GBL/GHB deaths rise dramatically in the UK year on year

the literature
from around the world of similar events. A female student at Brighton University died recently in the UK having taken the drug and this has pushed the issue very much into the media. Previously the drug was seen as the preserve of misfits who attended all night raves.

When someone is known to have taken GBL/GHB and there are problems such as aggression, drowsiness, coma, vomiting, etc then an ambulance should be called and the patient admitted to hospital. There is currently no specific antidote but supportive
ventilation; airway protection so vomit aspiration is limited; fluid management;
control of seizure activity and sedation are all readily available.

GBL/GHB is highly addictive. Those most at risk are people using the drug for sleep on a regular basis, mood enhancement and weight loss Freese et al (The effects and consequences of selected club drugs. J Subst Abuse Treat 2002;23:151-156).

There is no particular protocol developed as yet for management of GBL/GHB addiction excptthe usual supportive psychotherapy, Cognitive Behavioural Therapy, selective serotonin reuptake inhibitors or a mix of selective serotonin and noradreanline reuptake inhibitors plus or minus very high doses of benzodiazepines. Given the excess risks these patients have unwittingly taken we commonly require admission to a competent drug-dependance unit or psychiatric hospital under expert nursing and medical supervision. Live in Clinical Nurse Practitioners are useful also.

GBL/GHB withdrawal syndrome is a medical emergency and needs to be addressed aggressively – and almost invariably in an inpatient setting.

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