Treatment consumption and treatment re-enrollment in GHB-dependent patients in The Netherlands

•γ-Hydroxybutyric acid (GHB) dependence is on the rise in the Netherlands.•Clinical experience suggests high relapse rates after detoxification.•In this study, treatment characteristics and re-enrollment rates were studied.•Nationwide administrative data of over 65,000 patients were used.•GHB patients showed high treatment consumption and the highest re-enrollment rates.

BackgroundThe objective of this study was to assess treatment consumption and re-enrollment in treatment in patients with gamma-hydroxybutyrate (GHB)-dependence in Dutch Addiction Treatment Centers (ATCs) in comparison with other addictions.MethodsA cohort-study using nationwide administrative data from regular Dutch ATCs associated with the Dutch National Alcohol and Drugs Information System (LADIS), covering an estimated 95% of ATCs. We selected in- and out-patients with alcohol, drug and/or behavioral addictions with a first treatment episode in 2008-2011 and consecutive treatments until 2013 (n = 71,679). Patients still in treatment at that date (n = 3686; 5.1%), forensic patients (n = 1949; 2.7%) and deceased patients (n = 570; 0.8%) were excluded, leaving 65,474 patients (91.3%). Of those, 596 (0.9%) patients had GHB dependence. We analyzed number of treatment contacts, treatment duration, admissions and admission duration of the first treatment episode, and re-enrollment (defined as having started a second treatment episode in the study period).ResultsGHB-dependent patients showed the highest number of treatment contacts, duration of treatment and chance of being admitted. Re-enrollment rates were 2-5 times higher in GHB-dependent patients than other patients with adjusted HR of other addictions ranging from 0.18 (95% confidence interval [CI]: 0.15-0.21) to 0.53 (95% CI: 0.47-0.61).ConclusionsThis study demonstrates high levels of treatment consumption and high rates of treatment re-enrollment in GHB-dependent patients. These findings highlight the urgency of developing effective relapse prevention interventions for GHB-dependent patients.