The silent "G": a case study in the production of "drugs" and "drug problems".
We situate our account of G within the UK drug policy context of the last decade, which we have elsewhere characterized as the "proactive prohibition" of a growing number of substances consumed in leisure spaces such as bars, clubs, festivals and private parties, and which amount to the "criminalization of intoxication" (Measham & Moore, 2008). Given that G is also used in such spaces, the relative historical silence surrounding its use and the tardiness of its criminalization is surprising and so requires explanation, particularly given the contrasting high profile that the NPS or former "legal high" mephedrone enjoyed in the UK, not to mention the rapidity with which mephedrone and NPS were brought under the MDA 1971. (3) This unevenness in the production of a "drug" (an illegal high) adds weight to the argument that the very concept of "drugs" amounts in part to a regulatory concept, with substances grouped as drugs bearing limited resemblance to one another apart from the regulatory regimes which seek to control their legitimate/illegitimate use (Ruggiero, 1999; Seddon, 2010). By "problematizing drugs," we are engaging with the very notion of drug itself (Fraser & Moore, 2011, p.10), understood as a hybrid entity of pharmacology and politics (Derrida, 1993; Latour, 1993; Valverde, 1998; Moore, 2007).
What of "users"? The meanings of a substance rest in part on those who are viewed as the (dominant) user groups; the purposes to which a substance is put; and the regulatory regimes under which a substance is placed--all of which are interdependent and can vary significantly according to historical and sociocultural context. In this messy process, user groups--in G's case largely stigmatized minority user groups--have a crucial role to play in the production of the legitimate/illegitimate use binary, attracting variability in the regulatory regimes that seek to control consumption. As Stevens (2011a) highlights in his argument for progressive decriminalization, the inequalities produced and compounded by drug, crime, and health policies are often forgotten in debates about appropriate policy responses to substance use. Under minimum pricing and differential taxation, expensive wine consumed by those of higher socioeconomic status in the pursuit of permissible forms of sociable and celebratory intoxication (the theater interval tipple) attracts a lower economic sanction in the UK compared to the higher taxed, lower priced, high-strength lager or cider consumed by street drinkers in their isolated pursuit of oblivion through intoxication (Moore & Measham, 2012).
There are obdurate moral undertones to the differentiation between legitimate substances/users and illegitimate substances/users (Duster, 1970), just as there are with the division of substances into "medicines" and "drugs." Race (2009) notes that consuming what are produced as medicines for pleasure 'transgresses the moral logic of "restoring health" that guarantees pharmaceutical legitimacy' (Race, 2009, p.ix). The erectile dysfunction medication Viagra (Sildenafil) is a clinically sanctioned biochemical technology used to shore up heterosexual relationships, available on National Health Service (NHS) prescription in the UK in recognition that "health" includes sexual wellbeing. Viagra could be included in a growing range of "lifestyle" drugs and cosmetic procedures which reflect our willingness to submit to medical interventions, not just to reduce ill health but to improve quality of life. Yet in the hands, or rather in the bodies, of gay men, Viagra transforms from "medicine" to "recreational drug" illegitimately deployed for the purposes of facilitating and prolonging impermissible pleasures, doubly deviant because taken to counteract the effects of illicit stimulant drugs and facilitate gay sexual encounters. This issue of normative heterosexuality and moral conservatism echoes concerns about "sexual sociality" (Green & Halkitis, 2006, p. 68) in part materialized by G (and other club drugs) when purposively consumed by gay male clubbers in leisure spaces such as gay bars, clubs, sex parties, and saunas.
With these concerns in mind and drawing on work from within critical drugs research--which in turn has drawn on key concepts from Actor Network Theory (ANT) (4)--we use G as a case study to broadly explore how drug cultures move through phases whereby a diffuse and contested network of practices, agencies and processes are ordered into a more stable and conventional set of problems and actors. G users, researchers, policy makers, practitioners, the media and the materialities of G (Fraser & Moore, 2011, pp. 4-6; Race, 2009, p. 23) are implicated in the production of G as a "drug" and a "drug problem" at a particular moment in time and across space. We begin with an account of our own research on G in light of this acknowledgment.
Our research explores the relationship between drug use and drug policy, particularly issues of deterrence, desistance and displacement between psychoactive substances following legislative control. We became curious about G across the course of many years of club drug research. Previously G had featured in our research as one of a range of drugs in weekend recreational repertoires, from in situ dance club surveys with gay, mixed (Measham, Aldridge, & Parker, 2001) and hard dance crowds (Measham & Moore, 2009). Most recently we became curious at what we saw as a contrast between the silence surrounding GBL among researchers, policy makers, and practitioners and the high profile emergence, criminalization and academic consideration of another legal high--mephedrone--in the spring of 2010 (Measham, Moore, Newcombe, & Welch, 2010; Measham, Wood, Dargan, & Moore, 2011). At the time, as the risk assessment report on GBL and 1,4-BD produced by the UK's Advisory Council for the Misuse of Drugs (ACMD) signalled, there were a small number of published reports of their use by bodybuilders, clubbers, and gay men (ACMD, 2007a, p.14). We successfully applied for funding in early 2009 in order to concentrate on G. The following sections draw on our subsequent research activities undertaken as part of a British Academy funded project titled "The Contexts, Meanings, Motivations and Consequences of GHB/GBL Use in the UK". (5)
Ten in-depth interviews were conducted in 2009-10, five with GBL users and five with service providers in contact with GBL users. Our attempts to access G users for interview through attendance at after-hours (6) electronic dance music (hereafter EDM) clubs in the north-west of England frequented by predominately (but not exclusively) heterosexual EDM clubbers were largely unsuccessful. Given this lack of success identifying many G users in EDM clubs in the north-west of England, an initial interview with a Manchester gay clubber about his G use proved productive in informing us of potentially prolific G use occurring in South London clubs where he had first used G. This coincided with us starting to work with colleagues who had undertaken some of the earliest research on G use in the UK at two of the largest gay dance venues in London, and indeed the UK, crucial locations for understanding gay dance culture (Wood et al, 2007, 2008). Therefore the process of locating G users for this study resulted in us following our Manchester respondent's path to South London to conduct in situ club surveys in the very clubs where our respondent had first used G.
