Trends in GHB use and harms in Australia

Background: There is evidence of greater availability of gamma hydroxybutyrate (GHB), gamma-butyrolactone (GBL) and 1,4-butanediol (1,4-BD) (hereafter collectively called ‘GHB’) in Australia. There are also indicators of increased harms in several jurisdictions, and concern about rising use among demographic groups who historically have not commonly used GHB. The aim of this study was to use a range of national data sources to describe and triangulate trends over time in GHB use and harms in Australia from 2003-2023. 

Methods: Data were obtained on patterns of GHB use from triennial general population household surveys and annual surveys of sentinel samples who regularly use illicit stimulants and samples who regularly inject drugs. Data were also obtained on rates of GHB-related hospitalisations, deaths and treatment episodes. Joinpoint software was used to identify changepoints and estimate the annual percentage change. 

Results: Preliminary analyses suggest that prevalence of GHB use in the general population was typically low until 2019 (2022/2023 data pending). By contrast, past six-month GHB use was reported by 12% of people who regularly use ecstasy and 17% of people who regularly inject drugs in 2023 (previously 10% or less, in each sample). GHB-related hospitalisations increased from 2018-19; methamphetamine was commonly associated with presentation. A similar trend was observed for GHB-related deaths and drug treatment episodes where GHB was the client’s principal drug of concern. 

Conclusions: GHB use is rising among some people who use illicitdrugs, and population-level harms are increasing. Findings reinforce the importance of harm reduction education for consumers and clinical awareness among health professionals given the complexity of treating GHB overdose, dependence, and withdrawal.