|Titre :||Going knock - Recurrent comatose GHB intoxication in the Netherlands & Flanders (Belgium) (2018)|
|Auteurs :||J. P. GRUND ; D. DE BRUIN ; S. VAN GAALEN|
|Type de document :||Article : Périodique|
|Dans :||International Journal of Drug Policy (Vol.58, August 2018)|
|Article en page(s) :||137-148|
|Discipline :||EPI (Epidémiologie / Epidemiology)|
Thésaurus TOXIBASEGHB ; INTOXICATION ; COMA ; SURDOSE ; ETUDE TRANSVERSALE ; GEOGRAPHIE ; REGION ; FACTEUR DE RISQUE
Thésaurus GéographiquePAYS-BAS ; BELGIQUE
Background: Gamma-hydroxybutyrate (GHB) overdose is an important concern in the Netherlands and Flanders, Belgium and accounts for most overdoses reported by emergency services. Few stu dies have focused on GHB overdose. Appropriate public health responses have yet to be developed. We report an explorative survey of people who use GHB and their experience with GHB overdose, aiming to identify risk and protective factors associated with comatose intoxication after GHB ingestion.
Methods: We conducted a cross-sectional survey of GHB consumers from different GHB consumption contexts. Between May and October 2014, 146 respondents were recruited in both the urban Randstad and in smaller towns in the Netherlands and Flanders, using a variety of sampling methods. Descriptive statistics were used to describe demographic, social economic, drug use, environmental variables and the experience of overdose and GHB induced coma in the resulting convenience sample. Multivariate CHAID (Chi-quadrat automatic interaction detector) was used in exploring interactions with overdose.
Results: All study respondents were poly drug consumers. We identified several factors associated with coma. The strongest relationship was found between coma and the lifetime number of GHB consumption episodes. Using alone, the number of doses per consumption episode (stacking) and the living region were strongly associated with GHB overdose as well. In the Netherlands, heavy, high risk GHB consumption is primarily found among poorly educated young adolescents in economically less privileged provincial communities.
Conclusions: We found extremely high rates of comatose intoxication after GHB use and the strongest association with GHB overdose concerned the lifetime number of GHB consumption episodes. Poly-drug consumption appears to be the norm in our entire sample, but does not necessarily distinguish heavy or high risk consumption from more recreational use. Using in the company of friends may offer some level of protection against GHB overdose. Overdose prevention, stabilizing heavy and harmful drug consumption patterns and reducing the harms associated therewith should become an important priority in the Dutch response to GHB.
GHB overdose is a growing concern in the Netherlands.
Those most experienced with GHB seem most at risk while stacking doses and using alone are important risk factors for GHB coma.
Collective use in leisure contexts seems to offer a level of protection against GHB overdose.
Recurrent GHB coma is more common in provincial communities and a minority of daily consumers deliberately induces overdose during the night.
Stabilizing heavy consumption patterns and reducing overdose and other harms should be prioritized in responding to heavy GHB consumption.
|Domaine :||Autres substances / Other substances ; Drogues illicites / Illicit drugs|
|Affiliation :||CVO, Utrecht, The Netherlands|