Harmen Beurmanjer

42 Chapter 3 more GHB. Withdrawal symptoms started with heavy sweating, followed by shaking, palpitations, anxiety and visual hallucinations. When they became hardly able to keep up with withdrawal further on in their GHB dependence they wanted to stop being dependent on GHB. This was the moment to develop more negative perceptions about GHB and the main motivation for detoxification. “Without GHB I felt like I was dying. My hart pounded so hard inmy chest. Everything aroundme was frightening and intimidating, everything was too much to cope.” During withdrawal participants experienced high levels of anxiety, panic attacks and hallucinations. They referred to this as psychological dependence, meaning a combination of complaints such as anxiety, depressive moods and feeling suicidal. All these problems and negative feelings disappeared instantly when GHB was used again. Depressed mood and anxiety were the main reasons to start using GHB again. During the long period of GHB use a wide range of problems developed, such as loneliness, high debts, loss of work, and sometimes homelessness. Realising these problems when being sober increased stress and the need to use GHB again. Participants reported severe sleeping problems after detoxification. They considered this one of their main problems and were aware that these were the result of their GHB use. During the night they woke up every few hours to take GHB in order to prevent withdrawal and induce sleep. After detoxification sleeping problems often continued for several months. Treatment needs Participants found it hard to pin point what they needed from treatment. Participants initially tried to quit GHB on their own at home, but few managed to significantly reduce their GHB intake. During home detoxification without medical support the development of delirium and psychotic symptoms was common. The reason why participants first tried to detoxify themselves, instead of seeking professional care, was that they didn’t perceive themselves as “addicted”, requiring professional treatment. When participants were “admitted in crisis”, after for example being found in a delirious state, they didn’t remember the actual admission itself. As their mental state improved during detoxification, they realized that they were admitted and often left the clinic because of lack of motivation for treatment. After failed attempts to quit on their own, participants had themselves admitted in addiction care. Family, particularly parents, played an important role in seeking help. Especially during the first few treatment episodes, participants reported that they didn’t want to let their family down and agreed to go through detoxification for the sake of their family. Prior to detoxification most participants had limited or no expectations about the treatment programs they would enrol after detoxification.