Prevalence of GHB-Related Presentations to a Metropolitan Emergency Department in Melbourne

Introduction

Gamma-hydroxybutyrate (GHB) is a commonly used recreational substance. It has a narrow therapeutic index. The management of GHB overdose in the emergency department (ED) is labour and resource intensive. This study aims to provide a comprehensive analysis of GHB presentations at one of Victoria's largest tertiary hospitals.

Methodology

We conducted a retrospective study on GHB-related ED presentations between 2014 and 2024 and reported a case series of admissions to the Intensive Care Unit (ICU). For ICU admitted patients, confirmation of GHB presence in blood was collected through the Emerging Drug Network of Australia—Victoria (EDNAV) study.

Results

We recorded 2631 cases of GHB-related presentations. The median age was 29 years and 42.3% of cases were female. The presentations of individuals under 25 years of age declined from 61.4% to 14.0%. The majority of patients (81.0%) were brought in by ambulance, with 12.5% accompanied by police. Most patients (93.9%) were managed and discharged from the ED or Short Stay Unit. Only a small proportion of patients (108, 4.1%) required ICU admission. The median stay in the ICU was 2 days. 88.7% of cases admitted to the ICU required intubation. Eight ICU-admitted patients, recruited for the EDNAV study, had a confirmed presence of GHB and other co-ingestions.

Discussion

Our study showed a significant increase in GHB-related presentations to our ED. There has been a notable shift in the demographics of patients presenting to EDs with GHB-related issues. GHB use poses a significant impact on EDs and intensive care services.