GHB (Gamma 4- Hydroxybutayric Acid) has seen an exponential growth in most European countries over the past few years. Intoxication and withdrawal syndromes occasionally seen at First Aid and liason psychiatry services of General Hospitals were mostly cases of recreational GHB use, i.e. in relatively low dosage, less than 40 mg/kg GHB. The state of the art treatment of states were based on treating the symptoms by means of high dosage benzodiazepines and systemic support.

The growth in GHB intake has caused a new patient population arriving at the General Hospital on a very high GHB dosage, showing rather serious delirant states concomitant with very aggressive behaviour. They usually end up under narcosis at the IC.

We will present management guidelines developed by us for treating this problematic, drawn from guidelines for detoxification treatment within rehab care and based on Medicinal GHB.

The system for treatment proposed here has by now been successfully implemented in various hospitals in the Netherlands.