|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.|
|Discipline :||TRA (Traitement et prise en charge / Treatment and care)|
Thésaurus TOXIBASEETUDE DE CAS ; GBL ; GHB ; DEPENDANCE ; PRISE EN CHARGE ; TRAITEMENT ; SEVRAGE ; TRAITEMENT AMBULATOIRE
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|