GHB Drug Information

Gamma-HydroxyButyric Acid (GHB)

Classification

GHB was first developed as an anesthetic, but was discontinued for this use due to its adverse and unpredictable effects. However, GHB is readily available and used in Europe as a sedative. The salt form of GHB has been marketed in gymnasiums and health food stores for the past few years as a steroid alternative for body-building and as a tryptophan replacement for sedation. There have also been increasing reports of GHB being used recreationally as a euphoriant at "rave" type parties. As typically follows, there have also been reports of GHB being associated with sexual assault or as a "date rape" drug due to its severe hypnotic and sedative effect at higher dosages.

Metabolism

GHB is thought to be extensively metabolized by alcohol dehydrogenase and/or succinic semialdehyde dehydrogenase. Metabolic precursors to GHB, gamma-butyrolactone (GBL) and 1,4 butanediol are also readily available as substances of abuse. Endogenous GHB is also a product of GABA metabolism, and concentrations of 0 – 6.6 mg/L have been reported. Oral doses of approximately 2.5 g (I teaspoon of GHB powder) dissolved in water, produced urine GHB concentrations of 29 mg/L in a 100 kg man. Studies also indicate peak urine GHB concentrations of 100 mg/L following a 100 mg/kg oral dose, and no detectable drug in the urine by 12 hours. Less than 5% of an oral dose is eliminated unchanged in urine. To distinguish between endogenous and exogenous GHB, a reporting cutoff of 10 µg/mL is suggested.

Abuse

Typical illicit use of GHB involves dissolving 2 – 3 grams of powder in water or other beverages. Onset of effects occur within 10 – 30 minutes of ingestion and include euphoria, increased libido, drowsiness, reduced inhibitions, dizziness, nausea and may persist for 2 – 5 hours. Toxic effects include hypotension, respiratory depression, seizure, unconsciousness, and coma. Deaths have been reported when GHB is used alone or in conjunction with ethanol, heroin, or ketamine. The California Department of Health Services and the Food and Drug Administration (FDA) banned over-the-counter sales of GHB in 1990 and GHB is currently classified as Schedule I by the federal Controlled Substances Act.

Laboratory drug testing: Methods of Analysis

Determination of gamma-hydroxybutyric acid (GHB), also known as liquid Ecstasy, in human samples is challenging. Due to the small size of GHB, immunological testing is very difficult and limited immunoassays are available for screening. GHB detection in urine relies on specific chromatographic methods such as gas chromatography/mass spectrometry (GC/MS) or liquid chromatography/tandem mass spectrometry (LC/MS/MS). RTL's test utilizes GC/MS for the direct analysis of GHB from urine after liquid-liquid extraction and silyl-derivatization. Compared to existing methods, this method is superior because it is specific to GHB without conversion to gamma-butyrolactone (GBL).


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Drug information data is not definitive and should be used for reference guidelines only.