Gamma-hydroxybutirate poisoning in Ljubljana between the years 2000 and 2014.

Background: Gamma-hydroxybutyrate (GHB) is an illicit drug causing unconsciousness and respiratory depression. The aim of this study was to evaluate the clinical presentation and treatment in patients admitted to the University Medical Centre Ljubljana (UMCL). Methods: In this study we included all retrospectively reviewed cases of GHB-poisoning admitted to the UMCL between 2000 and 2014. We collected all the data regarding the overdose circumstances, clinical presentation, treatment and toxicological analysis of blood and urine. Results: In the previous 15 years a total of 74 patients were admitted to the UMCL due to GHB-poisoning. The first case of GHB-poisoning was observed in 2002 and the numbers have largely increased since 2012. 86% of all the patients ingested the drug intentionally, 82% were male and the median age of admitted patients was 27 years. We recorded 6 mass GHB-poisonings in which 2-4 patients were admitted simultaneously. The most common presenting symptom of GHB-poisoning was diminished level of consciousness (95%), with 53% being unresponsive to pain. Vomiting (30%), bradycardia (28%), hypotension (26%), hypoventilation with respiratory insufficiency (19%) and agittation upon awakening (31%) were common as well. Concomitant alcohol and illicit drug use was recorded in 61% of cases. 80% of all the patients were treated symptomatically, 14% were mechanically ventilated. Conclusions: The incidence of GHB-poisoning has increased in recent years. GHB-poisoned patients are predominantly male, often admitted in groups, who ingest the drug intentionally at parties during weekends. The most common presenting symptom of GHB-poisoning is unconsciousness. Treatment is symptomatic.