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Inpatient treatment of GHB/GBL dependence: a case report

Published online by Cambridge University Press:  19 July 2023

M. Delic*
Affiliation:
Center for Treatment of Drug Addiction, University Psychiatric Clinic Ljubljana, Ljubljana, Slovenia

Abstract

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Introduction

Gamma-hydroxybutyrate (GHB) and its precursor gamma-butyrolactone (GBL) are popular drugs of abuse used for their euphoric, (potential) anabolic, sedative, and amnestic properties. Daily use of GHB/GBL can lead to dependence and the possibility of a withdrawal syndrome on cessation which results in tremor, tachycardia, insomnia, anxiety, hypertension, delirium, and coma.

Objectives

To describe the inpatient treatment and outcome of treatment of a patient with GHB/GBL dependence.

Methods

A review of the case of patient reporting GHB/GBL dependence who was admitted for inpatient treatment.

Results

The patient was using more potent substance GBL daily, 1.5 to 2 ml every two hours. She was using cannabis, alcohol, cocaine, and amphetamine-type stimulants additionally. Psychiatric comorbidities such as personality disorders, and eating disorders were recognized. Delirium developed after six hours of the last dose of GBL. The patient was treated with diazepam, clomethiazole, and atypical antipsychotics. She completed detoxification but stopped her treatment earlier. After two weeks she started to drink alcohol and after one month relapsed with GHB/GBL.

Conclusions

GHB/GBL withdrawal can be severe and retention in the program is poor. Polysubstance use, psychiatric co-morbidities, and heavier GHB/GBL use as possible predictors of poor treatment outcomes need consideration in treatment planning.

Disclosure of Interest

None Declared

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association
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