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2 results

  • Chapter 13 - Novel Psychoactive Substances and Club Drugs

  • Edited by Ed Day
  • Book:
    Seminars in Addiction Psychiatry
    Published online:
    02 November 2021
    Print publication:
    04 November 2021, pp 230-251

  • Summary

    This chapter looks at ‘club drugs’ and novel psychoactive substances (NPSs; previously known as ‘legal highs’). It examines the acute and chronic adverse health effects of these drugs and focuses in particular on their effects on mental health, including their dependence liability and associated withdrawal symptoms. The chapter is based on the best available research evidence on NPSs, which is currently limited, but nonetheless broadly consistent. It also provides practical patient case studies to illustrate key clinical points. Overall, the evidence suggests that interventions aimed at NPSs must be based on the guiding principles and national guidelines used for the management of substance misuse in general. However, NPSs pose a number of additional challenges, which are highlighted in this chapter. This chapter also establishes a conceptual framework for NPSs, which is crucial in helping clinicians to navigate the hundreds of new substances detected in recent years while allowing them to drawn on their existing experience of substance misuse.

  • The ‘G’ men: a profile of GBL/GHB users in an area of high drug-related mortality

  • S. Durgahee, G. Allen, H. Williams
  • Journal:
    Irish Journal of Psychological Medicine / Volume 31 / Issue 4 / December 2014
    Published online by Cambridge University Press:
    11 August 2014, pp. 275-280
    Print publication:
    December 2014
  • Objectives

    Gamma-butyrolactone/gamma-hydroxybutyrate (GBL/GHB) and related analogues are increasingly misused. The study reports on patient characteristics, nature and pattern of use, complications and comorbidity for a cohort of patients presenting to a large Substance Misuse Service in Brighton and Hove City.

    Method

    A retrospective case-note review of routinely collected clinical data on patients with primary GBL/GHB misuse.

    Results

    In all, 24 individuals were male and 3 female, with a mean age of 34 years. A total of 21 males identified themselves as gay and 1 female as bisexual. Just over half (15, 56%), respectively, were living in stable accommodation and were in employment or third-level education. In all, 22 (81%) met criteria for physical dependence and two-thirds (18, 67%) had experienced overdose. The group was using large amounts of GBL (mean 53 ml/day) with a significant number (25, 93%) using ‘around the clock’ (every 1–3 hours). Over one-third (10, 37%) had a diagnosis of HIV and with 24 (89%) having a presumptive diagnosis of anxiety disorder.

    Conclusions

    A profile of gay men with relatively stable lifestyles, but nevertheless with a high rate of complication of GBL/GHB use and with a significant comorbidity (HIV and psychological problems) was identified. The need for integrated specialist services and the importance of liaison with Emergency Departments and HIV services is highlighted.