Paramedics, taking patient on stretcher from ambulance to hospital
An Australian-first study has sounded the alarm over the increasing harms associated with gamma-hydroxybutyrate (GHB), a party drug whose popularity is on the rise. Conducted by the National Drug and Alcohol Research Centre (NDARC) at UNSW Sydney, the study highlights a growing need for prevention and harm-reduction strategies as experts call for improved follow-up care.
The research reveals that while GHB use remains relatively low compared to other illicit substances like MDMA, cocaine, and methamphetamine, its appeal is growing. Often consumed in liquid form at parties, GHB is a depressant with a dangerously narrow therapeutic dose range, making it easy to overdose.
Surging Statistics and Rising Concerns
The NDARC study presents a stark picture: GHB-related deaths have increased tenfold since 2013, and hospitalizations have more than tripled. Survey data from 2013 to 2024 shows a rise in lifetime use among Australians aged 14 and over from 0.9% to 1.2%, while past 12-month use climbed from 0.07% to 0.2%.
GHB-related hospitalizations increased from 5.3 per 100,000 people in 2012 to 19.1 a decade later, and deaths rose from fewer than six in 2012 to 52 in 2022.
These findings underscore a “clear and accelerating trend” of rising GHB harms, according to the study’s lead author, Associate Professor Amy Peacock, Deputy Director of NDARC. “These numbers are a cause for alarm,” she stated. “Without targeted action, the situation will only worsen, and more people will be harmed.”
The Role of General Practitioners
Dr. Hester Wilson, Chair of RACGP Specific Interests Addiction Medicine, emphasizes the critical role general practitioners (GPs) play in harm-minimization discussions and follow-ups after overdoses and emergency department visits. “One of the issues we see clinically is people overdosing, ending up in the ED, waking up, and discharging themselves without accepting follow-up,” she explained.
Dr. Wilson points out the challenges posed by GHB’s narrow therapeutic dose range. “If you take too little, it does nothing. You take too much, you become unconscious. An ambulance is called,” she said. For patients whose GPs receive discharge summaries, there’s an opportunity for crucial conversations. “I’d be quite proactive, because it’s my patient who has overdosed, and I’m worried this is going to happen again,” Dr. Wilson added.
Prevention and Harm Reduction Strategies
In some regions with active drug-testing programs, GHB can be tested at large events such as music festivals. However, Dr. Wilson notes that it remains one of the “more challenging” substances to analyze due to its liquid form and high-potency variability. A recent alert about pure methamphetamine found in a GHB sample warned of an “extremely high” potential for accidental overdose.
“Education around how to recognize and respond to a GHB overdose is important, regardless of frequency of use or dependency,” Associate Professor Peacock emphasized.
The NDARC authors advocate for “acceptable and tailored” prevention and harm-reduction strategies for key populations, alongside stronger national monitoring efforts. They stress that GHB use is not limited to young adults in nightclubs or gender and sexuality diverse communities but spans a broad demographic.
A Healthcare Perspective on Drug Use
Dr. Wilson, a long-time advocate for harm reduction, views drug use through a healthcare lens. “It’s not up to me to decide whether you want to take risk-taking behaviors or not. What I want to ensure, as your GP, is that you don’t come to harm, and you have access to good information to make informed choices,” she said.
She believes that supporting patients in making safer decisions is integral to the role of GPs. “Anything we can do to support patients to help make safer decisions, that is part of what we do as GPs. It doesn’t mean you need to have an in-depth knowledge of all the drugs, you just need to be open to those conversations and to supporting people in a non-judgmental way,” Dr. Wilson concluded.
As the conversation around GHB continues, the study’s findings highlight the urgent need for comprehensive strategies to mitigate the risks associated with its use. The role of healthcare professionals, particularly GPs, remains pivotal in guiding patients towards safer practices and preventing further harm.
