Mind the G(ap): bridging prevention needs and approaches for GHB/GBL users and their social environment

Gamma-hydroxybutyrate (GHB) and its precursors gamma-butyrolactone (GBL) and 1,4-butanediol (BD) have become a significant concern due to the increase in their recreational use and the high risks associated with it (e.g., overdose, addiction, life-threatening withdrawal syndromes). However, targeted prevention and treatment strategies are lacking, and little is known about the specific needs of users regarding supportive approaches.

To address this gap, a mixed-methods longitudinal study was conducted with two waves of online data collection (11/2022-01/2023; 11/2023-01/2024) in Germany. The adult convenience sample (N = 2,196, with n = 240 participating in the follow-up) was mostly connected to Berlin's nightlife scene and included GHB/GBL/BD users and their (non-user) social environment. Perceptions and needs regarding prevention and harm-reduction, reasons and measures of decreasing use, and the impact of GHB/GBL/BD use were analyzed both quantitatively and qualitatively.

Education, harm reduction strategies, and specialized support options were welcomed by users and non-users, while restrictive approaches were viewed negatively, particularly by heavy users. Many participants expressed a desire to reduce GHB/GBL/BD use, driven primarily by health concerns, immediate use risks, and addiction, but only few participants had previously accessed preventive/therapeutic services. The follow-up showed little change in perceptions and experiences over time.

The findings underscore the need for comprehensive and integrative prevention and treatment strategies for GHB/GBL/BD use, with harm reduction approaches prioritized over restrictions. They provide a crucial foundation for future research and interventions and emphasize the necessity of adequately addressing the growing issues related to GHB/GBL/BD use.

The study protocol was pre-registered with the German registry for clinical studies (Deutsches Register Klinischer Studien; drks.de/search/de/trial/DRKS00030608) on October 28, 2022.