GHB, GBL and related compound 1,4-BD should be reclassified as class B substances, the ACMD has stated in a letter to home secretary Priti Patel. She had written to the ACMD earlier this year requesting an urgent review of GHB’s classification following high profile cases in which it had been used to facilitate rapes and murders (DDN, February, page 5). GHB (Gamma hydroxybutyrate) is an anaesthetic used for sedation However, classification and scheduling on their own are ‘unlikely’ to be sufficient to significantly reduce the harms associated with GHB and related substances (GHBRS), the commission states, and calls for improved monitoring and reporting of levels of use. While there was an increase in use in the decade to 2015, it has since plateaued and remains relatively low – although this may well be underestimated as GHBRS are quickly eliminated from the body, making identification in testing and post-mortems difficult. There was a steep rise in deaths between 2008 and 2015, although again the level again remains relatively low. There also needs to be better integration of drug treatment and sexual health service commissioning to tackle the harms associated with GHBRS use, it says, as well as measures to ensure that services are accessible and non-exclusive. GHBRS use is higher among LGBT populations, particularly in ‘chemsex’ situations, although it is increasingly used as a club drug and in other non-sexual contexts. The ACMD also notes that the harm related to GHBRS – particular in terms of mental health and their use in serious crimes – has changed since it last reviewed the substances. Testing for GHBRS should be routinely undertaken in all cases of unexplained sudden death, it says, and clearly stated on the toxicology report where this was not carried out.