GPs are key to tackling the problem, which is especially bad in some pockets of Victoria.
Urgent help is needed to address the growing number of GHB-related ambulance attendances, experts say.
Victoria saw nearly 17,000 GHB-related attendances between 2015 and 2024, and Greater Geelong emerged as a hotspot, accounting for more than a third of all attendances in regional Victoria.
Monash University and Turning Point, a national drug and alcohol research centre affiliated with Eastern Health, recently analysed state data from the world-first National Ambulance Surveillance System (NASS).
Researchers split the state into metropolitan Melbourne and regional Victoria and further broke attendances down by LGA.
They found that attendances in regional Victoria were 31% more likely to result in more severe outcomes from than in metropolitan areas.
Attendances in Melbourne were around 300 per 100,000, while regional attendances were roughly 140 per 100,000.
Geelong ranked as the fourth highest LGA in the entire state for GHB-related ambulance attendances. This spiked in recent years, jumping tenfold between 2018 and 2023.
GHB-related harm also grew significantly across the state, rising 67% between 2022 and 2023 alone, resulting in nearly 4000 ambulance attendances for the drug.
There was a 150% increase statewide in GHB-related attendances between 2012 and 2019. Of the 2600 attendances in 2020, 56% involved acute overdose.
The researchers also identified a seasonal trend, with greater numbers of GHB-related ambulance attendances occurring during the fourth quarter of each year.
Associate Professor Shalini Arunogiri, clinical director at Turning Point Statewide Centre for Addiction and Mental Health, told TMR that GPs played a key role in reducing the rising rates of GHB-related harm.
“GPs may be the first port of call for people who use GHB and experience harms; and they can often be the health practitioner supporting someone after discharge from acute health or emergency services,” she said.
Dr Rowan Ogeil, senior author of the study, strategic lead of the National Addiction and Mental Health Surveillance Unit at Turning Point and senior research fellow at Monash University, agreed.
“Through assessment and management in primary care supported by an awareness of the context of GHB use, familiarity with harm-minimisation advice and being cognisant of markers of risk which warrant referral to specialist addiction services, GPs play a significant role,” Dr Ogeil said.
Related
According to Turning Point, one in five Australians meet lifetime criteria for a substance use disorder, but less than a quarter of those affected seek professional help.
“Importantly, due to stigma, individuals may not disclose GHB use or seek help for this specifically – so it is important to consider GHB-related harms in differential diagnoses and utilise systematic screening questions to identify those at risk,” Professor Arunogiri said.
Within general practice settings, Professor Arunogiri said that a welcoming, inclusive and non-judgemental atmosphere was critical to support individuals to engage in open and trusting relationships and discussions about substance use.
Researchers also discussed findings from the mobile drug testing service in service during the four-day long Beyond the Valley music festival in 2023.
Of the 700 service users who were interviewed by harm reduction workers, more than 70% said it was their first time engaging in an honest and judgement‐free conversation about drug and alcohol safety with a healthcare professional.
This highlighted the vital opportunities for conversations about reducing drug-related harm that drug checking services create, researchers said.
A fixed site in Melbourne is set to open in August this year, similar to CANTest in ACT, but researchers stressed the need for more fixed site services, particularly in the Greater Geelong region.
The ambulance study found Geelong surpassed metropolitan LGAs such as Stonnington and Yarra, areas which have high concentrations of scenes traditionally associated with GHB use such as nightclubs and bars.
Half of Victoria’s GHB-related ambulance attendances were also attended to by police, and more than 50% of attendances were for individuals using GHB alongside other drugs, particularly methamphetamine.
The median age was 28 and 55% were male.
Resources for GPs
- The Drug and Alcohol Clinical Advisory Service (DACAS) is a free 24/7 telephone advisory service for health professionals in Victoria, Tasmania and the Northern Territory.
- There is also DASAS in NSW, DACAS in South Australia, DACAS in Western Australia and ADCAS IN Queensland.
- DACAS also provides clinical resources, including guidance and information to assist identification and treatment of alcohol and other drug problems.
- The RACGP Alcohol & Other Drugs GP Education Resource Library includes a series of resources on assessment, working through complex cases and comorbidities and resources to support patients with harm minimisation strategies, as well as opportunities for further training.
- There is a recent webinar on the harms related to GHB, tailored to health service providers.
- A recent paper published in The Australian Journal of General Practice is a useful and targeted resource for GPs which discusses relevant approaches to managing GHB use in GP settings, provides a brief assessment tool specifically for GHB use and describes symptoms of GHB withdrawal.
- The Australian Drug Foundation’s ‘Power of Words’ flipbook has several suggestions for how to create a welcoming clinical practice for stigmatised subjects such as drug use.
