GHB

Overview

Contrary to popular belief, GHB (gamma-hydroxybutyrate) is not a newly-discovered designer drug. It is actually a natural product of human metabolism. It is a carbohydrate found in abundance in our diet as animal meat contains GHB, as does wine and small citrus fruits. It is also biologically synthesized from GABA (gamma-aminobutyric acid), an amino acid that is structurally similar to GHB.

When artificially synthesized, GHB takes the form of a clear liquid or a white, crystalline powder much like table salt. In the U.S., GHB is only available through prescription from compounding pharmacies.

It is sometimes called “G” or “liquid ecstasy” and is popular among the party crowd at clubs or raves, who use it for its euphoric and sedative effects.1 Combined with free-flowing alcohol at these parties, GHB has become a major “weapon” against women (and sometimes even men) who unwittingly ingest GHB through their unattended drinks, hence it’s other nickname, “date rape drug”. The illicit recreational use of GHB in the United States has been steadily increasing since the mid-1990s, made possible by local production activities by underground laboratories.

Screening Cut-off and Detection Time

In drug screening, the cut-off level is that point which separates a negative and a positive test result. Screening cut-off levels are established where drug detection is optimized with the least probability for false positives. It is important to remember that a negative sample does not necessarily mean that it is drug-free, only that it contains a drug at a concentration that is below the established cut-off.

Cut-off Level (GC/MS) Detection Time
Urine 5mg/L < 12 hours after dosing

DEA Drug Class

GHB for non-medical use is classified under Schedule I of the Controlled Substances Act which lists drugs. When used as prescribed for therapeutic purposes (sodium oxybate), it is a Schedule III substance.Schedule I substances or chemicals are those that:

  • have a high potential for abuse;
  • have no currently accepted medical/therapeutic use in the U.S.;
  • lack an accepted “safe-to-use” under medical supervision.

Drugs under this class are considered dangerous and no prescriptions may be written for them as they are for clinical use. Other examples of drugs that fall under Schedule I include:

Drug Type

GHB (gamma-hydroxybutyrate) is a CNS depressant. These drugs are also called “downers”, sedatives or tranquilizers. They slow down brain activity, inducing a state of relaxation. Depressants are prescribed for the treatment of anxiety and sleep disorders. The 3 major groups of depressants are benzodiazepines (Valium, Xanax), non-benzodiazepine sleep meds (Ambien, Lunesta, Sonata) and barbiturates (Luminal Sodium, Mebaral, Nembutal)

Forms and Routes of Administration

GHB is odorless and colorless but has a slight soapy or salty taste to it. It may be easily combined with alcohol and given to unsuspecting victims prior to being taken advantage of. It comes in the form of a tablet, capsule, white powder or clear liquid that looks like water and sold in small vials.

All of these forms of GHB are administered orally, typically by dissolving or mixing into a drink. The powder form can also be snorted or dissolved in liquid and injected. GHB typically takes from 10-20 minutes to take effect, and depending on the dose, can last up to 4 hours.

Brand Names

  • Alcover (Italy)
  • Anetamin
  • Gamanest
  • Gamma-OH (Europe)
  • Gioron
  • Somsanit
  • Xyrem (U.S., Canada)

Uses of GHB

Medical Uses

In the United States:

  • Treatment of cataplexy (Xyrem)

In Europe:

  • General anesthetic
  • Hypnotic agent
  • Treatment for insomnia
  • Aid to childbirth (enhancing dilation of the cervix)
  • Anti-anxiety/anti-stress/anti-depressant
  • Treatment for narcolepsy
  • To suppress symptoms of alcohol dependence
  • To help manage symptoms of opiate withdrawal syndrome

Recreational Uses

  • Increased sex drive/enhanced sensuality
  • As an alternative to anabolic steroids9
  • Euphoria
  • Increased sociability/ Reduced inhibitions
  • Positive mood changes
  • Tranquility/Relaxation
  • Sedation and/or loss of consciousness (for those whose objective is to take advantage of another person)

