Gamma-Hydroxybutyrate (GHB) is a sedative and classified as a central nervous system depressant. The drug is known to occur naturally in the body and may have a role in inducing sleep. GHB is a controlled drug in the USA and is classified as a schedule I controlled substance.
Gamma Hydroxybutyrate (GHB) is an illicit chemical that has become a major cause of drug-related comas in the US. GHB is fast becoming the most common cause of illicit drug induced coma. The drug traffickers also claim that the drug is an antidepressant, can help reduce weight and has anabolic properties - none of which is substantiated by scientific data.
The drug was initially used in anesthesia but because it’s severe toxicity and unreliable clinical affects, the drug is no longer used. However, the drug was highly touted as an anabolic steroid and thus is frequently sold at gyms and exercise parlors. In fact, the majority of abusers claim that it is the anabolic properties which first led them to use the drug. To date, there is no scientific data to suggest that the drug has any body building properties.
GHB was first manufactured in Europe and was planned to be used as an intravenous anesthetic and for use in narcolepsy. However, clinical studies soon revealed that the drug had major side effects and its results were highly unpredictable.
For the past two decades the drug has been used for illicit purposes. Over the years, the drug was classified as a club drug and is widely available at parties, raves, bar and night clubs. It’s most recent fame has come from its use as a date rape drug. Restrictions on its manufacture and availability have allowed proliferation of GHB-look-alike drugs which proliferate all over America.
Analogs of GHB
In recent years, various States have passed legislation to control the sale of GHB, thus making it a criminal offence to possess the drug. This forced limitation in the supply of GHB has resulted in a proliferation of related chemicals, like Gamma Butyrolactone (GBL) and 1, 4-butanediol (BD). These chemicals are converted to GHB in the body. They are widely available at gyms, parties and night clubs across the nation.
Users of GHB
The most frequent users of GHB are college students and young teenagers. A majority of users attend dance clubs, parties, or rave parties. Recent data indicate that body builders, exotic dancers, strippers and some professional athletes are also frequent users of this drug. Recent seizures indicate that professional business men also consume the drug for sleep. In addition, the gay and lesbian population also uses GHB on an increasing basis.
GHB is available as a liquid, powder, tablet and or capsule. It is colorless, odorless and has a salty taste. It is generally swallowed as a pill. The physiological effects of GHB occur within a few minutes after taking it by mouth. The duration of GHB’s actions usually last between six to eight hours.
GHB has the street names Georgia Home Boy, Liquid Ecstasy (though it is not the liquid form of ecstasy), Easy Lay, Gamma-Oh, Salty Water and Scoop.
Side Effects of GHB
In low doses GHB is a CNS depressant and has similar effects like alcohol. It can induce a sense of calm, relieve anxiety and cause generalized relaxation. When combined with alcohol and other CNS depressants, it can cause severe lethargy, mental confusion, coma and even breathing difficulties
Other adverse effects of GHB use include:
- Loss of peripheral vision
- Unconsciousness and coma
Overdose can and does occur in individuals who consume GHB. At high doses and especially in combination with alcohol, respiratory depression and coma can occur rapidly. A number of deaths have been reported from GHB overdose.
Tolerance and Dependence
Even short term use of GHB is associated with the development of dependence. When GHB is abruptly stopped, the individual may develop:
- Profuse sweating
- Anxiety attacks
- Blood pressure increases
- Fast heart rate
These symptoms persist for a few days and in many cases require a benzodiazepine for relief. The symptoms may subside on their own after two or three days or in response to medication. Unlike other club drugs, GHB withdrawal symptoms also occur on a delayed basis or second phase symptoms. In the delayed phase of withdrawal the individual may have extreme mental clouding, anxiety, confusion and paranoia. The second phase of withdrawal usually lasts another 2-4 days and may require drug treatment.
GHB DETOXIFICATION PROTOCOLS
Treatment of the GHB withdrawal syndrome is empirical and no standard protocols have yet been devised. However, most treatment centers have utilized benzodiazepines, anti-seizure medications and sedative to help with the detoxification/withdrawal symptoms. In addition, it is highly recommended that medications to control the blood pressure be available because of the extreme levels of BP that can occur. Most individual studies indicate that detoxification is a lot safer with the use of antipsychotic medications.
It is also recommended that GHB detoxification be done as an inpatient, so that the individual can be carefully monitored. Most detoxification programs ensure that the individual is slowly tapered of GHB to help reduce the symptoms of withdrawal during detoxification. A number of fatalities have occurred when GHB has been abruptly stopped because GHB withdrawal symptoms may be severe and unpredictable. The help of an addiction specialist is highly recommended during the detoxification procedure. The detoxification program usually takes 10-14 days.
Post Detoxification Treatment
GHB withdrawal is comparatively new to the medical field. Withdrawal is often hazardous and even life threatening. Seeking medical attention from an experienced physician is highly recommended. Even after detoxification, multiple relapses are common in the majority of GHB addiction cases. Sleeping difficulties, depression and anxiety usually require some form of medical therapy. Work with a multidisciplinary group is essential to prevent relapses.