Definition of Gamma hydroxybutyrate (GHB)

Gamma hydroxybutyrate (GHB): Known in Europe as Gamma-OH, gamma hydroxybutyrate is a colorless and odorless drug used illicitly for "recreational" purposes and for "date rape." GBH is a central nervous system depressant. It tends therefore to increase sociability and function as something of a transient antidepressant.

Some persons who have sustained adverse effects of GHB have reported being given the drug surreptitiously (e.g., having it slipped into their drink), while others have admitted to intentional use.

GHB has been marketed as a liquid or powder and has been sold on the street under numerous names such as "Grievous Bodily Harm," "Georgia Home Boy," "Liquid Ecstasy," "Liquid X," "Liquid E," "GHB," "GBH," "Soap," "Scoop," "Easy Lay," "Salty Water," "G-Riffick," "Cherry Menth," and "Organic Quaalude."

In February, 2000, federal legislation was passed in U.S. that toughened the penalties for the distribution and possession of drugs used in date rapes. The principal drug covered by the law was GHB. A few drops of GHB added to a drink are enough to make the victim lose consciousness within 15-20 minutes. At the time GHB had been implicated in more than 5,700 recorded cases of overdose and in at least 57 deaths.

The combination of GHB with alcohol or other CNS depressants is especially deadly. A teaspoon (5 cc) of GHB mixed with alcohol can render a person unconscious and drastically depress respiration within 20 minutes of ingesting it. The use of GHB can also be physically addictive.

In the U.S., GHB has been produced clandestinely in widely varying degrees of purity. "Liquid" GHB varies in concentration according to preparation. Improper preparation of GHB can result in a mixture of GHB and sodium hydroxide that can be severely toxic because of the combined effects of the GHB and the direct caustic effects of sodium hydroxide.

GHB increases dopamine levels in the brain and has effects through the endogenous opioid system; most GHB is excreted during the first hours after ingestion.

The features of acute GHB toxicity include coma, seizures, respiratory depression, and vomiting. Other documented effects of GHB include amnesia and hypotonia (associated with doses of 10 mg/kg body weight); a normal sequence of rapid eye movement (REM) and non-REM sleep (doses of 20-30 mg/kg body weight); and anesthesia (doses of approximately 50 mg/kg body weight). Doses of >50 mg/kg body weight can decrease cardiac output and produce severe respiratory depression, seizure-like activity, and coma.

There is no antidote for GHB overdose, and treatment is restricted to nonspecific supportive care. Patients have required urgent emergency care; many of those hospitalized have required ventilatory support and intensive care.

The Drug Enforcement Administration (DEA) of the U.S. Department of Justice has issued the following statement: "Gamma Hydroxybutyrate (GHB), known as liquid x, Georgia home boy, Goop, gamma-oh, and grievous bodily harm, is a central nervous system depressant abused for its ability to produce euphoric and hallucinatory states and its alleged ability to release a growth hormone and stimulate muscle growth. Although GHB was originally considered a safe and "natural" food supplement and was sold in health food stores, the medical community soon became aware that it caused overdoses and other health problems. GHB can produce drowsiness, dizziness, nausea, unconsciousness, seizures, severe respiratory depression, and coma. GHB can be found in liquid form or as a white powdered material. It is taken orally and is frequently combined with alcohol. Abusers include high school and college students and rave party attendees who use GHB for its intoxicating effects. Some body builders also abuse GHB for its alleged anabolic effects. Several cases have documented the use of GHB to incapacitate women for the commission of sexual assault."

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