Gamma-butyrolactone (GBL) dependence and withdrawal
Article first published online: 6 OCT 2010
© 2010 The Authors, Addiction © 2010 Society for the Study of Addiction
Volume 106, Issue 2, pages 442–447, February 2011
How to Cite
Bell, J. and Collins, R. (2011), Gamma-butyrolactone (GBL) dependence and withdrawal. Addiction, 106: 442–447. doi: 10.1111/j.1360-0443.2010.03145.x
- Issue published online: 5 JAN 2011
- Article first published online: 6 OCT 2010
- Submitted 7 April 2010; initial review completed 14 June 2010; final version accepted 22 July 2010
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.