Abstract
PurposeGamma-hydroxybutyrate (GHB) withdrawal is a life-threatening condition that does not always respond to standard treatment with benzodiazepines. Baclofen has potential utility as a pharmacological adjunct and anecdotal reports suggest that it is being used by drug users to self-manage GHB withdrawal symptoms. Here, we investigate current patterns of use and the online availably of baclofen.MethodsData triangulation techniques were applied to published scientific literature and publicly accessible Internet resources (grey literature) to assess the use of baclofen in GHB withdrawal. An Internet snapshot survey was performed to identify the availability of baclofen for online purchase and the compliance of retailers with the UK regulations. Data were collected according to pre-defined criteria.ResultsA total of 37 cases of baclofen use in GHB withdrawal were identified in the scientific literature, as well as 51 relevant discussion threads across eight Internet forums in the grey literature. Baclofen was available to purchase from 38 online pharmacies, of which only one conformed to the UK regulations.ConclusionsThere is limited published evidence on the use of baclofen in GHB withdrawal, but both scientific and grey literature suggests clinical utility. Online pharmacies are readily offering prescription-only-medication without prescription and due to inadequate regulation, pose a danger to the public.
Highlights
IntroductionA high incidence of adverse effects during early clinical trials restricted its use in anaesthesia, but at lower doses, it has found some clinically utility and is licenced for treating sleep disorders ( narcolepsy with cataplexy) and alcohol dependence [2]
Gamma-hydroxybutyrate (GHB) is a naturally occurring metabolite of the neurotransmitter gamma-aminobutyric acidElectronic supplementary material The online version of this article contains supplementary material, which is available to authorized users.(GABA) and was first synthesised as an anaesthetic agent in 1964 [1]
Stimulation of GHB receptors increases dopamine release resulting in stimulant-like effects, whilst at higher doses, binding to GABA-B receptors results in hypnotic effects and eventually coma [5]
Summary
A high incidence of adverse effects during early clinical trials restricted its use in anaesthesia, but at lower doses, it has found some clinically utility and is licenced for treating sleep disorders ( narcolepsy with cataplexy) and alcohol dependence [2]. It has been used illicitly in both bodybuilding and as a recreational drug [3, 4]. Stimulation of GHB receptors increases dopamine release resulting in stimulant-like effects, whilst at higher doses, binding to GABA-B receptors results in hypnotic effects and eventually coma [5]. There is no specific antidote for GHB and so acute toxicity is managed by supportive care which, in the case of significant consumption, may include endotracheal intubation for airway protection [6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
