• Sonia Habibian, Keith Ahamad, Mark McLean, and Maria Eugenia Socias.
• British Columbia Centre on Substance Use, Vancouver, BC, Canada (SH, KA, MM, MES); Department of Family Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada (SH, KA, MM); Vancouver Detox, Vancouver Coastal Health, Vancouver, BC, Canada (SH, KA, MM); Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada (MES).
• J Addict Med. 2019 Sep 1; 13 (5): 415-417.

BackgroundGamma-hydroxybutyrate (GHB)-a GABA-B agonist-can lead to a use disorder, and a withdrawal syndrome similar to that of alcohol. At present, evidence is lacking for how to best manage GHB withdrawal, and often clinicians rely on alcohol withdrawal management approaches, using medications like benzodiazepines (BZD). However, BZD doses needed to control GHB withdrawal symptoms are typically much higher than those required for alcohol, posing significant safety risks. Novel approaches include the use of baclofen as an adjunct to BZD, allowing reductions in BZD requirements. While the use of baclofen as monotherapy may result in even greater risk reductions, research to support this approach is limited.CaseWe present a case of a 26-year-old female with severe GHB use disorder and history of severe withdrawal symptoms, whose withdrawal was successfully, managed using baclofen alone.ConclusionIn keeping with other case reports, baclofen appears to have potential to be used in the management of GHB withdrawal. Here, we presented a case of severe GHB withdrawal which was managed solely by baclofen. Clinical research is needed to evaluate baclofen's potential as a standalone treatment for GHB withdrawal.

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