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"To have that many deaths from a brand-new drug is impressive. It's a particularly high number in relation to the rest of the country," says Spillane, who pegs deaths nationwide at 49 to date as reported to the DEA. He suspects the true toll is probably higher, because many medical examiners still don't test for the drug's presence, although Broward County's do.
Since he started to gather stats on GHB, Spillane's noted at least three cases of severe GHB withdrawal. Symptoms include agitation, elevated vital signs, and tremors, but he adds that auditory and visual hallucinations are not uncommon, with patients horrified and unable to sleep. "The problem is we don't have anything to treat it with. Benzodiazepine is used to treat alcohol withdrawals, and it works very well. But it doesn't work with GHB," says Spillane.
He's also witnessed the usual overdose reactions, which he says are further complicated by street myths that discourage medical attention if a user slips into unconsciousness. Many GHB and GBL users believe that, unless other drugs or alcohol have been taken, the best bet is to sleep it off. Uninformed medical personnel, hospital expenses, and painful methods of arousal are all mentioned by users as reasons to skip the 911 call.
"People need to know this: The only treatment is to get the person to an emergency room. What they need is airway management," says Spillane. One of the problems with GHB is that a user might relax so much that his tongue could block his airway. If he vomits he could choke and die. Typically a GHB overdose is treated through intubation, and although most people regain consciousness in three to four hours, Spillane cautions those betting on it. "You're taking a big chance if you try to sleep it off. Sure, [you'll ] probably wake up eventually, but do you want to be the one person who doesn't?"Rule #1: No alcohol. "Drinking on G is a no-no," says Michael, a 33-year-old professional in the travel industry who takes the drug recreationally. He's standing in the middle of his teal-painted bedroom. Shirts, jeans, Calvin Klein underwear, and bulky black Sketchers litter the carpet and bed, where an open-mouthed suitcase lies. Michael's packing for a weekend getaway to Orlando with his boyfriend. His most precious cargo is four glass vials of GHB and fourteen hits of Ecstasy. He likes to use the two together. State prosecutors and police call it polydrug use, but Michael calls it fabulous. He has his routine down pat. First he takes a tablet of Ecstasy. When that starts winding down, he gulps a shot of G. "I tell the people I'm with, "OK, my stuff isn't working, I don't feel like dancing, I'll be back in about ten minutes with my new mood modifier,'" he says and holds up the Ziploc bag housing his stash.
"Then I'll buy a cranberry juice or a Coke, go to the bathroom, and make my own cocktail. When I come back, things are aaaalllll different," he says, laughing. "I feel really sexual, crazy, I want to dance. You just feel really alive and wonderful. It's what partying's all about."
Ecstasy is easier to score in clubs than GHB. The white- or pastel-color tabs can be stashed anywhere, in a Chap Stick tube, an M&M or Skittles bag, the foil of a cigarette box. Because G's usually sold in water bottles or small glass ampoules, carrying it in bulk is next to impossible, although some users opt for Visine bottles.
Rule #2: Know your dose. "I had a friend of mine who got it from a factory in Tennessee, but that supply's not coming in anymore. Now I get it here from people who make it," says Michael. The extent of his research is minute. When he buys, he discusses the batch's potency with his supplier. That's about it. If he's told the G is strong, he'll only take three-quarters of a cap. If it's weak or already diluted with water, he'll take more. For this weekend's getaway, he plans on taking all four vials, sharing sips with his boyfriend along the way.
"Isn't he cute?" he asks and stops packing for a minute to admire the photo floating on his computer's screen saver: a square-jawed, dimple-cheeked guy with thick lashes. "He doesn't need it like I do. Ecstasy alone doesn't work for me anymore. It's not enough. I like the feeling with G. You're just in the moment, having fun, and you're with other people who're feeling exactly the same way."
Rule #3: Wait a while before your next dose. Michael holds off for at least an hour and a half before dose number two. He learned the hard way what health care workers already know: A heavy dose of GHB can induce unrousable sleep. Even an extra thimbleful can be the difference between elation and illness. At a circuit party in Montreal, Michael found himself unable to stand or remain conscious, falling down at least twice facefirst on the floor. "People told me to sleep it off, but I thought that was a bad idea. So I used this railing to help me stand up, and I threw up all over it," he says.