The subsequent in situ club surveys (Measham et al., 2011) utilized an anonymous, two-page questionnaire to gather data regarding sociodemographic details and use of alcohol, cigarettes, and a range of legal and illegal drugs. We accessed location-based samples of club-goers across the course of three evenings in July, 2010, in two gay dance clubs in south London. Customers were approached at random in clubs in the cordoned-off smoking/"chill-out" area earlier in the evening when customers were more likely to have low levels of intoxication (Measham & Moore, 2009). (7) Overall, 308 respondents participated in the survey (17% of the total number of club customers attending the three club nights across the two venues, n = 1,838). A further 28 customers refused to participate, meaning a high consent rate of 92%. The sample characteristics were: 82% male, 75% white, 70% gay/lesbian, 69% in full time employment, 81% London residents, and the average age was 30 (see Measham et al., 2011 for further details of research design and sample characteristics).
However, it is important to note that while our research led us south, with surveys and interviews concurring that G use is higher in the capital than regions (Ashworth & Fountain, 2009), there remain pockets of G use across the UK we have not identified or accessed, including those in private domestic spaces. Focusing on G use in Australia, Dunn, Topp, & Degenhardt (2009) note, for example, that alongside an increase in reported use of G in Sydney's urban center, users and drug workers ("key experts") reported a change in the contexts in which G was being consumed, highlighting that although primarily associated with the (gay) dance music scene in the city, increasingly use was also occurring in domestic spaces (p. 3). The drug workers in a Scottish city interviewed for our G study also highlighted their concerns about (potential) GBL use amongst the city's urban poor and homeless populations; (8) with such users neglected because of both their "hard-to-reach" position in research, policy, and practice, and by the vagaries in the progress of our G research so far. (9)
Here then is an account of the way in which we as researchers have contributed to the production of the contested meanings of G through our research activities, by working to frequent those spaces in which G was being used, surveying those who frequented such spaces, and interviewing those with experience of G (users, club promoters, drug service professionals, and outreach volunteers). As we have sought to challenge what we perceived to be the relative historical neglect of GBL use in the UK, so we became part of the process of shaping "what G is" and notably who its (dominant) user groups are. We worked to make G visible, yet this was not a linear, "objective" process of uncovering a "truth," but rather a messy contingent process (Law, 2004) which constructed a particular version of the "G problem," contingencies resting on gender/sexual relations, for example. Some spaces remained closed to us as female researchers. We were informed of G use in near-by gay saunas by respondents in our South London club surveys but neither of us suggested to the other to even attempt to access G users through these venues. We were mutually silent on the issue, a silence that was endorsed by hearing that female ambulance staff have been excluded from entering saunas when called out to attend to male customers who have collapsed following G use.
By concentrating on G use in gay clubs (but not saunas) and using location-based samples of targeted populations, we (and others) have contributed to the production of (one of) G's multiple meanings as a "gay drug" (see below). The production of "evidence" via academic research--on drug prevalence for example--is ultimately and unavoidably a politicized activity. Making visible (dominant) user groups of particular drugs is not a necessarily negative process: For example, public health initiatives may be better targeted on the basis of such evidence; to argue otherwise entails a strong Foucauldian position in the exercise of power which can amount to misrepresenting all public health initiatives as "exercises in disguised coercion" (Stevens, 2011a, p. 6). Yet heightened visibility undoubtedly has implications for historically marginalized and stigmatized minority groups given the inequities compounded by the prohibitionist drugs/crime nexus. Whilet alcohol and drug laws and related enforcement practices purport to be applicable to the general population, they are in practice typically targeted at those deviating from societal norms (e.g. gay men) and/or those who are visible in their pursuit of the pleasures of intoxication (e.g. clubbers, some festival-goers, working class drinkers in the night time economy (NTE)) (Measham & Moore, 2008; Moore & Measham, 2012; Race, 2009). As Stevens (2011b, pp. 249-250) notes in his ethnographic work on policy-making practices in the British civil service, the selective, narrative use of evidence is "ideological" in that it supports "asymmetrical relations of power" by silencing social inequality in the promotion of policies that are "totemically tough" on drugs. In relation to press selection of crime stories (Jewkes, 2011), our qualitative study (see Moore & Measham, 2008) evidencing the controlled use of ketamine amongst clubbers at the time of its crimininalization in the UK was not the "research story" reported in the press despite our best efforts (see Shepherd, 2008), nor did it fit the dominant policy narrative. So we are (all) implicated in the process of ordering practices, agencies and processes into a more stable and recognizable set of "problems" and actors--that is G as a "drug" and a "drug problem." This ordering process produces the multiple and sometimes seemingly contradictory meanings of "drugs," as we now highlight in relation to G.
The multiple meanings of G
G as a "date rape drug"
We are familiar with the notion of an undeserving drug victim (Jewkes, 2011). Extensive UK media reporting of the female medical student Hester Stewart's GBL-related death drew on discourses of social class, gender, and victimhood, themes that have been explored in previous research on media coverage of drug deaths (Forsyth, 2001; Manning, 2006; Murji, 1998). Retaining this focus on class, gender, and victimhood, we note that one of G's contested meanings is that of "date rape drug," alongside ketamine and Rophenol. Drug-facilitated sexual assault (DFSA) may be perpetrated by someone (usually male) either known or unknown to the victim (usually female) (ACMD, 2007b; Olszewski, 2009; Sturman, 2000). Furthermore, DFSA is closely associated with acquaintance rape or what is more problematically known as "date rape" (Lees, 1995), with those illicit substances administered by perpetrators coming to be known as date rape drugs. GHB/GBL have long been identified as date rape drugs by the British press (Mail Online, 2006), government bodies and the police despite scant evidence of their use in rape cases in comparison with alcohol (Finney, 2004; Moore, 2009; Nemeth, Kun, & Demetrovics, 2010). (10) Configuring G as a date rape drug positions its recreational use as wholly irrational and irresponsible given that in other contexts the substance facilitates harm to others, notably to women in the NTE, a leisure space already constructed as potentially risky for intoxicated women (Sheard, 2011). The emergent meaning of G becomes stabilized into dangerous drug as its most easily performed and most likely recognized enactment.
