Harmen Beurmanjer

37 Illness Perception in Patients with GUD 3 Introduction The party drug GHB (gamma hydroxybutyrate) is an endogenous neurotransmitter (Snead 3rd & Gibson, 2005), known for its prosocial (Bosch et al., 2015), relaxing and erotogenic properties(Bosch et al., 2017), but can also be addictive (T M Brunt, van Amsterdam, & van den Brink, 2014; L Degenhardt, 2003; Kamal et al., 2017; M. Van Noorden et al., 2016). GHB is also registered and widely prescribed for the treatment of narcolepsy (Busardò, Kyriakou, Napoletano, Marinelli, & Zaami, 2015). Main motives for using GHB recreationally include social disinhibition, increased sexual drive, forgetting problems, helping to fall asleep and replacement for alcohol without hangover (Dijkstra et al., 2017; Sumnall et al., 2008). While prevalence of GHB use in most European countries is lower dan 1% of the general population, it is the fourth most common substance in emergency room presentations in Europe(European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), 2018). Overdosing of GHB is common due to its narrow boundaries between plasma levels required for the desired effect and plasma levels associated with overdose (Degenhardt, 2003). Overdose commonly results in temporary coma or in more extreme cases in respiratory depression (van Amsterdam, Brunt, Pennings, & van den Brink, 2015). GHB users themselves counterintuitively seem not to consider these coma’s harmful (de Weert-van Oene et al., 2013). Several studies show that recurrent use of GHB can lead to a substance use disorder (SUD), in about 4% to 21% of cases (Carter, Pardi, Gorsline, & Griffiths, 2009; Louisa Degenhardt, Darke, & Dillon, 2002; Karen Miotto & Roth, 2001). Dependent users take GHB up to 12 times a day or more (Galloway et al., 1997; Gonzalez & Nutt, 2005). Severe withdrawal symptoms occur when they stop using GHB, including severe autonomic dysregulation, anxiety, delirium and seizures (Craig et al., 2000; McDaniel & Miotto, 2001; McDonough et al., 2004; M. S. van Noorden, van Dongen, Zitman, & Vergouwen, 2009). It is therefore recommended for dependent GHB users to stop using GHB with medical support. Most common detoxification methods are tapering off with high doses of ben- zodiazepines or with pharmaceutical GHB in a clinical setting (Dijkstra et al., 2017; Kamal et al., 2017). Over 60% of patients with a GHB use disorder (GUD) relapse within three months after detoxification (Dijkstra et al., 2017). GHB dependent patients consume relatively more (mental) health care than any other group of patients with (SUD) and are frequently hospitalized at emergency rooms for comas and withdrawal (Mol, Wisselink, Kuijpers, & Dijkstra, 2014; M. S. van Noorden et al., 2017). Given the many negative consequences of GHB use, and limited treatment success of GUD on the one hand, versus the positive perceptions about GHB among GUD patients on the other we aim to explore how GUD patients see their own condition/situation of GHB use and what they think should be done to help them. We applied a qualitative approach to illness perceptions, using the most widely studied theoretical model of illness perceptions: the Self-Regulation Model (SRM) (Leventhal, Meyer, & Nerenz, 1980; Howard Leventhal, Phillips, & Burns, 2016). This model proposes that patients form common-sense beliefs concerning their illness, in