| Titre : | Gamma-butyrolactone (GBL) dependence and withdrawal (2011) |
| Auteurs : | J. BELL ; R. COLLINS |
| Type de document : | Article : Périodique |
| Dans : | Addiction (Vol.106, n°2, February 2011) |
| Article en page(s) : | 442-447 |
| Note générale : | Commentary: Out-patient management of gamma-hydroxy butyric acid (GHB) withdrawal - an alternative strategy for the future? ZEPF F.D., p.448. |
| Langues: | Anglais |
| Discipline : | TRA (Traitement et prise en charge / Treatment and care) |
| Mots-clés : |
Thésaurus TOXIBASE ETUDE DE CAS ; GBL ; GHB ; DEPENDANCE ; PRISE EN CHARGE ; TRAITEMENT ; SEVRAGE ; TRAITEMENT AMBULATOIRE |
| Résumé : |
AIM: To describe morbidity associated with gamma-butyrolactone (GBL) dependence, and outcomes of withdrawal.
DESIGN: Case series. SETTING: Specialist out-patient clinic and affiliated in-patient detoxification unit. Patients with home support were offered the option of out-patient withdrawal management, based on high-dose diazepam and baclofen, titrated against withdrawal severity in an initial session lasting approximately 4 hours. Patients were then reviewed daily during the first 3 days of treatment, offered weekly follow-up for 4 weeks, and telephoned 2-4 months later. PARTICIPANTS: People dependent on GBL seeking detoxification. MEASUREMENTS: Drug history and social functioning were obtained by self-report in clinical interviews with a single clinician. Treatment completion, outcomes and adverse events associated with withdrawal are reported. FINDINGS: Patients reported impaired social functioning associated with GBL dependence and difficulty in accessing treatment. Nineteen patients commenced detoxification; 17 initially declined admission and were treated as out-patients. Mean diazepam dose in the first 24 hours was 75 mg (range 40-110 mg). Sixteen patients completed withdrawal, although several had lapses to GBL use during treatment. One patient developed delirium and required transfer to the in-patient detoxification unit. Most patients had persisting insomnia, anxiety and depression for weeks after withdrawal. CONCLUSIONS: GBL withdrawal can be managed in ambulatory settings, but needs to be backed up with seamless access to in-patient treatment if required. |
| Domaine : | Drogues illicites / Illicit drugs |
| Refs biblio. : | 11 |
| Affiliation : | King's College London, Addictions Department, Institute of Psychiatry and South London and Maudsley NHS Foundation Trust, Camberwell, London, UK |
| Cote : | Abonnement |
| Lien : | http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2010.03145.x/abstract |
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