Harmen Beurmanjer

97 Summary and Discussion 7 Once people start developing GUD it is important that they receive care to prevent them slipping away from society and fall between the cracks of the healthcare system. The Trimbos Institute has recently written a comprehensive guideline( Nijkamp, 2019) for municipalities for tracking people with GUD and getting them in care, partly based on studies from this thesis. Phan and colleagues (Phan et al., 2020) also provide a comprehensive overview of materials to be used in the at risk group for GUD. These include an English screening list for GUD and a brief intervention aimed at people who use GHB and are at risk for GUD or display other problems due to their GHB use. For an overview in Dutch, screenings tools and treatment options, the recently published GHB treatment guide can be viewed (https://nispa.nl/projecten/behandeling/handreiking-ghb-behandeling ). Table 1 STAING SAFE overview STAYING SAFE S Seek medical attention immediately if you have taken too much GHB. Do not use other drugs in the hope of reversing the effects. T Two or more substances used at the same time increase the risk of overdose significantly (especially sedatives; eg alcohol, ketamine). A Always measure GHB doses accurately (eg with a syringe or pipette). Wait until the effects are felt and do not re-dose for at least two hours. Y You should always avoid using GHB on your own and always use in a safe place and with someone who has not taken it, as it is common to become unconscious. I If you have used and are going to sleep, sleep on your side in case you are sick. Place sleeping or unconscious friends in the recovery position. N Never keep GHB in drink bottles, where it might be drunk by others not aware of the content. Add food colouring to avoid accidental drinking. G GHB is addictive and dependence can happen quickly. Avoid frequent use, especially daily use. S Severe and potentially serious GHB withdrawal symptoms occur if you are dependent and you miss a dose or reduce amounts taken abruptly. A Acute withdrawal symptoms and have no GHB? Seek medical help immediately in an emergency department. F Find medical support for planned GHB detoxification. Do not attempt to stop abruptly on your own. If you want to reduce your dose, do so in very small doses until you find medical support. E Employ methods to stabilise your use; consumption diaries can be helpful. Originally from Phan and colleagues(Phan et al., 2020)