Harmen Beurmanjer

41 Illness Perception in Patients with GUD 3 becoming aware that they needed to take GHB in order to prevent withdrawal. At this point school, work and relationships started to suffer and it became harder to maintain functioning in everyday situations. When participants were no longer able to maintain their daily activities, the frequency of GHB use increased further. Participants now felt stressed, gloomy and bored each time the effects of GHB faded out. This led to the point where using GHB was just to prevent withdrawal. GHB was then used in a frequency between once every fifteen minutes to two hours, and participants were intoxicated 24 hours a day. Severe sleeping problems occurred, which were dealt with by using more GHB and overdosing to pass out in order to get some sleep. Participants additionally used benzodiazepines to sleep or prevent withdrawal. These GHB-induced comas would eventually happen on a daily basis. “You needmore andmore GHB and it basically controls you day and night, because you need to have it. At one point you start using almost anything [e.g. benzodiazepines] in order to sleep for a few hours.” Perceptions of GHB Participants generally reported a transition in their perceptions of GHB with increasing use. Initially, they had a rather positive attitude towards GHB. They mentioned that using GHB mainly had advantages for them and quitting GHB mainly disadvantages. Mainly when not using GHB, during periods of abstinence, and after detoxication, participants felt empty and lonely. Participants compared GHB with alcohol, which they perceived much more harmful for them. They reasoned that after drinking alcohol they felt hungover, and after GHB they felt fine the next day. GHB use didn’t cause any harm to them in the short term. According to the participants, their GUD didn’t leave any damage, either physical or psychological. Passing out was mainly a problem for the bystanders and family members, not for participants themselves. When they woke up they felt fine. Participants described passing out as something positive, because they didn’t feel anything when they passed out and they could sleep for a while. Even waking up in a hospital was something they got used to and was not considered a relevant issue. “Oh yes, I passed out all the time and ended up in hospital. It was kind of normal for me. At afterparties it was very common that people passed out. We called it GHB sleep. I don’t think it’s bad, it’s something you accept.” During the interview participants mentioned that finally their GHB use became problematic and they called themselves dependent. All of them mentioned that it took them multiple treatment admissions to reach this conclusion. Participants reported their main burden to be physical dependence. The schedule of taking GHB every two hours to prevent withdrawal was perceived as inconvenient. Participants dealt with withdrawal by taking