Doing sex, doig drugs: G as a "sexual or sensual drug"
The disinhibition experienced by G users is crucial to producing the contested identity of G as a sexual or a sensual drug which heightens desire and allows the user to pursue atypical or unbounded sexual encounters (Rodgers, Ashton, Givarry, & Young, 2004). One heterosexual male interviewee who had an extensive drug history, including previous problems with heroin and alcohol, compared GBL with alcohol:
G-User 1: Just like relaxed and sort of my anxieties went away and a bit more talkative and I tell you what the difference was, the difference was it definitely had some sort of sensual feel. I think people get that with alcohol. I don't get that with alcohol. They say they get "beer goggles" and birds [women] look nice and that. Well with GBL that happens to me you know. Without a doubt, what no other drug's done that to me before.
In the above quotation the interviewee compares GBL to other substances with depressant effects on the body but notes a point of distinction regarding the "sensual" effects of the substance. In opposition to this framing of G as a sensual drug, another male interviewee, who self-identified as heterosexual and as being dependent on GBL for nearly 2 years, spoke of the disruptive nature of this aspect of G consumption:
G-User 2: I don't know if you have heard of this but it (GBL) makes you a lot hornier, and sex is a lot better and prolonged, and not only that, in the end you become obsessed with sex to the point where you are living on the porn channel and going to places you shouldn't be going, well not that I have, but it crossed my mind.
Discussion of the desiring body frames G as a sensual or (more problematically in normative terms) sexual drug, a corollary of G as a biochemical agent acting to produce disinhibition in its encounters with and between human bodies (Race, 2009). Disinhibition emerges from these encounters but without "predictable, stable effects and meanings" (Fraser & Moore, 2011, p. 5). Instead G as a sensual or sexual drug had diverse meanings for our interviewees as they considered their own positioning as gendered and sexually orientated subjects who are located in broader networks of meaning, affect and practice (Ahmed, 2006). For G-user 1, for example, disinhibition was a positive effect in the context of his social anxiety around women. For G-user 2, the substance precipitated an obsession with sex, whereas a female (bisexual) G-user (3) we interviewed experienced the disinhibiting effect of G as both positive and negative:
Interviewer: So, in terms of positive experiences, would you say that the first time was positive?
G-User 3: Absolutely, because it was, obviously it heightens your sexual arousal and it was unlike anything and I think that night it sort of made us really close and that was just a sort of a really nice factor for me it made me feel really, really close with him [her boyfriend] also that we were sharing something as well, so yes definitely.
On being asked about her G use in relation to nights out clubbing, she recounted more negative experiences, discussing how the disinhibiting effects of G meant she undertook sexual practices which disrupted her own (usual) self-regard:
G-User 3: Yes sort of quite bad personal experiences when I used to take it. It was more sort of in the house, but the times when I did take it when I was out clubbing I used to, I was very promiscuous and I sort of propositioned people for threesomes and which isn't sort of me, that's not really me.
This woman's concern about her sexual practices in leisure spaces is particularly interesting given aforementioned associations between G, drug-facilitated sexual assault (DFSA), and the gendered power dynamics of sexual assaults. More broadly, the effects of psychoactive substances are not separate from the gender and sexual orientation norms of appropriate behavior in specific drug-taking contexts (Demant, 2009; Hunt, Moloney, & Evans, 2010). Elsewhere we have highlighted variability with regard to the acceptability or otherwise of bodily demeanors following drug-taking (Measham, 2002; Moore & Measham, 2008). The bodily demeanors of G users in the gay dance clubs we surveyed (Measham et al., 2011) contrasted strikingly with acceptable behavior in previous predominantly heterosexual fieldwork sites, where similar demeanors had resulted in immediate eviction, unless produced as a result of alcohol intoxication which tends to be more acceptable in bars, live music gigs, and (some) clubs aimed at a heterosexual customer base. The acceptability (or otherwise) of G in South London gay clubs and supported by UK and international research on gay men's use of the drug (Duff, 2005; Measham et al., 2011; Palamar & Halkitis, 2006) acts to stabilize G as a gay drug, its most easily performed and most likely recognized but perhaps most contested enactment.
G as a "gay drug"
Despite GHB being controlled in June 2003 and GBL in December 2009, it was only in October 2009 that GHB and GBL were added to the British Crime Survey (BCS), the then UK annual national household survey. Both drugs were included together "due to the similarity of these drugs and the belief that respondents may not know/be able to tell the difference in which was being used" (Hoare & Moon, 2010, p. 66). Past year use of GBL/GHB in the 2009/10 BCS was estimated to be 0.1% in the general population, 0.5% amongst young adults aged 16-24, and under 0.05% among older adults aged 25-59 (Hoare & Moon, 2010, p.72). GHB/GBL use has fallen with 0.1% of 16-24 year olds reporting past year use and reported use being too low among older adults to produce estimates for the general population (Smith & Flatley, 2011, p. 22).
By contrast, club surveys have consistently shown far higher levels of G use. Over a decade ago the Manchester dance drug survey (Measham et al., 2001) of more than 2,000 clubbers in three dance clubs found that one in ten had tried GHB at least once in his or her lifetime, and that male and older clubbers were significantly more likely to have tried GHB than female and younger clubbers, with GHB having the oldest average age of initiation of any legal or illegal drug included in the survey. Furthermore, lifetime prevalence of GHB use was significantly higher at the gay and mixed city center club (21%) which had the oldest and most affluent customer base, compared with the warehouse club (7%) and the out-of-town, multiple-arena "rave" (4%) which had a younger and more working- class clientele.
