Gay men, lesbians and substances of abuse and the 'club and circuit party scene': What clinicians should know.

Many researchers believe that substance use rates are higher among gay men and lesbians than in the general population. In particular, recreational drugs, used as part of weekend and night "life" are particularly popular. This chapter reviews several of these so-called "club drugs," which have become a regular part of many gay men and women's social life. MDMA (methylenedioxymethamphetamine), or "Ecstasy," is a synthetic amphetamine derivative, with some unique physiological properties. MDMA can induce depression and panic attacks. A serious concern is the potential that MDMA may cause long-lasting, even permanent neuropsychiatric damage, in particular to serotonin neurons. Ketamine, or "Special K," is a dissociative anesthetic that induces feelings of unreality, and may even cause catatonia (a "K hole"). GHB (gamma-hydroxybutyrate) is a naturally occurring biological substance that has effects similar to alcohol. Modest doses can cause sleep and even coma. The number of reports of fatal overdoses associated with GHB is growing. The clinician working with gay and lesbian people should become aware of these particular substances, as well as other recreational drugs, and their dangers, to more effectively work with his or her clients. (PsycINFO Database Record (c) 2009 APA, all rights reserved) (from the chapter)