„A chemical love story“: Treatment of a gamma-butyrolacton (GBL)-dependent chemistry student with diazepam – a case report

Abstract

We describe the case of a 25 year old chemistry student and highly experienced drug user with a GBL dependency. He developed his addiction in a group of chemistry students indulging in an experimental and recreational use of various substances at the local chemistry department. The patient was admitted to our in-patient detoxification unit after a 3-year history of increasing dependence on GBL. Before admission he predominately used GBL. His use had escalated to the point where he was taking 2ml GBL every hour, waking up at night to take it. The daily use reached up to 50ml without being sufficient to suppress withdrawal symptoms consisting of agitation, severe tremor, sweating and massive insomnia. To cope with these symptoms, repeated application of diazepam was necessary. In the first 24h after admission he received several hundreds mg diazepam with persisting insomnia. In the course of treatment he also needed haloperidol because of delusional symptoms. Under high dose diazepam treatment his symptoms gradually improved and by the third day of hospitalization delusions, tremor and sweating slowly resolved, while the insomnia persisted. The patient was commenced on a diazepam reducing regime 1 week after admission from 30mg over 10 days. Further detoxification was uneventful and after suspension of the diazepam the symptoms did not recur. He was also treated for depression and was subsequently discharged in a stable condition 11 weeks after admission.