Gamma Hydroxybutyrate

Aka: Gamma Hydroxybutyrate, GHB

1. See Also
   1. Chemical Dependency
   2. Substance Abuse Evaluation
2. Street Names
   1. Liquid E
   2. Liquid Ecstasy
   3. Liquid X
   4. Grievous Bodily Harm
   5. Easy Lay
3. Illicit Uses
   1. Date Rape for Sedation and incapacitation
   2. Recreational drug for Sedation and euphoria
   3. Anabolic Steroid alternative in bodybuilding
4. Previous Medical Uses
   1. Surgical anesthetic in Europe (1960 in France)
   2. Induce short term coma
   3. Narcolepsy (Sodium oxybate)
   4. Alcohol Withdrawal (Sodium oxybate)
   5. Opiate dependency
   6. Classified as a Schedule I controlled substance
      1. Non-prescription use banned in 1990 in U.S.
5. Pharmacology
   1. Derivative of gamma aminobutyric acid
   2. Colorless, odorless liquid
   3. Salty Taste
   4. Onset of effect within 15 to 30 minutes
   5. Peak activity at 20 to 60 minutes
   6. Effect decreases after 3-4 hours
6. Symptoms
   1. Early
      1. Euphoria
   2. Later
      1. Dizziness
      2. Sialorrhea
      3. Hypotonia
      4. Amnesia
   3. Overdose
      1. Cheyne-Stokes Respiration
      2. Seizures
      3. Coma
7. Drug Interactions
   1. May be lethal in combination with drugs or Alcohol
8. Adverse Effects (see above)
   1. High risk of overdose (dose often unknown)
      1. Sixty deaths from GHB in 2000 due to overdose
   2. Bradycardia
   3. Hypothermia
   4. Respiratory depression
   5. Altered Level of Consciousness
   6. Seizure-like activity
   7. Coma
9. Withdrawal Syndrome from frequent large dose GHB use
   1. See GHB Withdrawal
10. Toxicology
    1. Detected by urine or Blood Gas chromatography
       1. Requires special testing by sensitive instrument
       2. Free GHB detection by National Forensic Laboratory
          1. National Medical Services: 800-522-6671
    2. Measurable only for 6-12 hours after ingestion
       1. Quickly excreted into urine
       2. Often cleared with first void
11. References
    1. Galloway (1996) News of Cal Soc Addict Med 23(1):1
    2. Dyer (2001) Ann Emerg Med 37(2):147-52
    3. Gahlinger (2004) Am Fam Physician 69:2619-27