Clinical relevance of ethanol coingestion in patients with GHB/GBL intoxication

Galícia, Miguel; Dargan, Paul I.; Dines, Alison; Yates, Chris; Heyerdahl, Fridtjof; Hovda, Knut Erik; Giraudon, Isabelle; Wood, David M.; Miró, Òscar; Anand, Jacek Sein; Bonnici, Jeffrey; Caganova, Blazena; Eyer, Florian; Jürgens, Gesche; Kabata, Piotr Maciej; Liakoni, Evangelia; Liechti, Matthias E.; Mégarbane, Bruno; Moughty, Adrian; O’Connor, Niall; Paasma, Raido; Persett, Per Sverre; Põld, Kristiina; Radenkova-Saeva, J.; Scholz, Irene; Vallersnes, Odd Martin; Waring, W. Stephen; Zacharov, Sergej

doi:10.1016/j.toxlet.2019.07.001

Cited by 25 publications

(25 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The combined use of (meth) amphetamines and alcohol decreases alcohol-specific feelings of intoxication, such as feeling drunk and sedated, resulting in more severe alcohol intoxications [12]. The combination of alcohol and other sedatives, such as gamma-Hydroxybutyric acid (GHB), increases the risk of reduced consciousness, respiratory depression and admission to an intensive care unit [13,14]. In adolescents who were not intoxicated, the simultaneous use of cannabis and alcohol was associated with the use of higher quantities of both substances than when either substance was used concurrently or alone [15][16][17].…”

Section: Introductionmentioning

confidence: 99%

The role of tobacco smoking and illicit drug use in adolescent acute alcohol intoxication

et al. 2021

View full text Add to dashboard Cite

Background This study aims to determine the prevalence of tobacco smoking and illicit drug use among Dutch adolescents admitted to hospital for acute alcohol intoxication treatment. Furthermore, socio-demographic predictors for smoking and illicit drug use in the sample population will be studied. The relationship between illicit drug use and specific characteristics of intoxication, such as blood alcohol concentration (BAC) and duration of reduced consciousness is also investigated. Methods The national Dutch Paediatric Surveillance Unit was used to prospectively register cases of acute alcohol intoxication from 2007 through 2017. Cases were included if they met the following inclusion criteria: BAC > 0.0 g/L, aged between 10 to 18 years old and requiring hospital treatment due to reduced consciousness. Questionnaires were sent to paediatricians to obtain clinical information. Results During the period 2007–2017, 5322 cases that met the inclusion criteria were reported. In this patient group, the prevalence of tobacco smoking was 22.2% (CI 21.0–23.5%), while the prevalence of illicit drug use was 11.8% (CI 10.9–12.7%). The predictors for smoking were the absence of alcohol-specific parental rule-setting, lower educational level, non-traditional family structure and positive drug screening. The predictors for illicit drug use were the absence of alcohol-specific parental rule-setting and smoking. Illicit drug use was also associated with a lower BAC at the time of admission. Conclusions Assessing smoking and illicit drug use among adolescents admitted for acute alcohol intoxication is important in acute cases of intoxication, for outpatient follow-up and for the purposes of prevention. The relationship between simultaneous illicit drug use and a lower BAC is of relevance for paediatricians’ attempts to diagnose acute intoxication. With respect to outpatient follow-up and preventive measures, it is important to be aware that adolescents’ alcohol consumption, tobacco and illicit drug use are related and, ultimately, increase the odds of using other substances.

show abstract

Section: Introductionmentioning

confidence: 99%

The role of tobacco smoking and illicit drug use in adolescent acute alcohol intoxication

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Poly-drug use, especially with concomitant alcohol consumption, is a "red flag" because it has been reported that this condition is associated with an increase in adverse events, greater consciousness impairment, higher need for care, ICU admission, and longer h-LOS. [39] It is useful, in adolescents, to also evaluate other variables that can predict drug and alcohol abuse, like depression, impulsivity, low self-esteem, delinquent predisposition, low peer insecurity, and history of child abuse [32].…”

