Harmen Beurmanjer

126 Nederlandse samenvatting en discussie farmaceutisch GHB als de voorkeursoptie voor detoxificatie kan worden beschouwd in vergelijking met benzodiazepinen. Dit komt overeen met het beperkte aantal studies in de literatuur over dit onderwerp (Dijkstra et al., 2017; McDonough et al., 2004; Neu, 2018) en zou verklaard kunnen worden door de effecten van GHB op de GHB-receptor en GA- BA-B-receptor, vergeleken met de BZD’s die alleen werken op de GABA-A-receptor (Snead & Gibson, 2005). Terwijl het afbouwen met farmaceutisch GHB als veilig en effectief kan worden beschouwd, blijven gezonde slaappatronen bij patiënten verstoord vanwege de korte halfwaardetijd van GHB. Het blijft daarom belangrijk om de detoxificatiemethoden van GHB verder te optimaliseren. In de volgende paragrafen zal ik enkele voorstellen doen voor toekomstige studies om de behandeling van patiënten met GUD te verbeteren, met name wat betreft het gebruik van baclofen. Table 1 STAING SAFE overview STAYING SAFE S Seek medical attention immediately if you have taken too much GHB. Do not use other drugs in the hope of reversing the effects. T Two or more substances used at the same time increase the risk of overdose significantly (especially sedatives; eg alcohol, ketamine). A Always measure GHB doses accurately (eg with a syringe or pipette). Wait until the effects are felt and do not re-dose for at least two hours. Y You should always avoid using GHB on your own and always use in a safe place and with someone who has not taken it, as it is common to become unconscious. I If you have used and are going to sleep, sleep on your side in case you are sick. Place sleeping or unconscious friends in the recovery position. N Never keep GHB in drink bottles, where it might be drunk by others not aware of the content. Add food colouring to avoid accidental drinking. G GHB is addictive and dependence can happen quickly. Avoid frequent use, especially daily use. S Severe and potentially serious GHB withdrawal symptoms occur if you are dependent and you miss a dose or reduce amounts taken abruptly. A Acute withdrawal symptoms and have no GHB? Seek medical help immediately in an emergency department. F Find medical support for planned GHB detoxification. Do not attempt to stop abruptly on your own. If you want to reduce your dose, do so in very small doses until you find medical support. E Employ methods to stabilise your use; consumption diaries can be helpful. Originally from Phan and colleagues(Phan et al., 2020)