More recent in situ surveys in Manchester dance clubs in the late 2000s found that customers frequenting EDM clubs had higher lifetime prevalence of GHB use at 19% compared to those frequenting the city's bars (6%). Furthermore, when comparing lifetime prevalence of GHB at EDM clubs playing different genres of dance music, respondents reported significantly higher use at a gay and mixed hard dance club (47%) compared to a funky house club aimed at a heterosexual customer base (34%), a trance club drawing a mixed clientele (16%), and two drum and bass clubs aimed at a heterosexual customer base (8% and 4%, respectively) (Measham & Moore, 2009).
Data from Australian national population surveys highlight a similar picture of extremely low prevalence amongst the general population (Degenhardt & Dunn, 2008) as compared to far higher rates amongst convenience samples of targeted populations such as EDM clubbers (Dillon & Degenhardt, 2001). When GHB users in Sydney and Melbourne were recruited from a range of sources, 61% self-identified as gay and bisexual in the resulting sample (Degenhardt, Darke, & Dillon, 2002). Halkitis and Palamar (2006, p. 2135) note in relation to the United States that GHB use has been relatively understudied despite its popularity in gay communities. A total of 29% of their sample of 450 club-drug-using men in New York City reported past month use of GHB, principally alongside other illicit substances during the course of 1 or 2 days partying (Halkitis & Palamar, 2006).
Our surveys in South London clubs across 3 weekend nights in July, 2010, found similarly high prevalence rates for G (see Table 1) (Measham et al., 2011), particularly when compared to the low prevalence figures in the BCS national household survey reported above (Smith & Flatley, 2011). Notable in these surveys is that even within gay-friendly leisure spaces, G use was significantly related to self-defined sexual orientation and gender, with a third of gay men reporting having used G at least once, a quarter in the past year and one in five in the past month. By comparison only 2% of straight men and women had ever tried G, 2% within the past year and 1% in the past month. For lesbians the figures were even lower.
Barker and Langdridge (2010, p. 69) note the "difficulties and discomforts" experienced in selecting and presenting research stories on gay men's sexual practices, bisexuality, nonmonogamous relationships and sadomasochism "knowing the potential political implications this may have for a set of sexual identities and practices which remain pathologised and criminalized." The relative historical neglect of GBL use in the UK relates to G intersecting with already pathologized and criminalised sexual identities and practices such as gay sex party (11) and/or dance club attendance. Illicit drug use by gay men and lesbians around the world is assumed, expected, even normalized as it is simultaneously pathologized (Race, 2011). Indeed widespread concern about GBL (including demands for the immediate banning of GBL) emerged in 2009 only after female medical student Hester Stewart died having taken GBL after drinking alcohol, with which it is contraindicated. The extensive press coverage of Hester's death contrasts with the disproportionate lack of media coverage of volatile substance abuse deaths (Manning, 2006) and a similar lack of coverage of the first confirmed mephedrone death in the UK, an HIV positive gay man taking multiple drugs at a sex party. The relative silence surrounding G prior to Hester Stewart's death echoes the way in which HIV/AIDS--perceived as a "gay disease" (Epstein, 1998) and "junkie disease"--was neglected as a public health issue until it was seen as "spreading" to "straight" society (that is, heterosexual, noninjecting individuals).
Such processes work to define deviance, contain transgression, and invigorate the political category of drugs, typically as being one we should 'naturally' want to avoid (or should be compelled to avoid) in light of the central Western dualism of rationality and free will versus irrationality and compulsion (Fraser & Moore, 2011). Of late, GBL has come to the attention of the "civilising technologies" (Vrecko, 2010, p. 36) of policy makers and contemporary addiction studies after campaigning by (former) users or "addicts," bereaved family members and some drug workers. G has first had to be constituted as drug and its identity contested as to the kind of drug it is or is not (i.e., a recreational drug; an addictive drug).
GBL as a chemical "not fit for human consumption"
GBL is used globally in a range of industrial and commercial contexts, including as an alloy wheel cleaner, a paint stripper, and nail varnish remover. Its use as an industrial chemical reinforces the meaning of G as a substance that is "not for human consumption." This phrase became familiar in the media furor surrounding the emergence of NPS or legal highs in Europe, North America, and Australia. "Not for human consumption" is a term favored by producers and distributors of NPS and used in conjunction with fictitious functions--such as plant feed and bath salts--in order to circumvent legislation controlling the sale of medicines and foodstuffs explicitly intended for human consumption.
However, the term "not for human consumption" has a broader relevance to the contested meanings of all "drugs," relating to the aforementioned moral undertones of the legitimate/illegitimate binary and the division of substances into medicines, drugs and also, as noted here in relation to GBL, chemicals.
As with drug, both substance and chemical are morally and politically loaded terms, with chemical most frequently negatively juxtaposed with the concepts of organic or natural. We see this "displaced moral dichotomy of good and evil" (Keane, 2002, p. 18) also in relation to concern about the so-called designer drugs of the 1990s rave scene or more recently synthetic stimulants. By contrast herbal highs imply a degree of innocuousness, while anti-drug campaigners frequently proclaim their preference for "being on a natural high" through their pursuit of sport for example. (12)
"Not for human consumption" is for some (retailers) a means by which to resist regulatory regimes and for others (non-users) merely confirms the irrationality of those who undertake illegitimate consumption practices in the pursuit of "impermissible pleasures" (Moore & Measham, 2011). Ketamine, for example, is constructed as not for human consumption through the reiteration of its legitimate use on animals as a veterinary anaesthetic and hence its inappropriateness for humans. The construction of ketamine as not for human consumption is reflected in the UK media's accounts of clubbers using the "horse tranquiliser drug" (e.g. Doyle, 2011) and parodied by the T-shirt slogan "Ketamine, Just Say Neigh." Certain cultural products position recreational ketamine consumption (in opposition to veterinary use) as inherently problematic and illegitimate, yet overlook ketamine's legitimate clinical use in pediatric and palliative care. This is paralleled by the framing of the (former) legal high BZP as a "worming pill for dogs" (e.g., Hope, 2007) so, again, clearly for animal rather than human consumption. A substance that is 'not for human consumption' is "matter out of place" which challenges the social and moral order (Douglas, 1966; Szasz, 1985; Keane, 2002). Similarly G users are framed as doubly deviant, even within the realms of drug users, by choosing to imbibe an industrial chemical rather than "misuse" drugs which have had a legitimate clinical usage at some point in history, as has been the case with established street drugs such as heroin, cocaine, amphetamines, and (in some countries) MDMA.
