Unity in diversity: A systematic review on the GHB using population

Dijkstra, B.A.G.; Beurmanjer, Harmen; Goudriaan, Anna E.; Schellekens, Arnt; Joosten, E.A.G.

doi:10.1016/j.drugpo.2021.103230

Cited by 27 publications

(33 citation statements)

References 83 publications

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“…Ketamine, opioids and MDMA are less common co-ingestants, being reported by less than 20% of treatment seekers. 2 Men are overrepresented in all studies of GHB use. 2 In those presenting to emergency departments, young men predominate.…”

Section: Epidemiology Of Current Usementioning

confidence: 99%

“…2 Men are overrepresented in all studies of GHB use. 2 In those presenting to emergency departments, young men predominate. 2 Of these, 40% are also using alcohol or stimulants.…”

Section: Epidemiology Of Current Usementioning

confidence: 99%

“…2 In those presenting to emergency departments, young men predominate. 2 Of these, 40% are also using alcohol or stimulants. 2 In community-based general population studies, men represent up to 90% of the sample.…”

Section: Epidemiology Of Current Usementioning

confidence: 99%

“…2 Of these, 40% are also using alcohol or stimulants. 2 In community-based general population studies, men represent up to 90% of the sample. 2 Up to 89% of people attending addiction treatment services for GHB use are men.…”

Section: Epidemiology Of Current Usementioning

confidence: 99%

“…This recreational use of GHB is gaining recognition and the associated acute and chronic harms can cause significant morbidity and mortality. 1,2 In this narrative review, a summary of the pharmacology of GHB will be provided. The epidemiology of GHB use will be described with a discussion of identification and management of acute and chronic harms.…”

Section: Introductionmentioning

confidence: 99%

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Current Insights on the Impact of Gamma-Hydroxybutyrate (GHB) Abuse

Tay¹,

WKW²,

Murnion³

2022

SAR

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Recreational gamma-hydroxybutyrate (GHB) use, although less common than other substance use, is increasingly recognised and is over-represented in emergency toxicology presentations. This narrative review summarizes GHB pharmacology, current patterns of use, potential harms and management of GHB toxicity and withdrawal. There is a complex interplay between GHB and GABA as GHB is both a prodrug and metabolite of GABA and GHB activates both GHB and GABA receptors. GHB is rapidly absorbed, with effects seen within minutes of ingestion. Metabolism is non-linear at higher doses. While GHB is listed as a controlled substance, its precursor's gamma-butyrolactone (GBL) and 1,4-butanediol (1,4-BD) are easily available as both have industrial applications. National surveys indicate low rates of GHB use, with identification of high-risk populations in men who have sex with men and polysubstance users. GHB is one of the three drugs most commonly used in chemsex. GHB is often co-ingested with other interacting psychoactive substances. Acute toxicity is dose-dependent, and management is supportive care. Withdrawal management is generally with benzodiazepines with addition of baclofen for more severe withdrawal. Barbiturates may have a role. Titration and tapering of pharmaceutical GHB is commonly used in the Netherlands. Complicated withdrawal with delirium may require intensive care and treatment with intravenous sedation. There are high rates of relapse after withdrawal and medications for longerterm management are currently being investigated. Chronic use is associated with poorer mental, physical and sexual health, social dysfunction and poor work performance. Laboratory detection is complicated as GHB is an endogenous substance with a short halflife, and therefore not often routinely assayed in the clinical setting. Future research should focus on improving GHB detection and management of GHB withdrawal and dependence. Interventions specific for high-risk groups should be developed and assessed.

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Section: Epidemiology Of Current Usementioning

confidence: 99%

“…2 Men are overrepresented in all studies of GHB use. 2 In those presenting to emergency departments, young men predominate. 2 Of these, 40% are also using alcohol or stimulants.…”

Section: Epidemiology Of Current Usementioning

confidence: 99%