![]() At low dose, stimulation of GHB receptors increases dopamine release resulting in stimulant-like effects, whilst at higher doses, binding to GABA-B receptors results in hypnotic effects and eventually coma. Use of GHB and its precursors (gamma-butryolactone (GBL) and 1,4-butanediol (1,4-BD)) have a dose-dependent effect on glutamate and dopamine release. In addition, it has been used illicitly in both bodybuilding and as a recreational drug. A high incidence of adverse effects during early clinical trials restricted its use in anaesthesia, but at lower doses, it has found some clinically utility and is licenced for treating sleep disorders (particularly narcolepsy with cataplexy) and alcohol dependence. Gamma-hydroxybutyrate (GHB) is a naturally occurring metabolite of the neurotransmitter gamma-aminobutyric acid (GABA) and was first synthesised as an anaesthetic agent in 1964. Online pharmacies are readily offering prescription-only-medication without prescription and due to inadequate regulation, pose a danger to the public. There is limited published evidence on the use of baclofen in GHB withdrawal, but both scientific and grey literature suggests clinical utility. Baclofen was available to purchase from 38 online pharmacies, of which only one conformed to the UK regulations. ResultsĪ total of 37 cases of baclofen use in GHB withdrawal were identified in the scientific literature, as well as 51 relevant discussion threads across eight Internet forums in the grey literature. ![]() Data were collected according to pre-defined criteria. An Internet snapshot survey was performed to identify the availability of baclofen for online purchase and the compliance of retailers with the UK regulations. ![]() MethodsÄata triangulation techniques were applied to published scientific literature and publicly accessible Internet resources (grey literature) to assess the use of baclofen in GHB withdrawal. Here, we investigate current patterns of use and the online availably of baclofen. Baclofen has potential utility as a pharmacological adjunct and anecdotal reports suggest that it is being used by drug users to self-manage GHB withdrawal symptoms. Gamma-hydroxybutyrate (GHB) withdrawal is a life-threatening condition that does not always respond to standard treatment with benzodiazepines. ![]()
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