In contrast to established street drugs, GBL has no legitimate clinical use. Furthermore GBL's function as an industrial chemical has shaped the regulatory regime to which it has been subject and users' encounters with G. While GHB was brought under the MDA 1971 in June 2003, the control of GBL was delayed for over 6 years because of concerns not to restrict legitimate industrial use of this chemical, despite Italy and the United States already having overcome this obstacle to control (ACMD, 2007a). This inaction is in stark opposition to the aforementioned rapidity of controlling mephedrone in the UK. The key difference is that mephedrone has no clinical or industrial use and thus no pharmaceutical or industry stakeholders, therefore facilitating the UK legislative control process which took just 18 days from ACMD recommendation to statute book. By contrast, GBL has pharmaceutical and industry stakeholders and thus it took over 6 years for control to be extended from GHB to GBL (ACMD, 2007a). Finally, it is due to GBL's legitimate industrial use as a chemical that possession is only illegal if intended for human consumption: subsequently it remains easy to purchase online as distributors merely ask for a disclaimer form to be attached to UK orders stating that the GBL is "not for human consumption."
The contested meanings of G highlight what is at stake in the production of "drugs" and "drug problems" in need of rapid "solutions." Yet in this article we have highlighted the relative neglect of G by researchers, policy makers and practitioners, notably the tardy criminalization of GBL that we found surprising in the context of a frenetic drive to criminalize many other forms of intoxication in the UK (Measham & Moore, 2008). Most contentiously we have suggested that the apparent lack of concerted and coordinated action (before Hester Stewart's GBL-related death) was related to G primarily affecting an already stigmatized minority group. We suggest that one of the manifestations of G's contested meanings across multiple times and spaces--notably its prior positioning as a "recreational" club drug and problematically a "gay drug"--has been confusion amongst UK practitioners about what G is, a resulting lack of pathways to appropriate services, and a dearth of detoxification facilities nationwide. Serious difficulties encountered by GBL users--including acute toxicity (13) and long term dependency--have only recently been identified in the UK (Wood, Brailsford, & Dargan, 2011). To date there are no national guidelines from the UK's NHS or the National Institute of Clinical Excellence. Instead we have local clinical guidelines on detoxification drawn up by several NHS trusts, leading to patchy provision for those experiencing difficulties with G. (14) Linked with often employed and rarely offending user groups, G remains detached from the association of drug users with social exclusion and acquisitive crime (as with heroin) or with public disorder and domestic violence (as with alcohol) and therefore does not fit the drugs-crime policy priorities of several generations of UK policy makers (Hough, 2001; Hunt & Stevens, 2004).
In the UK the rise of NPS (specifically mephedrone) juxtaposed with the relative historical neglect of G and the tardiness of the criminalization of GBL lays bare the unevenness of attention given to various substances. In the face of a perceived attention gap, we as academic researchers embedded in the cultures we study tend towards the production of forms of data that can "draw attention." Yet in drawing attention and making visible we fear we (re)produce "the problem" in a particular vein. As Fraser and Moore (2011, p. 5), drawing on Karen Barad's work (2003), note, "each encounter produces reality uniquely, based on the specifics of people, objects and concepts encountering each other and being remade by these encounters." Highlighting the illicit practices of our club-going research participants, for example, may result in greater surveillance and social control of the very cultural scenes we are committed to and care so greatly about. However it is often this concern, commitment, and care that motivates partial-insider researchers (Measham & Moore, 2006), as it was with our decision to focus on G in UK club cultures.
Our unique, situated encounters with our research concerns, the political consequences of research methods alongside the realities subsequently produced, may compound or even extend the inequities embedded in drug, crime, and health policies (Moore, 2011; Stevens, 2011a, 2011b). There is no easy way out of this emotional, ethical, and practical impasse. Reflecting on our own experiences of how research findings are translated by the press and policy makers for their own purposes, sometimes positively and other times negatively (see Blackman, 2007), we suggest that however careful we are to acknowledge that we contribute to the performative and material constitution of drugs as particular kinds of agents and particular kinds of problems, our research outputs have agentic materiality (see Leonardi, 2010), that is as the manifestation of abstract or theoretical constructs such as "drug prevalence" made material through the creation of data sets, SPSS files, journal articles and press releases. Recognizing this with regard to our research outputs means accepting that there are limits to the control we might have over their circulation in a network and possible translation into policy and practice contexts.
The ways in which we as researchers contribute to the performative and material constitution of drugs as problems is a conundrum which has a lengthy history, drawing the attention of those working within critical drug studies and is particularly pertinent to those researchers who claim partial insider status in the drug cultures they study. Being embedded in such drug cultures as a researcher involves being constituted as a particular type of social agent with normative roles and responsibilities relevant to a wide range of constituents. Identifying and potentially problematizing this constitution demands a reflexive approach to our place in the network of behaviors, agencies, and processes which are ordered into a more stable and recognizable set of "problems" and actors. This ordering is not without its contestations, contestations that coalesce in the multiple and sometimes seemingly contradictory meanings of "drugs," as we aimed to demonstrate here with G.
AUTHORS' NOTE: Thanks to Paul Dargan, David Wood and the club staff for their help with the South London club surveys. Thanks to Annette Dale-Perera, Smita Kaur, David Nutt and David Stuart for help regarding statistics, guidelines and policy developments. Thanks also to those at the Contemporary Drug Problems conference held in Prato, Italy, in October 2011 and to our anonymous reviewers, whose comments on this paper have proved invaluable. For further information about this article contact Karenza Moore, Dept. of Applied Social Science, Lancaster University, Bailrigg, Lancaster, LA1 4YW, UK. Email: email@example.com
ACMD. (2007a). GBL & 1,4-BD: Assessment of risk to the individual and communities in the UK. London: Home Office.
