Harmen Beurmanjer

25 Review on the GHB using Population 2 demographic characteristics, GHB use patterns, and psychosocial aspects across settings. Secondly, we synthesize the information from the individual studies to identify the primary groups of people using GHB. Demographic characteristics, GHB use and psychosocial aspects across settings People reporting at emergency departments with GHB overdose Studies (n = 22) on people using GHB who present at Emergency Departments show that these people are typically young males (male sex: mean 60%, range 54–93%; average age: 25 years, range 21–32 years). From 1999 to 2003, an increase of GHB-related incidents with women was reported (from 38% to 60%) by Anderson et al. (2006). KapitanyFoveny, Zacher, Posta, and Demetrovics (2017) found that men were more severely intoxicated than women. None of the studies reported education level or current employment status. Only Liechti, Kunz, Greminger, Speich and Kupferschmidt (2006) and Miro, Nogue, Espinosa, To-Figueras, and Sanchez (2002) reported the GHB dose used (average: 6 ml, range 1–12 ml). Prevalence of GUD was identified in four studies, varying between 5% to 59% (Anderson et al., 2009; Boyd, Kuisma, & Randell, 2012; Liakoni, Walther, Nickel, & Liechti, 2016; Liechti et al., 2006). Presence of psychiatric problems was mentioned in three studies, varying between 6 and 27% (Chin, Sporer, Cullison, Dyer, & Wu, 1998; Horyniak et al., 2013; Liechti et al., 2006). Fifteen studies reported on prevalence of co-ingestion of other substances (median 60%, range 12–93%). The most reported substances were alcohol (median 39%, 17 studies), cocaine (12%, 12 studies), cannabis (10%, 10 studies), amphetamines (median 20%; 9 studies), 3,4-methyleendioxymethamfetamine (MDMA) (median 18%; 7 studies), opioids (median 8%; five studies), sedatives (10%; five studies), and methamphetamines (two studies: 9% and 24%). Ketamine use was reported in six studies, but only by 2,5% (median) of the individuals. More than one substance next to GHB was reported by two studies by 12,5% of individuals (Chin et al., 1998; Krul & Girbes, 2011). Most common mentioned reason for GHB-use was recreation (range 90–99%). Some studies reported accidental ingestion (4%), unintentional GHB use (29%), sexual assault (2,8%), poisoning (4%), or suicide attempt (1–3%). Toxicity differ between studies. Severe intoxication was reported in three studies (range 10–72% of individuals), profound uncon- sciousness in 44% of the participants (Dietze, Cvetkovski, Barratt, & Clemens, 2008; Dutch & Austin, 2012; Van Sassenbroeck et al., 2007). Most of them happens at weekend (46% - 90%) or during the night (40% - 67%) (Liechti & Kupferschmidt, 2004; Miro et al., 2017; Miro, Nogue, Espinosa, To-Figueras, & Sanchez, 2002) People using GHB recruited from the general population People using GHB recruited from the general population were predominantly young males (median 74%, range 47–90%), with a mean age of 27 years (range 24–32 years).