GHB or gamma-hydroxybutyrate

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What is GHB?

GHB or gamma hydroxybutyrate (C4H8O3) is a central nervous system (CNS) depressant commonly known as a “club drug” or “date rape drug”. GHB is consumed by adolescents and young adults at bars, parties, clubs, and raves (all-night dance parties) and is often incorporated into alcoholic beverages. Euphoria, increased sexual desire, and tranquility are the reported positive effects of GHB abuse. Adverse effects may include sweating, loss of consciousness, nausea, hallucinations, amnesia, and coma, among other side effects.

Xyrem (sodium oxybate), a brand name drug, was approved by the Food and Drug Administration (FDA) in 2002 for the treatment of narcolepsy, a sleep disorder that causes excessive sleepiness and recurrent daytime sleep attacks. It is the sodium salt of gamma hydroxybutyrate. Xyrem is a highly regulated drug in the United States. It is a Schedule III control substance and requires patient enrollment in a Restricted Access Program. Buy GHB Products

GHB is also a naturally occurring metabolite of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) found in the brain. The natural metabolite GHB is present in much lower concentrations in the brain than the levels found during drug abuse. As a result of fermentation, naturally occurring GHB can also be found in small but insignificant amounts in some beers and wines. Buy GHB Products

Methods of GHB abuse

GHB is available as an odorless, colorless drug that can be combined with alcohol and administered to unsuspecting victims prior to sexual assault. It can have a soapy or salty taste. Use for sexual assault has led to GHB being referred to as a “date rape” drug. Victims are incapacitated by the sedative effects of GHB and are unable to resist sexual violence. GHB can also induce amnesia in its victim. Common user groups include high school and college students and rave attendees who use GHB for its intoxicating effects.

GHB has also been postulated to have anabolic effects due to protein synthesis, and bodybuilders have used it to build muscle and reduce fat.

What is GHB or gamma-hydroxybutyrate

GHB can be purchase on the street or on the Internet in liquid or white powder form for illicit use. It is taken orally and is often combined with alcohol. Much of the GHB found on the street or on the Internet is produced in illegal laboratories. GHB can be adulterated with unknown contaminants that can increase its toxicity. The production of GHB generally involves the use of bleach or sewage cleaner mixed with GBL, a chemical cousin of GHB and an industrial solvent often used to strip floors.

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In 1990, the Food and Drug Administration (FDA) issued a warning stating that the use of GHB is unsafe and illegal except under FDA-approved, physician-verified protocols. In March 2000, GHB was placed on Schedule I of the Controlled Substances Act.

GHB sodium salt, brand name product Xyrem (sodium oxybate), is classified as a Schedule III drug by the DEA when legally prescribed and used in a Restricted Patient Access Program. Xyrem is not available in regular retail pharmacies. If Xyrem is trafficked as a recreational drug, its status changes to Schedule I and it becomes an illegal drug.

Pharmacology

GHB acts at two receptor sites in the brain, GABAB and GHB-specific receptors. Action at these two receptor sites results in the psychomotor impairing, stimulant and CNS depressant effects of GHB.

About 95% of GHB is metabolize in the liver and its half-life ranges from 30 to 60 minutes. Only 5% of the original drug is excreted renally. Detection of GHB in urine can be difficult after 24 hours due to its short half-life.

Health risks of GHB use

Euphoria, increased sexual desire, and tranquility are the reported positive effects of GHB abuse. However, the immediate negative effects of GHB use can include

sweating
loss of consciousness
nausea
auditory and visual hallucinations
headache
vomiting
exhaustion
laziness
amnesia
confusion
clumsiness
GHB can have addictive potential when used repeatedly. Withdrawal effects can include insomnia, anxiety, tremors, and sweating. Withdrawal can be severe and disabling.

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Combined use with alcohol, other sedatives or hypnotics (such as barbiturates or benzodiazepines) and other drugs that have CNS depressant activity can cause nausea, vomiting and aspiration and dangerous CNS and respiratory depression.

Large doses of GHB, even without other street drugs or alcohol, can cause deep sedation, seizures, coma, severe respiratory depression, and death. Club drug use Episodes of erectile dysfunction often involve the use of various substances, such as marijuana, cocaine, and other club drugs, such as methamphetamine, ecstasy, or Rohypnol.

Emergency department physicians may not know that GHB has been abuse when a patient arrives at the hospital. Because of the drug’s short half-life, detection in urine can be difficult. Supportive care and keeping the airway open are the main measures use in overdose emergencies. GHB or gamma-hydroxybutyrate

GHB use during pregnancy

The effects of GHB use during human pregnancy are unknown. Women should not use GHB during pregnancy. Pregnant women or those planning to become pregnant and using GHB should seek the advice of a health care professional immediately.

Treatment options for GHB abuse

Little information is available on treatment options for people addicted to any disco drug, including GHB. Some GHB users are not physically dependent on GHB and can be treated and inform on an outpatient basis. Chronic use can cause severe withdrawal symptoms during detoxification, and these patients require close medical supervision and supportive care. Hospitalization can range from 7 to 14 days. Buy GHB Products

Withdrawal effects are reported to be severe, and patients may try to detoxify with benzodiazepines or alcohol. Use of these additional substances can worsen withdrawal and lead to respiratory depression, coma, and death. Medications such as benzodiazepines, antihypertensives and/or anticonvulsants may be needed during rehabilitation, but only under medical supervision.

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