ACMD. (2007b). Drug facilitated sexual assault. London: Home Office.
Ahmed, S. (2006). Queer phenomenology: Orientations, objects, others. Durham, NC: Duke University Press.
Ashworth, S., & Fountain, J. (2009). Part of the picture: The National LGB Drug and Alcohol Database--Year one results, England: April-October 2009. Manchester: Lesbian and Gay Foundation/UCLAN.
Barad, K. (2003). Posthumanist performativity: Towards an understanding of how matter comes to matter. Signs: Journal of Women in Culture and Society, 28(3), 801-831.
Barker, M., & Langdridge, D. (Eds.). (2009). Silencing accounts of silenced sexualities. In R. N. Flood & Rosalind Gill (Eds.), Secrecy and silence in the research process. Abingdon, UK: Routledge.
Blackman, S. (2007). "See Emily Play": Youth culture, recreational drug use and normalisation. In M. Simpson, T. Shildrick, & R. MacDonald (Eds.), Drugs in Britain: Supply, consumption and control (pp. 39-92). Basingstoke: Palgrave Macmillan.
Borria, M. (2011, October). The raw pleasures of prashed dancing: Accounts of after-hour clubbing in London, UK. Paper presented at Beyond the Buzzword: Problematising 'Drugs'--Contemporary Drug Problems Conference, Prato, Italy.
Boseley, S. (2011, September 26). Club drug clinic opens its doors. The Guardian. Retrieved May 1, 2012, from http://www.guardian.co.uk/society/2011/sep/26/club-drug-clinic-lauch
Degenhardt. L., Darke, S., & Dillon, P. (2002). GHB use among Australians: Characteristics, use patterns and associated harm. Drug and Alcohol Dependence, 67(1), 89-94.
Degenhardt, L., & Dunn, M. (2008). The epidemiology of GHB and ketamine use in an Australian household survey. International Journal of Drug Policy, 19(4), 311-316.
Demant, J. (2009). When alcohol acts: An actor-network approach to teenagers, alcohol and parties. Body & Society, 15(1), 25-46.
Derrida, J. (1993). The rhetoric of drugs: An interview. Differences: A Journal of Feminist Cultural Studies, 5(1), 1-25.
Dillon, P., & Degenhardt, L. (2001). Ketamine and GHB: New trends in club drug use? Journal of Substance Use, 6(1), 11-15.
Douglas, M. (1966/1978). Purity and danger: An analysis of concepts of pollution and taboo. London: Routledge.
Doyle, J. (2011, July 21). Fears over 50% rise in use of deadly horse tranquiliser drug. Mail Online. Retrieved July 23, 2011, from http://www.dailymail.co.uk/news/article-2017104/Fears-50-rise-use- deadly-horse-tranquiliser-drug.html
Duff, C. (2005). "Charging" and "blowing out": Patterns and cultures of GHB use in Melbourne, Australia. Contemporary Drug Problems, 32(4), 605-653.
Dunn, M., Topp, L., & Degenhardt, L. (2009). GHB in Sydney, Australia, 2000-2006: A case study of the EDRS as a strategic early warning system. International Journal of Drug Policy, 20(5), 413-417.
Duster, T. (1970). The legalisation of morality: Drugs, law and moral judgement. New York: The Free Press.
Epstein, S. (1998). Impure science: Aids, activism and the politics of knowledge. Berkeley and Los Angeles: University of California Press.
Finney, A. (2004). Alcohol and sexual violence: Key findings from the research [Home Office findings 215]. London: Home Office.
Forsyth, A. (2001). Distorted? A quantitative exploration of drug fatality reports in the popular press. International Journal of Drug Policy, 12(5-6), 435-453.
Fraser, S., & Moore, D. (2011). Introduction: Constructing drugs and dddiction. In S. Fraser & D. Moore (Eds.), The drug effect: Health, crime and society (pp. 1-16). Cambridge: Cambridge University Press.
Green, A., & Halkitis, P. (2006). Crystal methamphetamine and sexual sociality in an urban gay subculture: An elective affinity. Culture, Health and Sexuality, 8(4), 317-333.
Halkitis, P.N., & Palamar, J.J. (2006). GHB use among gay and bisexual men. Addictive Behaviours, 31(11), 2135-2139.
Hoare, J., & Moon, D. (2010). Drug misuse declared: Findings from the 2009/10 British Crime Survey. London: Home Office.
Hough, M. (2001). Balancing public health and criminal justice interventions. International Journal of Drug Policy, 12(5), 429-433.
Hope, J. (2007, April 27). Latest dance drug is a worming pill for dogs. Mail Online. Retrieved July 23, 2011, from http://www.dailymail.co.uk/news/article-451108/Latest-dance-drug-worming- pill-dogs.html
Hunt, G., Moloney, M., & Evans, K. (2010). Youth, drugs and nightlife. New York: Routledge.
Hunt, N., & Stevens, A. (2004). Whose harm? Harm reduction and the shift to coercion in UK drug policy. Social Policy and Society, 3(4), 333-342.
Jewkes, Y. (2011). Media and Crime (2nd Ed.). London: Sage.
Keane, H. (2002). What's wrong with addiction? Melbourne, Australia: Melbourne University Press.
Latour, B. (1993). We have never been modern (C. Porter, Trans.). Cambridge, Mass: Harvard University Press.
Law, J. (2004). After Method: Mess in Social Science Research. London: Routledge.
Law, J., & Hassard, J. (1999). Actor network theory and after. Oxford: Blackwell.
Lees, S. (1995). Media reporting of rape: The 1993 "date rape" controversy. In D. Kidd-Hewitt, & R. Osbourne (Eds.), Crime and the media: The post-modern spectacle (pp. 107-130). London: Pluto Press.
Leonardi, P. (2010). Digital materiality? How artifacts without matter, matter. First Monday [online], 15(6).
