Chemsex/slamsex-related intoxications: A case report involving gamma-hydroxybutyrate (GHB) and 3-methylmethcathinone (3-MMC) and a review of the literature

• Published in: Forensic science international Vol. 321; p. 110743
• Main Authors: Drevin, Guillaume, Rossi, Léa-Héléna, Férec, Séverine, Briet, Marie, Abbara, Chadi
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.04.2021; Elsevier Limited
• Subjects: 3-Methylmethcathinone; Acute intoxication; Adult; Case reports; Caustic soda; Chemsex; Chromatography; Chromatography, Liquid; Cocaine; Consciousness; Drug Overdose; Drugs; Emergency medical care; Emergency medical services; Forensic science; Forensic sciences; Forensic Toxicology; Gamma-hydroxybutyrate; Global marketing; HIV; Human immunodeficiency virus; Humans; Intoxication; Laboratories; Libraries; Liquid chromatography; Literature reviews; Male; Mass spectrometry; Mass spectroscopy; Methamphetamine - adverse effects; Methamphetamine - analogs & derivatives; Methamphetamine - analysis; Psychotropic Drugs - adverse effects; Psychotropic Drugs - analysis; Public health; Scientific imaging; Sexual Behavior; Slamsex; Sodium Oxybate - adverse effects; Sodium Oxybate - analysis; Substance Abuse Detection; Tandem Mass Spectrometry; Urine; γ-Hydroxybutyric acid; France; 3-Methylmethcathinone; Slamsex; Chemsex; Gamma-hydroxybutyrate
• ISSN: 0379-0738; 1872-6283
• DOI: 10.1016/j.forsciint.2021.110743

•Chemsex and slamsex related intoxications are a public health concern.•Here, a slamsex-related intoxication case involving 3-MMC and GHB is reported.•Thirteen cases already published are reviewed with a fatal outcome in 6 cases.•GHB and 4-MEC are the two predominant drugs identified in published cases. Chemsex and slamsex represent a serious public health concern that has to be considered by both clinical and forensic toxicologists. Indeed, such practices appear to carry a significant degree of risk, including acute intoxication. Here we report the case of the intoxication of a 31-year-old male involving 3-methylmethcathinone (3-MMC) and gamma-hydroxybutyrate (GHB) during a slamsex session. In addition, we conducted a review of further cases. The 31-year-old man was admitted to the emergency department for severe impaired consciousness following the administration of psychoactive substances during a chemsex party. The detection and determination of 3-MMC and GHB concentrations were achieved using liquid chromatography-tandem mass spectrometry. 3-MMC and GHB blood concentrations were 177 ng/mL and 131 mg/L, respectively. Further, an English and French exhaustive literature search was performed using several different electronic databases without any limiting period in order to identify all published case reports detailing chemsex/slamsex-related (fatal and nonfatal) intoxications. Nine publications detailing chemsex/slamsex-related intoxication cases have been published (between 2016 and 2020). These articles reported an overall of 13 cases, all involving men with a mean age of 39.1±9.8 years. The outcome was fatal in only 6 cases. 4-MEC and GHB were the two predominant drugs identified. However, given the rapid emergence of novel NPSs in the global market as well as the ease with which they can be accessed through the Internet, toxicological laboratories have to be ready to face new patterns of intoxications resulting from chemsex/slamsex.