Emergency department presentations, hospitalisations and police seizure data related to gamma-hydroxybutyrate (GHB) in New South Wales, Australia, from 2015 to 2024

Background and aims: Gamma-hydroxybutyrate (GHB) is an endogenous neurochemical and illicit synthetic drug. Its precursors, gamma-butyrolactone (GBL) and 1,4-butanediol (1,4-BD), are often used as substitutes. We aimed to describe GHB-related harms in New South Wales (NSW), Australia. Design, setting and cases: Descriptive epidemiological study of data from three administrative datasets: emergency department (ED) presentations from 88 hospitals (1 July 2015 to 31 January 2024 – the latest available), admitted patient data from all NSW hospitals (1 July 2015 to 30 June 2023) and a subset of NSW Police Force seizure data. Note: analysis was not undertaken, data are presented descriptively. Measurements: ED presentations and hospitalisations were analysed for GHB-related presentations and admissions including severity of presentation, intubation and intensive care. NSW Police Force seizure data were examined for all analytically confirmed samples of GHB, GBL and 1,4-BD to assess trends over time. Findings: Over the study period, there were 9612 GHB-related ED presentations. Between July 2023 and January 2024, this was 101 per 100 000 unplanned presentations, relative to the previous full-year peak of 73.7 per 100 000 in 2022–2023 and the 2015–2016 rate of 24.9 per 100 000. The majority (56.1%) were assessed as Australian Triage Category 1 or 2, indicating the highest level of need. ED presentations in regional or remote areas accounted for 13.8% of all presentations in the most recent data, relative to 3.4% at the start of the study period. Hospitalisations totalled 6420 episodes, peaking at 19.6 per 100 000 population in 2020–2021. Nearly one in five patients required intubation, and a similar proportion required admission to intensive care. There was a trend of women accounting for a larger proportion of ED presentations and hospitalisations over time. GHB accounted for 0.1% of all police seizures analysed, and showed a shift from GBL to 1,4-BD dominance from 2022 onwards. Conclusions: ...