Harmen Beurmanjer

43 Illness Perception in Patients with GUD 3 “I hadmyself admitted to comfort mymother. I thought I will fool the counsellors for a fewweeks and then go back to GHB again.” The initial treatment goal of participants was detoxification, so they were no longer physically dependent on GHB. Abstinence was not their goal due to the perceived positive effects of GHB. The suggestion from therapists that it might be better not to use GHB overwhelmed them and caused fear and irritation. Participants wanted to use GHB without being physically dependent on it. Some said they just played being motivated for abstinence in order not to upset their family. After several relapses they started to realize that control over their GHB use was hard tomaintain andmotivation for abstinence started to emerge. “Well, I feel split about quitting GHB. On the one hand I feel so in love with it, it solves all my problems! But on the other side I know that it won’t bringme anything in the long run. However, I’ve never came across something that would make me say that I don’t want to use GHB anymore. Even a friend who overdosed on GHB didn’t make me want to quit fully.” Participants’ treatment needs were mainly aimed towards their psychological and emotional problems. After detoxification they felt overwhelmed with psychological complaints. Learning how to deal with setbacks, stress, anxiety, depression and boredom without GHB were often mentioned as main treatment needs. Participants felt that the treatment after detoxification focused too much on GUD, while this was not perceived as their main problem after detoxication. “As soon as you quit with GHB everything gets far worse. I never felt as bad as after detoxification. Stress and anxiety, it all comes back 10 times stronger as it has ever been. The only solution to this is the evil [GHB] itself, you want to start using again so everything goes away again. This makes it so hard to really make the choice to quit.” Participants mentioned that treatment should also focus on social problems. During treatment they end the contact with their “user-friends”, however these were usually the only social contacts they had left besides family. Participants wanted help with making new, non GHB-using friends. Without GHB, meeting new people was difficult to them, because they felt insecure to act amongst people when abstinent. This made them socially anxious, which negatively influenced initiating social contacts in order to develop friendships. For some it was almost impossible not to continue meeting other dependent users, because family members or partners were GHB dependent as well. Some wanted to find a new place to live, in order to get away from their old lives and have a fresh start. Others became homeless and needed help in finding proper housing in order to benefit from treatment. Having high debts made this difficult. The latter was also mentioned as