Mail Online (2006, October 26). The chilling ease with which "date rape" drugs can be bought online. Mail Online. Retrieved June 17, 2011, from http://www.dailymail.co.uk/news/article-412885/The-chilling- ease-date-rape-drugs-bought-online.html
Manning, P. (2006). There's no glamour in glue: News and the symbolic framing of substance misuse. Crime, Media, Culture, 2(1), 49-66.
Measham, F. (2002). "Doing gender"--"doing drugs": Conceptualizing the gendering of drugs cultures. Contemporary Drug Problems, 29(2), 335-373.
Measham, F., Aldridge, J., & Parker, H. (2001). Dancing on drugs: Risk, health and hedonism on the British club scene. London: Free Association Books.
Measham, F., & Moore, K. (2006). Reluctant reflexivity, implicit insider knowledge and the development of club studies. In B. Sanders (Ed.), Drugs, clubs and young people: Sociological and public health perspectives (pp. 13-25). Bristol: Ashgate.
Measham, F., & Moore, K. (2008). The criminalisation of intoxication. In P. Squires (Ed.), ASBO nation: The criminalisation of nuisance (pp. 273-288). Bristol: Policy Press.
Measham, F., & Moore, K. (2009). Repertoires of distinction: Exploring patterns of weekend polydrug use within local leisure scenes across the English night-time economy. Criminology and Criminal Justice, 9(4), 437-464.
Measham, F., Moore, K., Newcombe, R., & Welch, Z. (2010). Tweaking, bombing, dabbing and stockpiling: The emergence of mephedrone and the perversity of prohibition. Drugs and Alcohol Today, 10(1), 14-21.
Measham, F., Wood, D., Dargan, P., & Moore, K. (2011). The rise in legal highs: Prevalence and patterns in the use of illegal drugs and first and second generation 'legal highs' in south London gay dance clubs. Journal of Substance Use, 16(4), 263-272.
Moore, D. (2007). Criminal artefacts: Governing drugs and drug users. Vancouver, CA: UBC Press.
Moore, D. (2011). The ontological politics of knowledge production: Qualitative research in the multidisciplinary drug field. In S. Fraser & D. Moore (Eds.), The dry effect: Health crime and society (pp. 73-88). Port Melbourne. AU: Cambridge University Press.
Moore, K.. & Measham, F. (2008). "It's the most fun you can have for twenty quid": Meanings, motivations and consequences of British ketamine use. Addiction Research and Theory, 16(3), 231-244.
Moore, K., & Measham, F. (2012). Impermissible pleasures in UK leisure: Exploring policy developments in alcohol and illicit drugs. In C. Thomas, E. Barclay, & R. I. Mawby (Eds.), The problem of pleasure: Leisure, tourism and crime (pp. 62-76). Cullompton, UK: Willan.
Moore, S. (2009). Cautionary tales: Drug-facilitated sexual assault in the British media. Crime, Media, Culture, 5(3), 305-320.
Murji, K. (1998). The agony and the ecstasy: Drugs, media and morality. In R. Coomber (Ed.), The control of drugs and drug users: Reason or reaction? (pp. 69-85). Amsterdam: Harwood Academic Publishers.
Nemeth, Z., Kun, B., & Demetrovics, Z. (2010). The involvement of gamma-hydroxybutyrate in reported sexual assaults: A systematic review. Journal of Psychopharmacology, 24(9), 1281-1287.
Olszewski, D. (2009). Sexual assaults facilitated by drugs or alcohol. Drugs: Education, prevention and policy, 16(1), 39-52.
Palamar, J., & Halkitis, P. (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.
Race, K. (2009). Pleasure consuming medicine: The queer politics of drugs. Durham, NC: Duke University Press.
Race, K. (2011). Party animals: The significance of drug practices in the materialisation of urban gay identity. In S. Fraser & D. Moore (Eds.), The drug effect: Health, crime and society (pp. 35-56). Cambridge: Cambridge University Press.
Rodgers, J., Ashton, C.H., Givarry, E., & Young, A.H. (2004). Liquid ecstasy: A new kid on the dance floor [Editorials]. The British Journal of Psychiatry, 184(2), 104-106.
Ruggiero, V. (1999). Drugs as a password and the law as a drug: Discussing the legalisation of illicit substances. In N. South (Ed.), Drugs: Cultures, controls and everyday life. London: Sage.
Seddon, T. (2010). Let's not talk about drugs. Drugs and Alcohol Today, 10(3), 21-23.
Sheard, L. (2011). "Anything could have happened": Women, the night-time economy, alcohol and drink spiking. Sociology, 45(4), 619-633.
Shepherd, J. (2008). Ketamine use triples over decade, survey suggests. Guardian Online. Retrieved June 5, 2008, from http://www.guardian.co.uk/uk/2008/may/10/3
Smith, K., & Flatley, J. (2011). Drug misuse declared: Findings from the 2010/11 British crime survey, England and Wales. London: Home Office.
Stevens, A. (2011a). Drugs, crime and public health: The political economy of drugs. Abingdon: Routledge.
Stevens, A. (2011b). Telling policy stories: An ethnographic study of the use of evidence in policy-making in the UK. Journal of Social Policy, 40(20), 237-255.
Sturman, P. (2000). Drug assisted sexual assault: A study for the Home Office under the police research award scheme. London: Home Office.
Szasz, T. (1985). Ceremonial chemistry: The ritual persecution of drugs, addicts, and pushers (rev. ed.). Florida: Learning Publications Inc.
Valverde, M. (1998). Diseases of the will: Alcohol and the dilemmas of freedom. Cambridge: Cambridge University Press.
Vrecko, S. (2010). "Civilizing technologies" and the control of deviance. BioSocieties, 5(1), 36-51.
Weidel, J., Provencio-Vasquez, E., & Grossman, J. (2008). Sex and drugs: High-risk behaviors at circuit parties. American Journal of Men's Health, 2(4). 344-352.
