GHB, Ketamine, and Drug Checking

"Both clinical and public interest has been growing in the therapeutic use of some novel substances, particularly psychedelic substances, but also dissociative drugs such as ketamine. A growing number of clinical studies are exploring the potential of a range of psychedelic substances to treat different mental health conditions. Generalising in this area is difficult, and much of the research remains in its infancy, but some research in this area appears promising. These developments have also received considerable media attention. An associated concern here is that this may encourage greater experimental use of these substances without medical support, potentially putting some vulnerable individuals at risk of suffering adverse consequences. At the same time, there are signs of unregulated programmes being operated in the European Union and elsewhere, in which the use of psychedelic substances is included as part of a wellness, therapeutic or spiritually oriented intervention.

"Together, these developments have placed a renewed emphasis on the need to obtain a better understanding of the availability of both non-controlled and less common substances, as well as their impact on public health, in Europe. In particular, there are concerns about chronic harms from some of these substances, such as ketamine, and risks associated with more intensive patterns of use in certain niche settings and contexts, including the use of GHB in the chemsex scene. The presence of combinations of new synthetic opioids and new benzodiazepines further complicates overdose prevention efforts, potentially raising the need for reviewing the delivery methods of overdose-fatality prevention measures such as naloxone. There is an urgent need to improve our monitoring of the use and harms associated with these substances and to develop forensic and toxicological information sources in this area. Drug checking services will also continue to be an important sentinel data source. This information is needed to support the development and evaluation of effective harm reduction and other interventions appropriate to the settings and contexts in which these drugs are being consumed and the risks they may pose."