Section: Discussionmentioning

confidence: 99%

“…However, potential dangers advise against both imprudent early discharge and admissions to low-intensity wards (psychiatry, general medicine)-and therefore also frequent use of intensive care for the sole surveillance of the patient [39]. For these reasons, it is essential to have some time to decide in which situations to hospitalize or discharge the patient, also considering the implications of potentially involuntary holds [40] and the possibility of early readmissions [41].…”

Section: The Importance Of Temporary Observation Unit In the Emergencmentioning

confidence: 99%

See 1 more Smart Citation

Risk Management in First Aid for Acute Drug Intoxication

Piccioni

Cicchinelli

Saviano

et al. 2020

IJERPH

View full text Add to dashboard Cite

Drug abuse (cannabis, cocaine, opiates, and synthetic drugs) is an increasing phenomenon, especially in the younger population, thus leading to more cases of intoxication requiring evaluation in the emergency department and subsequent hospitalization. In 2017, 34.2% of students reported having used an illegal psychoactive substance in their lifetime, while 26% reported having done so over the past year. We made a review about the effectiveness of the role of the temporary observation unit in the emergency department to improve management of acute drugs intoxication. We checked medical literature from the last 10 years (2009–2019). The following electronic databases were systematically searched: MEDLINE-PubMed, Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials. Then, a systematic review was carried out according to the Preferred Reporting Items for Systematic Review standards. Intoxicated patients usually display a favorable medical course, few diagnostic and therapeutic interventions, a short stay in the hospital, and, when hospitalization is needed, semi-intensive therapy is a feasible solution; therefore, intoxicated patients are ideal candidates for a temporary observation unit. The emergency department is very important to manage intoxicated patients; however, the hospitalization of these patients is often not necessary.

show abstract

“…2 Although the GHB-related mortality risk is not wellknown, acute GHB-related hospital presentations are often severe as most patients are not communicative due to an altered state of consciousness, commonly combined with low body temperature, hypotension, and bradycardia. 1,[5][6][7] Acute hospital presentations may be especially severe in cases involving other substance use, which is related to a higher need of treatment, higher need for admission to the Intensive Care Unit (ICU) and longer hospital stay. 1,[5][6][7][8] In the Netherlands, 61% of GHB abusers report polydrug use, mainly alcohol, cocaine, and amphetamines.…”

Section: Introductionmentioning

confidence: 99%

Successful Treatment of Severe, Treatment Resistant GHB Withdrawal through Thiopental-Coma

et al. 2021

View full text Add to dashboard Cite

Background: In patients with gamma-hydroxybutyrate (GHB) use disorder (GUD), withdrawal can have a fulminant course with rapid progression of severe, potentially life-threatening complications. Case: We present a 45-year old man with severe GHB withdrawal, resistant to conventional treatment with pharmaceutical GHB, high doses of benzodiazepines and baclofen. GHB withdrawal finally responded to thiopental-induced coma therapy, with burst suppression pattern on electroencephalography (EEG). The patient fully recovered, without withdrawal or residual neuropsychiatric symptoms. Discussion: To our knowledge, this is the first case report in which barbiturates were used to induce a coma to treat severe, treatment resistant GHB withdrawal. This case suggests barbiturate coma therapy might be considered in severe GHB withdrawal which does not respond to conventional treatment.

show abstract

Clinical relevance of ethanol coingestion in patients with GHB/GBL intoxication

Cited by 25 publications

References 24 publications

The role of tobacco smoking and illicit drug use in adolescent acute alcohol intoxication

The role of tobacco smoking and illicit drug use in adolescent acute alcohol intoxication

Risk Management in First Aid for Acute Drug Intoxication

Successful Treatment of Severe, Treatment Resistant GHB Withdrawal through Thiopental-Coma

Contact Info

Product

Resources

About