Wood, D.M., Brailsford, A.D., & Dargan, P.I. (2011). Acute toxicity and withdrawal syndromes related to gamma-hydroxybutyrate (GHB) and its analogues gamma-butyrolactone (GBL) and 1,4-butanediol (1.4 BD). Drug Testing and Analysis, 3(7-8), 417-425.
Wood, D.M., Warren-Gash, C., Ashraf, T., Greene, S.L., Shather, Z., Trivedy, C., et al. (2008). Medical and legal confusion surrounding gamma-hydroxybutyrate (GHB) and its precursors gamma-butyrolactone (GBL) and 1,4-butanediol (1,4BD). Quarterly Journal of Medicine, 101(1), 23-29.
Wood, D.M., Warren-Gash, C.. Greene, S.L., Jones, A.L., Bishop, C., Shather, Z., et al. (2007). Case series of 150 GHB poisonings seen at a large inner-city teaching hospital in 2006. Clinical Toxicology, 45(6), 627-628.
(1.) See http://www.clubdrugclinic.coml.
(2.) There is considerable confusion surrounding GHB and its precursors, GBL and 1,4-BD. In our survey research a sizeable minority of respondents were unsure whether they had consumed GHB or GBL when asked. However, it is likely that most of the G currently consumed in the UK is GBL. Wood et al (2008) highlight this point from an analysis of drugs (53% of which were in liquid form) seized from those attending club venues in their Emergency Department's (ED) catchment area in 2006. Significantly more GBL (62%) than GHB (38%) was seized in local clubs, contrary to the belief of ED patients that they had ingested GHB (95%) rather than GBL (5%).
(3.) The term novel psychoactive substance (NPS) is becoming established in national/international research literature and drug control policy. However, the broader debate we deal with relates to what is known colloquially as the 'legal highs debate', that is the debate about the emergence of NPS not classified under conventional drug legislation such as the UK's MDA 1971.
(4.) "Actor-network theory" (ANT) is employed here as a loose, contingent label to refer to all approaches, early-, after-, and in-between-, that have associated themselves with ANT at some point (see Law and Hassard ,1999). Here we work with the assertion that network in ANT is understood as not simply connecting things that already exist, but instead actually configures ontologies. When exploring the multiple enactments that comprise any one object such as the emergence of a "drug' and the production of a drug problem, ANT approaches are well positioned to explore questions about how politics constrain, obscure or enable certain enactments--"dangerous drug," "the addict," "the criminal"--to be most easily performed and most likely recognized.
(5.) This research was funded by the British Academy and Lancaster University. The study was approved by the Lancaster University Research Ethics Committee (reference 45558, 27/05/2010).
(6.) This term refers to those clubs which are open after main clubbing times, typically from about 4 a.m. onwards. Some after-hours clubs occur on Sunday afternoons/evenings. There is scant research on the UK after-hours club scene (Borria, 2011). After-hours clubs may be differentiated from "after-parties" (also called "chill-outs") which typically occur in private domestic settings.
(7.) See Measham and Moore (2009) for a discussion of issues of venue and respondent sampling and informed consent in relation to in-situ bar, club and night-time economy surveys.
(8.) These drug workers thought that the appeal of GBL lay in it being a potentially cheaper alternative to alcohol, given that both substances have depressant effects.
(9.) Homeless and socially excluded G users may be particularly "hard to reach" for us given our position as NTE researchers and "outsiders" to these groups.
(10.) However it is worth noting that there are considerable difficulties here given the short window of GHB/GBL detection in blood and urine due to its rapid metabolization.
(11.) Such events are also known as "circuit parties." There has been considerable coverage of the use of G amongst gay men at such parties in the US (e.g. Weidel, Provencio-Vasquez, & Grossman, 2008) and Australia (e.g. Halkitis & Palamar, 2006).
(12.) See http://www.naturalhigh.org/
(13.) In our in situ surveys in South London gay clubs, one in five respondents reported having taken G in the past month. Of these past month G users, 28% had visited a club paramedic. By contrast amongst those club-goers who had not taken G in the past month only 3% had visited a club paramedic.
(14.) See http://www.nhs.uk/Pages/HomePage.aspx and http://www.nice.org.uk/
TABLE 1 Self-reported prevalence of GHB and/or GBL use by self defined sexual orientation at three gay dance club nights South London, July 2010 (%) n = 306 GHB Percentages Ever Had Past Year Past Month +/or GBL MALE Gay 33% 25% 20% n=252 n=206 Straight 2% 2% 1% n = 18 Bisexual 3% 2% 1% n = 19 Transgender -- -- -- n = 1 Other 1% 1% 1% n = 8 FEMALE Lesbian 1% 1% 0.3% n=54 n = 8 Straight 2% 2% 1% n = 33 Bisexual 2% 1% 1% n = 10 Transgender 0.3% 0.3% 0.3% n = 2 Other -- -- -- n = 1 TOTAL 44% 34% 25% 134 104 78 GHB Percentages Already Planning Had and/or +/or GBL Had Today tonight Planning MALE Gay 10% 11% 12% n=252 n=206 Straight 1% 1% 1% n = 18 Bisexual 1% 0.3% 1% n = 19 Transgender -- -- -- n = 1 Other -- -- -- n = 8 FEMALE Lesbian 0% 0% 0% n=54 n = 8 Straight 1% 1% 1% n = 33 Bisexual 1% 1% 1% n = 10 Transgender 0.3% 0.3% 0.3% n = 2 Other -- -- -- n = 1 TOTAL 14% 14% 16% 42 43 49
|Printer friendly Cite/link Email Feedback|
|Title Annotation:||United Kingdom; Beyond the Buzzword: Problematising "Drugs"|
|Author:||Moore, Karenza; Measham, Fiona|
|Publication:||Contemporary Drug Problems|
|Date:||Sep 22, 2012|
|Previous Article:||"Problematic intoxications": conceptualizing "abuse" of illicit drugs in postwar social treatment legislation in Finland.|
|Next Article:||The Federal Bureau of Narcotics, the states, and the origins of modern drug enforcement in the United States, 1950-1962.|