1. To describe the characteristics of a population entering an outpatient GHB/GBL detoxification pathway.
2. To examine the medication needs for medically assisted detoxification.
3. To estimate the outcomes for medically assisted detoxification.
Service evaluation. Data were collected retrospectively from all patients who started GHB/GBL detoxification between January 2011 and October 2014 at a specialist outpatient drug treatment service in Central London (N=80). This is the largest study to date on the subject.
Employment: 45% Unemployed
Sexuality: LGBT 81.3%
85% reported poly-drug use.
45% reported previous accidental GHB/GBL overdose.
Mean length of dependent use at presentation: 19months, 2days (N=63).
Mean daily use: 32.20ml.
Mean dose of diazepam used in detoxification: day1=40.20mg (N=75), day2=40.07mg (N=72), day3=37.68mg (N=69)
27.5% needed to deviate from standard prescription regimens.
Mean duration of diazepam treatment =9.5days (N=53).
Mean dose baclofen used 32.08 (N=77). Mean length of treatment on baclofen =20.32 days (N=75)
Detoxification completed: 73.8% (59)
1 month follow-up (N=59): 66.1% free from dependence.
3 months follow-up (N=59): 47.4% free from dependence.
Complications: 4 patients (5%) needed acute medical treatment including 1 (1.25%) that needed ICU. All complications had favorable outcome.
The challenges for treating GHB/GBL dependence include complexity of the population, complexity of treatment, absence of guidelines and severity of risks associated to withdrawals. Our data show that community detoxification is possible, safe and effective when delivered by a specialist team with availability for daily monitoring and access to acute medical treatment.