Table 2 Summary of the qualitative analysis of the reasons to reduce or cease GHB use perceived by occasional and heavy users
Perceived reasons to reduce or quit GHB use (n = 574) | |||
|---|---|---|---|
Category title | Description of category | Examples | Percentage |
Immediate risks / consequences | Experienced or feared severe immediate consequences of GHB use, such as overdoses, collapsing, and unconsciousness | “Overdose, unconsciousness, hospital” “Dangers overdosing” “Sometimes I had black outs” “Often going into sleepy mode” “Collapsing 3 times in a weekend” “Life-threatening risk. Besides using in clubs, I tend to use it” alone at home, which is very dangerous” “Mixing it with other substances is highly dangerous” | T1: 15.5% |
Addiction and problematic use | Experiences and fears of addiction, strong cravings, frequent or high-dose use, withdrawal symptoms, and loss of control over consumption | “Addiction” “Prevent addiction” “Physical and mental dependency” “Strong cravings of taking more” “Loss of control over consumption” “Withdrawal symptoms” | T1: 14.3% |
Physical health concerns | Experienced and feared physical harm from GHB, affecting various organs and systems, including digestive issues, oral health, and the immune system | “Destruction of the body” “Wounds in the oral cavity. Painful tongue. Pain while eating. Mucus in the throat. Heartburn.” “Physical (long-term) damage” “Stomach and dental health” “Immune system” | T1: 19.2% |
Mental health concerns | Experiences of negative mental health impacts, including affective and cognitive effects | “High anxiety” “Makes me feel insecure mentally with extended use” “Makes depressive over time” “Depression” “I could feel it affect my memory “ “Mental health” | T1: 3.1% |
Behavioral and personality changes | Short- and long-term personality and behavioral shifts, including increased disinhibition, heightened egoism, and frequent regret over actions taken | “Changes in personality” “Subtle changes in character. Even when you haven’t taken anything in a while, you feel like a different person” “Loss of sensitivity, less intelligent, loss of inhibitions, personal boundaries aren’t realized anymore; I often feel ashamed the next day about things I said (I feel alienated from myself when using too much G)” “My girlfriend says I change, and I don’t like that” “Guilt over actions taken under the influence of G” “I felt it turned me more aggressive when dealing with conflicts in a party environment” “Experienced personality shift to something I am not at all during long sessions” | T1: 5.6% |
Sexual behavior | Problematic patterns in sexual behavior related to GHB use, e.g., reliance on its enhancing effects and regretted encounters | “I don’t want to depend on sex-enhancing drugs to have sex” “Wrong sexual behavior” “Random sex” “Sex with people I don’t like/find attractive afterward” “Avoid chemsex addiction” | T1: 2.4% |
Social relationships and impact on others | Detrimental effects of GHB use on close social relationships, e.g., partners, friends, and family | “Spiraling into addiction, messing up relationships and friendships” “Disrespectful behavior toward friends” “Damage I’ve caused in my most important friendships, as they were very worried” “Trying not to jeopardize the partnership” “Family” | T1: 5.4% |
Impact on daily life and responsibilities | Negative impacts on profession-related activities and everyday life | “GBL/GHB enables or tempts very long parties like no other drug, negatively affecting everyday performance” “Like all drugs, it threatens my professional career” “Can’t manage daily life anymore and take ages to do everything” “Consumption dictates daily life” | T1: 2.6% |
Deterrent experiences in the social environment | Witnessing negative effects of GHB on individuals in the social environment; including addiction, life-threatening situations, and severe behavioral changes | “Friends who let the drug ruin their lives and drifted away despite attempts to help” “Some friends of mine are addicted” “Seen friends become more and more dependent” “So many friends died or almost died” “My ex-husband became heavily addicted to GBL and put his life at risk” “I have seen many people behaving like monsters because of it” | T1: 4.4% |
Stigma and social perception | Concerns about stigma, social pressure, and negative social associations with GHB use | “Stigma” “Not wanting to be part of ‘this’. Many bad things regarding G that I don’t agree with, socially, sexually, etc., not wanting to be associated with that” “Dealing with the shame or guilt of taking it can be stressful” “Pressure in the scene, negative opinions from friends and clubs” | T1: 1.9% |
Changed life circumstances and aims | Perceived changes in life circumstances that are no longer compatible with GHB use, or decision to abstain/reduce use | “Growing out of the party phase / friends no longer use it” “Travelling” “Exams / taking a break from partying” “Pregnancy” “Want to go sober again” | T1: 6.8% |