What is GHB?

History of Use

Russian chemist Alexander Mikhaylovich Zaytsev first reported the synthesis of GHB (gamma-hydroxybutyric acid) in 1874. French scientist Henri Laborit performed some of the first GHB research in the 1960s. In the late 1980s and 1990s, GHB was sold over-the-counter in the United States as a body-building supplement and sleep aid. Increased incidents of GHB intoxication moved the US Centers for Disease Control and Prevention (CDC) and the US Food and Drug Administration (FDA) to issue warnings regarding its potential dangers.

In the late 1990s, GHB was used in several highly publicized drug-facilitated cases of sexual assault. Because of this, people labeled GHB a “date rape” drug. Because illicit formulations of GHB are commonly colorless, odorless liquids, surreptitious addition of GHB to drinks in bars and clubs is difficult to detect. Also, several GHB side effects (sedation, euphoria, decreased inhibitions, enhanced sex drive, and mild amnesia) enhance its effectiveness in drug-facilitated cases of sexual assault. In 2000, the FDA placed Xyrem on the list of schedule III controlled substances and listed nonmedical GHB as a schedule I controlled substance.

Also during the 1990s, GHB became widely used as a club drug
. Club or party drugs are used by people who attend nightclubs, raves, and circuit parties. These drugs include methamphetamine, 3,4-methylenedioxymethamphetamine (MDMA, or ecstasy), lysergic acid diethylamide (LSD, or acid), and ketamine (special K). GHB, ecstasy, and ketamine are frequently used together, also in combination with alcohol, marijuana, and amphetamines.

The popularity of GHB as a club drug is largely due to the ease of its synthesis and its low cost. GHB is quite popular in dance clubs for persons younger than age twenty-one years, where alcohol is not sold; however, the youth in these clubs can drink water or other nonalcoholic beverages spiked with GHB. Club drugs related to GHB include gamma-butyrolactone (GBL) and 1,4-butanediol, both of which are liquids and found in paint strippers and varnish thinners. These chemicals are known as GHB “prodrugs” because they are converted to GHB by the body after ingestion.

Effects and Potential Risks

In the brain, cells called neurons generate and propagate nerve impulses. GHB exerts its effects by binding to specific receptors on the surfaces of neurons. GHB binds to the GABAB and GHB receptors. When it binds the GABAB receptor, GHB causes sedation. Conversely, binding of the GHB receptor increases the release of the neurotransmitter glutamate, which is the principal excitatory neurotransmitter in the brain. Simultaneous activation of both the GHB and GABAB receptors at low GHB concentrations induces the release of the neurotransmitter dopamine
in the ventral tegmental area (VTA). The VTA is one of the key reward regions of the brain, and dopamine release in the VTA produces a feeling of pleasure or satisfaction and is the reason for the addictive nature of GHB.

GHB induces sleep by binding GABAB receptors in the thalamo-cortical loop, which regulates sleep and arousal. Because GHB binds to the GHB receptor much more tightly than the GABAB receptor, decreases in the bodily concentration of GHB increase its stimulatory effects relative to its sedative effects. This causes people who have taken GHB to awaken abruptly after a particular time.

The effects of GHB are dose related. At 10 milligrams per kilogram body weight (mg/kg), GHB depresses the central nervous system and causes a general sense of calm and relaxation. GHB doses of 20 to 30 mg/kg induce sleep for two to three hours. A dose of 40 to 50 mg/kg induces even longer periods of sleep, but also causes amnesia, nausea and vomiting, dizziness, weakness, loss of peripheral vision, confusion, hallucinations, agitation, and low heart rate (bradycardia). Doses above 50 mg/kg cause seizures, unconsciousness, respiratory depression, and coma. GHB effects appear within fifteen minutes of oral ingestion, but the acute symptoms cease after seven hours.

Combining GHB with alcohol increases depression of breathing and can cause death. GHB is rather addictive, and long-term use can cause depression and suicidal tendencies. Between 1995 and 2005 in the United Kingdom, the United States, and Canada, there were 226 GHB-related deaths.

Bibliography

Abadinsky, Howard. Drug Use and Abuse: A Comprehensive Introduction. 8th ed. Belmont: Wadsworth, 2013. Print.

Drug Enforcement Administration. "GHB." Drugs of Abuse, 2015 Edition. US Dept. of Justice, 2015. PDF file.

Gahlinger, Paul. Illegal Drugs: A Complete Guide to Their History, Chemistry, Use, and Abuse. New York: Plume, 2003. Print.

Grim, Ryan. This Is Your Country on Drugs: The Secret History of Getting High in America. Hoboken: Wiley, 2010. Print.

Kuhn, Cynthia, Scott Swartzwelder, and Wilkie Wilson. Buzzed: The Straight Facts about the Most Used and Abused Drugs from Alcohol to Ecstasy. Rev. 4th ed. New York: Norton, 2014. Print.