CVO, Utrecht, The Netherlands(1).
CVO, Utrecht, The Netherlands(1).
Int J Drug Policy. 2018 Aug;58:137-148. doi: 10.1016/j.drugpo.2018.06.010. Epub 2018 Jun 26.
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.
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.
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.
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.
γ-羟基丁酸（GHB）过量在荷兰和比利时的佛兰德斯是一个重要的问题，也是紧急服务报告的大多数过量用药的原因。很少有研究集中在 GHB 过量上。尚未制定适当的公共卫生应对措施。我们报告了一项对 GHB 使用者及其 GHB 过量用药经历的探索性调查，旨在确定与 GHB 摄入后昏迷性中毒相关的风险和保护因素。
我们对来自不同 GHB 消费背景的 GHB 消费者进行了横断面调查。2014 年 5 月至 10 月期间，在荷兰的城市兰斯塔德和较小的城镇使用各种抽样方法招募了 146 名受访者。使用描述性统计数据来描述人口统计学、社会经济、药物使用、环境变量以及在便利样本中过量用药和 GHB 引起的昏迷的经历。多元 CHAID（卡方自动交互检测）用于探索与过量用药的相互作用。
所有研究参与者均为多药使用者。我们确定了与昏迷相关的几个因素。与昏迷关系最密切的是一生中 GHB 消费的次数。单独使用时，每次消费的剂量（叠加）和居住地区与 GHB 过量用药也有很强的关联。在荷兰，教育程度低的青少年在经济上处于不利地位的省级社区中，主要使用高风险的 GHB 进行高风险、高用量的消费。
我们发现 GHB 使用后昏迷中毒的发生率极高，与 GHB 过量用药关联最密切的是一生中 GHB 消费的次数。多药使用在我们的整个样本中似乎是常态，但不一定能区分重度或高风险使用与更具娱乐性的使用。在朋友的陪伴下使用 GHB 可能会提供一定程度的保护，防止 GHB 过量用药。预防过量用药、稳定重度和有害的药物使用模式并减少相关危害，应成为荷兰应对 GHB 问题的重要优先事项。
