Harmen Beurmanjer

40 Chapter 3 two participants were using GHB again. Their stories did not differ from the other 18 abstinent participants. Saturation started to occur after 12 interviews. Development of GHB use disorder Most participants reported regular substance use, mainly cannabis and stimulants such as amphetamine and ecstasy, before they first tried GHB. Substance use started between the age of twelve and twenty-five years old. Most participants were introduced to GHB through friends at parties and after parties. After using GHB they experienced that they were able to party longer and harder, that they felt more self-assured, had more intense sex and no hangover the next day. Using GHB was, at first, something one did occasionally in the weekend. “I only used (GHB) in the weekend, but when I felt bad during the weekdays I sometimes took some GHB and I felt fine again. This use increased over time and GHB became part of my routine.” During this early phase GHB was often combined with amphetamines, as this allowed participants to party longer. When participants started using GHB during weekdays the frequency of use increased rapidly. Physical dependence commonly developed over a time period of at least two years, with some exceptions of weeks. The combination with amphetamines became less common when participants became dependent on GHB, instead benzodiazepines were more frequently used to cope with withdrawal. Reasons to start using during weekdays were feeling hangover from parties in the weekend, skipping a night of sleep, and boredom. Initially, GHB use during weekdays resulted in better functioning at work or study because participants felt more confident, less stressed and experienced more pleasure in their daily activities. Participants who had depressed moods or were socially anxious felt that GHB made them feel and function better. This was confirmed by their social networks. Under the influence of GHB people were more active and satisfied with their lives. Participants reported only positive effects of GHB use during this period and experienced no down sides at all. They described it as “wonder drug”, “solution for everything” and “perfect antidepressant”. Under the influence of experienced positive effects, frequency of use increased. The occasional passing out due to overdosing was not perceived as problematic. “GHB changed my personality, it’s like liquid competences, it made me a 2.0 person instantly. You almost had to do nothing and you got so much in return for using GHB.” After using GHB daily for a while participants started to feel anxious and experienced tremors/trembling when they weren’t using GHB. First, participants did not associate these complaints with GHB use and they solved these by taking more GHB. This process repeated itself to a point where withdrawal symptoms were so severe that participants started