Perceptions of risk among GHB users: A rapid qualitative evidence synthesis

Indicators of GHB-related harms are increasing. While quantitative research has identified demographic patterns in GHB use and risk factors for harm, less is known about how people who use GHB themselves perceive these risks. This rapid qualitative evidence synthesis aimed to address this gap by examining people who use GHB's perceptions of risk, and how they mitigate GHB-associated risks. Qualitative evidence was identified through an electronic literature search. 11 studies were included in the thematic analysis of GHB-related risk perceptions. Five core themes were found regarding perception of risk, including the 'social costs of GHB use', 'fear of sexual regrets, victimisation, and perpetration', 'differing perceptions of GHB overdose', 'perceiving GHB as manageable and benign', and lastly, 'selective risk recognition in polysubstance use.' An additional four themes were identified around how people addressed the perceived risks, including 'education providing protection', 'safety obtained through the environment', 'actively preventing overdose', and 'utilisation of formal services'. By exploring these themes, this review provides valuable insights into how people who use GHB weigh the risks and benefits of use, and what actions they take to reduce those perceived risks. Such insights are crucial in designing contextually relevant interventions that resonate with individuals who use GHB.