Street Names

  • Blue nitro
  • Great Hormones at Bedtime
  • Oxy-sleep
  • Cherry fX bombs
  • Grievous Bodily Harm
  • Poor man’s heroin
  • Cherry Meth
  • G-riffick
  • Remforce
  • Easy Lay
  • Growth hormone booster
  • Revivarant
  • Ever Clear
  • Insom-X
  • Salty Water
  • Fantasy
  • Invigorate
  • Scoop
  • Firewater
  • Jib
  • Sleep
  • G
  • Lemon fX drops
  • Soap
  • G.H. revitalizer
  • Liquid E
  • Somatomax
  • Gamma G
  • Liquid ecstasy
  • Somatomax PM
  • GBH
  • Liquid X
  • Somsanit
  • Georgia Home Boy
  • Longevity
  • Vita G
  • GHB
  • Natural sleep-500
  • Water
  • Gib
  • Nature’s Quaalude
  • Wolfies
  • Goops
  • Orange fX rush
  • Zonked
  • Organic Quaalude

Effects

GHB occurs naturally in the central nervous system and peripheral tissue. It is also a minor metabolite and gamma aminobutyric acid (GABA) precursor. Depending on the dose, GHB alters dopamine activity in the brain:

  • At anesthetic doses, GHB blocks the flow of impulse from dopamine neurons, causing them to build up in the nerve terminals.
  • Below anesthetic doses, dopamine neurons get excited and produce increased levels of synaptic dopamine.
  • GHB imitates natural sleep state, enhances REM sleep and increases stage 3 & 4 of slow-wave sleep.
  • With at least 3-gram doses, GHB causes an increase in growth hormones and the concentration of prolactin, which many body builders believe is beneficial to them despite there being no actual evidence of body mass increase.

Short-Term Effects

  • Aggressive behavior
  • Amnesia
  • Auditory and visual hallucinations
  • Coma
  • Confusion
  • Death
  • Depression
  • Dizziness/Vertigo
  • Drowsiness
  • Exhaustion
  • Hallucinations
  • Headaches
  • Impaired judgment
  • Loss of consciousness
  • Loss of coordination/clumsiness
  • Lowered blood pressure
  • Nausea & vomiting
  • Respiratory distress/trouble breathing
  • Seizures
  • Slowed heart rate
  • Sluggishness
  • Sweating

Long-Term Effects

Long-term GHB use whether under medical supervision or recreational in nature can lead to the following symptoms:

  • Amnesia
  • Cardiovascular collapse
  • Extreme anxiety
  • Hallucinations
  • Headaches
  • Mouth sores and infections
  • Muscle pain
  • Poor concentration
  • Respiratory depression
  • Seizures
  • Slurred speech

Dependence

When used repeatedly, GHB has a high addictive potential. Severe and incapacitating withdrawal effects may include:

  • Anxiety
  • Insomnia
  • Tremors
  • Excessive sweating

There is little information available on treatment options for GHB addiction, as it is with other club drugs. However, the severe withdrawal symptoms upon detox typically require close medical supervision/hospitalization. Memory loss is a common complication of treatment, often resulting in relapse.

History

It was Russian chemist Alexander Zaytzev who first reported about the endogenous substance, gamma-hydroxybutyrate (GHB) but it wasn’t until the 1960s that Dr. Henri Laborit actually began clinical research about it. In 1963 it was discovered that GHB occurs naturally in the human brain. Throughout the 1960s GHB was initially used as an anesthetic, as a treatment for alcohol withdrawal and as an anti-ulcer agent. In Italy, France and other European countries GHB was widely used as an anesthetic in childbirth and as a sleeping agent.2

In the 1970s, they began studying the use of GHB in the treatment of narcolepsy-associated cataplexy and hypersomnia and found it to be actually effective but for its euphoric side-effects.

In the 1980s GHB began to be marketed as a muscle developer and fat burner, causing a spike in its popularity. Soon after, the risks of abuse began to surface and more than 30 documented reports of GHB-linked illnesses compelled the FDA to declare GHB unsafe and ordered its removal from store shelves, limiting access to it by non-medical users. In response to this ban, GHB manufacturers turned to its precursors GBL and BD and sold them as sleep aids and muscle enhancers.1 It was around this time that GHB started earning its reputation as a party drug for its euphoric aphrodisiac effects. GHB abuse has escalated such that the FDA federally banned the drug in 2000 making it a Schedule I substance.

Still, further research into the drug showed how effective it truly was in producing significant and long-term improvements in cases of cataplexy and daytime sleepiness. This led to the 2002 FDA approval of the sodium salt form of GHB, sodium oxybate, for the treatment of narcolepsy with cataplexy. The brand name for this drug in the U.S. is Xyrem.