RAH toxicologist warns about increasingly popular liquid drug fantasy

It’s cheap and rising in popularity – but a RAH toxicologist has warned that this dangerous party drug is the one most likely to see you end up in intensive care. Here’s why.

It comes in the innocent-looking little plastic fish that are usually filled with soy sauce in takeaway meals.

But a year on from six overdose cases presenting to Flinders Medical Centre within 24 hours last October, experts warn use of the ultra-cheap but potentially fatal drug fantasy is on the rise in South Australia.

A national study has found more regular drug users in SA take fantasy, the cause of 26 overdose deaths around the country from 2016-19, than those in any other jurisdiction.

A Royal Adelaide Hospital toxicologist says the drug, also known as GHB, is the biggest cause of illicit drug-related intensive care admissions.

And a peak drug body says it is so dangerous because users have no way of knowing the strength of what they are buying – a little fish bottle selling for as little as $1 could contain a dose that gives them a cheap high, or land them in hospital fighting for life.

Fantasy is now being sold in soy sauce fish containers. Picture: Supplied

A recently published study by the National Drug and Alcohol Research Centre found almost a quarter of regular drug users in SA (23 of 100 surveyed) had taken fantasy in the six months before they were interviewed last year, compared to 10 per cent of the national sample. And seven of those had overdosed, though most did not seek treatment.

Fantasy users were also much more likely to also be methamphetamine users than drug-takers who did not use fantasy, a concern as combinations of drugs are commonly found in overdose cases.

RAH emergency physician and clinical toxicologist Dr Sam Alfred said hospital data showed there was a “steady increase” in fantasy use “both in number of patients and volume, or dose, of the drug”.

Dr Alfred said it was “extremely easy” to overdose accidentally, with symptoms ranging from incoherence and uncontrollable sweating and vomiting to breathing problems, muscle contractions and, in the most severe cases, heart attack or death.

“Standard doses of GHB are very small and measured in millilitres and the dose range of relative safety is narrow,” he said. “Accidental increases in dose of a few millilitres is enough to cause an overdose. Ingestion of GHB at the same time as alcohol is extremely dangerous as alcohol interferes with the body’s handling of GHB and can significantly increase the risk of poisoning.”

Also known as liquid ecstasy, fantasy is often colourless with a bitter or salty taste.

It gives short-term feelings of euphoria and increases sex drive, but also causes nausea and drowsiness.

SA Network of Drug and Alcohol Services executive director Michael White said usage had risen in SA as it could easily be made locally, while pandemic restrictions had made it harder for criminals to import other illicit drugs across borders.

“A lot of people buy it in those little fishes that you can find soy sauce in,” he said. “I’ve heard of them selling for as little as a dollar. One of those could hold a dose, or it could also hold four or five doses.”

He urged people to call 000 if they believed they were overdosing.

For help with drug and alcohol problems, visit knowyouroptions.sa.gov.au