{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T05:05:24Z","timestamp":1739423124708,"version":"3.37.0"},"reference-count":14,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T00:00:00Z","timestamp":1721174400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>\u03b3\u2010hydroxybutyrate (GHB) is a GABA\u2010B agonist that rapidly produces effects that are likened to both alcohol and MDMA\/ecstasy. GHB use can lead to neuroadaptation with a characteristic withdrawal syndrome. There is currently a paucity of data on the progression of GHB withdrawal, however, due to the drug's short half\u2010life it is generally considered to be typically 5\u20137\u2009days, although some cases can be severe and complicated by life threatening delirium. Here, we present a case of severe GHB withdrawal, which recurred on multiple occasions over 56\u2009days, despite initial clinical stabilisation on each occasion and toxicological evidence of abstinence from GHB between episodes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Presentation<\/jats:title><jats:p>A male patient in his 30s presented with agitated delirium on a background of severe GHB use disorder with a 15\u2010year history of daily high dose GHB use. Following 3 hospital admissions over 8\u2009weeks, all requiring intravenous sedation and tracheal intubation, the patient's withdrawal delirium was successfully treated with a slow benzodiazepine and baclofen wean over a period of 6\u2009months. Relapse to GHB use between hospitalisations was excluded toxicologically via blood analysis performed at an institute of forensic pathology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and Conclusions<\/jats:title><jats:p>This case highlights that GHB withdrawal can be more prolonged than previously reported in the literature and in some cases may require slow and prolonged tapering of treatment to prevent re\u2010emergence of delirium. Similar to previous case reports, benzodiazepines and GABA\u2010B receptor agonists appear to be appropriate drug classes to manage GHB withdrawal.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dar.13911","type":"journal-article","created":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T04:59:55Z","timestamp":1721278795000},"page":"376-379","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A case of severe and prolonged \u03b3\u2010hydroxybutyrate (<scp>GHB<\/scp>) withdrawal syndrome successfully managed with a slow benzodiazepine and baclofen taper"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7099-8342","authenticated-orcid":false,"given":"Rachit","family":"Gupta","sequence":"first","affiliation":[{"name":"Department of Addiction Medicine St Vincent's Hospital  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Greta","family":"Moon","sequence":"additional","affiliation":[{"name":"Department of Addiction Medicine St Vincent's Hospital  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yvonne","family":"Bonomo","sequence":"additional","affiliation":[{"name":"Department of Addiction Medicine St Vincent's Hospital  Melbourne Australia"},{"name":"Department of Medicine, Faculty of Medicine, Dentistry and Health Sciences University of Melbourne  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Pastor","sequence":"additional","affiliation":[{"name":"Department of Addiction Medicine St Vincent's Hospital  Melbourne Australia"},{"name":"Department of Medicine, Faculty of Medicine, Dentistry and Health Sciences University of Melbourne  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,7,17]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2004.01.012"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3109\/15563650.2012.702218"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.12863"},{"key":"e_1_2_8_5_1","unstructured":"Australian Institute of Health and Welfare (AIHW).National drug household survey 2019. 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