria with normality. I know that those who become dependent on alcohol often experience a similar phenomenon: they feel increasingly normal as they continue drinking, while being sober is met with anxiety, low self-esteem, low self-confidence, and depression. Like the onset of clinical depression, the effect of drugs can have a steadily downward effect in your life, yet their impact is insidious – you don’t know it is happening at first and even when you become aware that you are having an increasingly difficult time coping, you don’t attribute it to the drug.
Following last month’s column on circuit parties, this month looks at the effect of the more commonly used “club drugs,” specifically 3, 4-methylenedioxymethamphetamine (MDMA, or “Ecstasy”), crystal methamphetamine (crystal meth), gamma-hydroxybutyrate (GHB), ketamine hydrochloride (ketamine), and flunitrazepam (Rohypnol). They are referred to as club drugs because of the environments in which they are commonly used: dance clubs, raves, and circuit parties. Technically, alcohol, marijuana, cocaine, and volatile nitrites (“poppers”) belong here as well, but will not be covered due to space considerations.
A study based on 1169 circuit party attendees found a high prevalence of drug use, with 72% reporting use of ecstasy, ketamine (60%), and GHB (28%) at parties in the past 12 months. [2] Of this large sample, using drugs was the main reason for attending a circuit party by 10.9% of the participants.
Some general findings regarding use of club drugs that I discovered while reading the literature include:
1. Risky Sex – club drug use is highly associated with risky sex (e.g., anal sex without condoms) between men-who-have-sex-with-men. This is especially true with users of crystal meth and ecstasy. [3, 4]
2. Polydrug Use – club drug users often combine drugs to create enhanced or varying effects. This is especially dangerous and potentially lethal when depressants (e.g., ketamine, GHB) are mixed with alcohol (another depressant). The effect of two or more drugs is often more potent than what you would otherwise expect. These are known as interaction effects.
3. Drug Use is Increasing and Expanding Outside of Club Environments – increasingly a higher percentage of people are using club drugs, and they are using them outside of club environments, such as at home, at house parties, etcetera.
4. Regular Users are Often Suffering Psychologically – there are many members of the queer community that feel isolated, alone, depressed, or anxious for a multitude of reasons. Drug use often disguises or hides underlying negative feelings and thoughts, at least temporarily. [5]
5. Regular Users are Often Sensation Seekers – sensation seeking is recognized in psychology as a temperament or personality trait, and drug users often score high in this tendency to seek novel and stimulating experiences. [6]
Remember from your high school years that our bodies try to reach homeostasis, meaning that for every reaction there is an equal and opposite reaction that attempts to bring our bodies (including our brains) back into equilibrium. This means that the more powerful the stimulant, the more our bodies (and brains) will react with physiological depression (and sometimes emotional depression) while in withdrawal from the drug. Likewise, the more powerful the depressant, the more stimulated we will feel while in withdrawal. These withdrawal effects, unlike the drug’s initial effect, are unpleasant. With that in mind, let’s explore some of the individual effects of club drugs.
Ecstasy
Abuse of ecstasy has increased sharply over the past 20 years, although the drug is not new. It was developed in 1914 and was frequently used recreationally in the 1960s and 1970s for its enhancement of sensory experience. [7] The drug was also believed to facilitate psychotherapy, but due to its toxicity, it became illegal in the mid 1980s. [8] The effects include (a) increased energy, (b) increased libido, (c) feelings of warmth and openness, (d) increased extroversion and self-confidence, and (e) elevated mood. Some have referred to ecstasy as the “love drug” or the “hug drug.” [9] Potential negative effects include feelings of being unreal, impaired decision-making, teeth grinding, jaw clenching, decreased appetite, headaches, and insomnia. Feeling depressed and exhausted are common withdrawal effects, beginning the next day after use. There is considerable evidence that ecstasy use leads to impaired memory function. [10] Furthermore, case reports have suggested that ecstasy use “can cause psychiatric symptoms, including depression, anxiety, and paranoia, even after abstinence from the drug.” [11]
Crystal Meth
Meth was abused for several years on the US West coast before moving to Miami toward the end of the 1990s. [12] Originally developed from ephedrine in 1893, the drug became popular when Japan, Germany, and the US gave it to their troops during WWII to increase endurance and performance. [13] It is a stimulant with a structure similar to but more potent than amphetamine. [14] More than other drugs, meth is described as “especially sexually arousing and disinhibitory.” [15] Its effects include (a) increased alertness and excitement, (b) increased activity, (c) increased libido, and (d) decreased appetite. Excessive doses can lead to a brain haemorrhage, stroke, seizure, hyperthermia, coma, and death. Potential psychological problems include insomnia, psychosis, paranoia, suicidal thoughts, and cognitive deficits, including problems with learning, memory, and other thinking processes. [16] Quitting the drug has been very difficult for users. [17] Meth users are the least likely to complete treatment when they do seek help to quit. [18]
GHB
