Abstract
This case series identifies all patients presenting for GHB related problems to Western Hospital’s Drug Health Service (between 2009-2012) and specifically focuses upon the small subgroup which have GHB Dependence and required hospitalisation. Of eight such cases, only one had a complicated inpatient course, reported the highest GHB daily dose consumption (~30 gm/day) and was concurrently Alcohol Dependent. All the other patients responded to supportive nursing care and simple pharmacotherapy with diazepam. The majority of patients with GHB Dependence in this review also took other drugs and also had an uncomplicated GHB withdrawal process. Hence, the outcome of this review questions the need for hospital admission in most cases of GHB Dependence except for cases involving high dose Dependence (e.g. >30 gm/day); this finding is consistent with recent literature reports.
Highlights
During the past decade, increasing numbers of patients with GHB dependence have presented to our hospital for treatment
Twenty seven patients presented to our service requesting help with GHB detoxification, each had been diagnosed by a specialist physician (Addiction Medicine) as having met DSM 1V-tr criteria for a Dependence Syndrome
None of the total cases had significant medical or psychiatric histories; details about employment, income and educational status was lacking, possibly reflecting the brief nature of the medical history recorded by the admitting hospital intern
Summary
During the past decade, increasing numbers of patients with GHB dependence have presented to our hospital for treatment. Some of the past literature relating to GHB dependence has suggested that the withdrawal syndrome and related complications may be severe [1,2,3,4,5,6,7] more recent reports including one case series [7,8,9,10] suggests otherwise. In 2001, GHB was placed under Schedule 1V of substances under control by member countries; later, several countries enacted legislation to control the use of GHB and a number of precursor substances, including GBL [1]. Certain social groups have been reported as having higher prevalent use of GHB and these include night-clubbers, bodybuilders (unsubstantiated claims of GHB inducing growth hormone release related muscle development) and polydrug users [6]. GHB is used medically for the treatment of certain sleep disorders such as cataplexy and narcolepsy (some evidence that GHB improves aspects of REM-sleep efficiency) and used in the treatment of alcohol dependence [7,11]
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