{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T12:29:12Z","timestamp":1786796952418,"version":"build-2736575974"},"reference-count":44,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T00:00:00Z","timestamp":1709251200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT2001107"],"award-info":[{"award-number":["GNT2001107"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Gamma\u2010hydroxybutyrate (GHB) use is associated with high risk of accidental overdose. This study examined the pre\u2010hospital circumstances, demographic characteristics and clinical outcomes of analytically confirmed GHB emergency department (ED) presentations in Western Australia (WA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This case series was conducted across three WA EDs involved in the Emerging Drugs Network of Australia, from April 2020 to July 2022. Patient demographics, pre\u2010hospital drug exposure circumstances and ED presentation and outcome characteristics were collected from ambulance and hospital medical records of GHB\u2010confirmed cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>GHB was detected in 45 ED presentations. The median age was 34\u2009years and 53.3% (<jats:italic>n<\/jats:italic>\u2009=\u200924) were female. Most patients arrived at the ED by ambulance (<jats:italic>n<\/jats:italic>\u2009=\u200937, 85.7%) and required immediate emergency care (Australasian Triage Score 1 or 2\u2009=\u200997.8%). One\u2010third of patients were admitted to intensive care (<jats:italic>n<\/jats:italic>\u2009=\u200914, 31.1%). Methylamphetamine was co\u2010detected in 37 (82.2%) GHB\u2010confirmed cases. Reduced conscious state was indicated by first recorded Glasgow Coma Scale of \u22648 (<jats:italic>n<\/jats:italic>\u2009=\u200929, 64.4%) and observations of patients becoming, or being found, \u2018<jats:italic>unresponsive<\/jats:italic>\u2019 and \u2018<jats:italic>unconscious<\/jats:italic>\u2019 in various pre\u2010hospital settings (<jats:italic>n<\/jats:italic>\u2009=\u200928, 62.2%). \u2018<jats:italic>Agitated<\/jats:italic>\u2019 and\/or \u2018<jats:italic>erratic<\/jats:italic>\u2019 mental state and behavioural observations were recorded in 20 (44.4%) cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and Conclusions<\/jats:title><jats:p>Analytically verified data from ED presentations with acute toxicity provides an objective information source on drug use trends and emerging public health threats. In our study, patients presenting to WA EDs with GHB intoxication were acutely unwell, often requiring intensive care treatment. The unexpectedly high proportion of female GHB intoxications and methylamphetamine co\u2010ingestion warrants further exploration.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dar.13830","type":"journal-article","created":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T11:09:44Z","timestamp":1709291384000},"page":"984-996","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["A multicentre case series of analytically confirmed gamma\u2010hydroxybutyrate intoxications in Western Australian emergency departments: Pre\u2010hospital circumstances, co\u2010detections and clinical outcomes"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0398-2121","authenticated-orcid":false,"given":"Jennifer L.","family":"Smith","sequence":"first","affiliation":[{"name":"Centre for Clinical Research in Emergency Medicine Harry Perkins Institute of Medical Research  Perth Australia"},{"name":"East 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