GHB was developed in 1960 as an anaesthetic and was sold in health food stores in the early 1990s as an aid for anxiety, insomnia, drug and alcohol abuse, and to assist athletes and bodybuilders. Recent studies have shown it may be helpful for those suffering from narcolepsy, cataplexy, fibromyalgia, and alcohol dependence and withdrawal. [19] The effect of GHB is similar to alcohol, although episodes of loss of consciousness are more frequent and unpredictable. [20] GHB produces anterograde amnesia (loss of memory for what occurred while under the influence of the drug, like a blackout from excessive alcohol), and consequently the drug has been used in cases of sexual assault. [21] Users report that the drug produces a pleasant state of relaxation and tranquility and it increases libido. [22] The drug is usually sold as a clear, salty liquid and is taken in capfuls or teaspoons. GHB has a high overdose prevalence and it can cause the sudden onset of coma and seizures. [23] “The one distinguishing feature of GHB toxicity is the sudden awakening of the patient from a comatose state to a normal or hyperactivated state of arousal.” [24]
Ketamine
Ketamine is a derivative of phencyclidine hydrochloride (PCP) and it originated in the 1960s. Its use in dance clubs (commonly sniffed) began in the early 1980s. [25] Similar to GHB, it was developed as an anaesthetic for humans, and it is used in trauma and emergency surgical procedures and in veterinary medicine. [26] Its effects include (a) sedation, (b) immobility, (c) amnesia, and (d) analgesia. Users may experience a distorted sense of space and time, with minutes feeling like hours. They may feel like they are on a spiritual journey or experience visual hallucinations. [27] Users feel dissociated (removed) from their environment. The effect of the drug is short lived, and in two hours, half of the drug is metabolized. At high doses, the drug can cause vomiting, slurred speech, amnesia, rapid or irregular heart beat, agitation, and delirium. Due to its dissociative properties, the user may have out-of-body or near-death experiences. Visual disturbances and flashbacks can occur days or weeks after using ketamine. [28] It is the most likely club drug to lead to periods of dependence. [29]
Rohypnol
Rohypnol is a benzodiazepine (same class of drugs as valium, ativan, and xanax) and was originally developed as an anaesthetic and treatment for insomnia. [30] At low does, it acts like a muscle relaxant and a sedative-hypnotic (a sleep agent), while at higher doses, it causes loss of muscle control and consciousness. This drug was specifically designed to create anterograde amnesia, so similar to GHB, it has been used by perpetrators of sexual assault. Some youth have referred to it as a “cheap drunk.” [31]
I cannot, in good conscience, either condone or condemn the use of club drugs in queer culture. They have been around for longer than I have been out, and they have served a purpose, regardless of whether it is for recreation or whether it cloaks threatening feelings or thoughts. Instead, I encourage you, the reader, to discern and decide for yourself what is appropriate. Drugs acquired through dealers as opposed to licensed pharmacists are not controlled for quality, content, or dosage. Frankly, you don’t know what you’re getting when you purchase a pill you think contains ecstasy. There were times in the past when a joint gave me a high that seemed more like something I would have experienced on mushrooms or speed. God knows what it was laced with. God knows what is really in the pill that you might be thinking of taking.
Dr. Alderson is an associate professor of counselling psychology at the University of Calgary who specializes in gay and lesbian studies. He also maintains a private practice. He can be contacted by confidential email at alderson@ucalgary.ca, or by confidential voice mail at (403) 605-5234.
References:
1. Kurtz, S. P. (2005). Post-circuit blues: Motivations and consequences of crystal meth use among gay men in Miami. AIDS and Behavior, 9(1), 63-72. [quote from p. 70].
2. Ross, M. W., Mattison, A. M., & Franklin, D. R. Jr. (2003). Club drugs and sex on drugs are associated with different motivations for gay circuit party attendance in men. Substance Use & Misuse, 38(8), 1173-1183.
3. Klitzman, R. L., Pope, H. G., & Hudson, J. I. (2000). MDMA (“ecstasy”) abuse and high-risk sexual behaviors among 169 gay and bisexual men. The American Journal of Psychiatry, 157(7), 1162-1164.
4. Theodore, P. S. (2006). A psychosocial model of club drug use and sexual behavior among men-who-have-sex-with-men. Dissertation Abstracts International: Section B: The Sciences and Engineering, 66(8-B), p. 4503.
5. Ibid.
6. Simons, J. S., Gaher, R. M., Correia, C. J., & Bush, J. A. (2005). Club drug use among college students. Addictive Behaviors, 30(8), 1619-1624.
7. Freese, T. E., Miotto, K., & Reback, C. J. (2002). The effects and consequences of selected club drugs. Journal of Substance Abuse Treatment, 23(2), 151-156.
8. Ibid.
9. Klitzman et al. (2000).
10. Freese et al. (2002).
11. Klitzman, R. (2006). From “male bonding rituals” to “suicide Tuesday”: A qualitative study of issues faced by gay male ecstasy (MDMA) users. Journal of Homosexuality, 51(3), 7-32. [quote from p. 8].
12. Kurtz (2005).
13. Freese et al. (2002).
14. Ibid.
15. Kurtz (2005). [quote from p. 64].
16. Freese et al. (2002).
17. Kurtz (2005).
18. Maxwell, J. C., & Spence, R. T. (2005). Profiles of club drug users in treatment. Substance Use & Misuse, 40(9-10), 1409-1426.
19. Freese et al. (2002).
20. Ibid.
21. Maxwell, J. C. (2005). Party drugs: Properties, prevalence, patterns, and problems. Substance Use & Misuse, 40(9-10), 1203-1240.
22. Palamar, J. J., & Halkitis, P. N. (2006). A qualitative analysis of GHB use among gay men: Reasons for use despite potential adverse outcomes. International Journal of Drug Policy, 17(1), 23-28.
23. Freese et al. (2002).
24. Maxwell (2005). [quote from p. 1221].
25. Lankenau, S. E., & Clatts, M. C. (2005). Patterns of polydrug use among ketamine injectors in New York City. Substance Use & Misuse, 40(9-10), 1381-1397.
26. Freese et al. (2002).
27. Maxwell (2005).
28. Freese et al. (2002).
29. Lankenau & Clatts (2005).
30. Maxwell (2005).
31. Ibid.