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Review
. 2018 Mar;74(3):349-356.
doi: 10.1007/s00228-017-2387-z. Epub 2017 Dec 3.

Baclofen in gamma-hydroxybutyrate withdrawal: patterns of use and online availability

Christopher N Floyd  1   2 , David M Wood  3   4 , Paul I Dargan  3   4
Affiliations
Review

Baclofen in gamma-hydroxybutyrate withdrawal: patterns of use and online availability

Christopher N Floyd et al. Eur J Clin Pharmacol. 2018 Mar.

Abstract

Purpose: Gamma-hydroxybutyrate (GHB) withdrawal is a life-threatening condition that does not always respond to standard treatment with benzodiazepines. Baclofen has potential utility as a pharmacological adjunct and anecdotal reports suggest that it is being used by drug users to self-manage GHB withdrawal symptoms. Here, we investigate current patterns of use and the online availably of baclofen.

Methods: Data triangulation techniques were applied to published scientific literature and publicly accessible Internet resources (grey literature) to assess the use of baclofen in GHB withdrawal. An Internet snapshot survey was performed to identify the availability of baclofen for online purchase and the compliance of retailers with the UK regulations. Data were collected according to pre-defined criteria.

Results: A total of 37 cases of baclofen use in GHB withdrawal were identified in the scientific literature, as well as 51 relevant discussion threads across eight Internet forums in the grey literature. Baclofen was available to purchase from 38 online pharmacies, of which only one conformed to the UK regulations.

Conclusions: There is limited published evidence on the use of baclofen in GHB withdrawal, but both scientific and grey literature suggests clinical utility. Online pharmacies are readily offering prescription-only-medication without prescription and due to inadequate regulation, pose a danger to the public.

Keywords: Clinical toxicology; Drug abuse; GABA; Pharmacotherapy.

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Conflict of interest statement

Competing interests

We have read and understood the EJCP policy on declaration of interests and declare the following interests:

PID is a member of the UK Advisory Council on the Misuse of Drugs, the European Monitoring Centre for Drugs and Drug Addiction Scientific Committee and the Glaxo Smith Kline Global Analgesics Advisory Panel and an expert advisor to the World Health Organisation and United Nations Office on Drugs and Crime.

DMW is expert advisor to the UK Advisory Council on the Misuse of Drugs, the European Monitoring Centre for Drugs and Drug Addiction and the United Nations Office on Drugs and Crime.

Figures

Fig. 1
Fig. 1
An example of the European Union common logo for UK-based online pharmacies
Fig. 2
Fig. 2
Price of baclofen according to dose and number of tablets purchased. Data expressed as mean ± SD. Tablet quantities available on less than three websites were excluded from this analysis as they may represent non-standard dispensing practices. [SD: standard deviation]
See this image and copyright information in PMC

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