Gamma Hydroxy Butyrate Usage, Effects and UK Prices

1.2 GHB was originally described as an anaesthetic and widely-used in Italy, particularly for obstetric operations, maxillofacial or laryngial surgery Lane considered GHB to be a "valuable and safe paediatric anaesthetic". However, GHB is not currently licenced for medical use in the UK.

2.3 The vast majority of those who had used GHB had done so experimentally or had stopped using the drug. Fifteen individuals stated they continued to use occasionally or more often, three on a regular and one on a daily basis. The drug was not popular among users as a whole, with a low subjective rating (2.45 on a scale of 0 to 10).

2.4 GHB is not normally a drug used by naive drug users, most users will have tried many other drugs before experimenting with GHB, the peak ages of initiation falling in young adulthood.

2.5 The relatively wide spread of initiation ages is consistent with the relatively recent arrival of GHB on the club-scene. Very few individuals had used the drug prior to 1993.

3.1 At low doses, GHB encourages a reduction of social inhibitions, similar to alcohol, euphoria, and increased libido. Higher doses lead to feelings of sedation, and can cause symptoms including vomiting, drowsiness, dizziness, vertigo, and seizures. After excessive use, some users have experienced loss of consciousness, irregular and depressed respiration, tremors, or coma. Cole reported intravenous dosages of 60-70mg/kg to be sufficient to induce anaesthesia in healthy patients, whereas up to 200mg/kg are needed in laboratory animals. Greenblatt reported "GHB is being marketed in England as an anti-aging medicine which allegedly increases the libido, decreases body fat, aids alcohol withdrawal, and induces sleep." Gallimberti reported therapeutic uses for the treatment of alcohol withdrawal.

3.2 A number of deaths have been attributed to recreational GHB use. A total of 69 poisonings and one death were reported in New York & Texas by the Centre for Disease Control (CDC). One 17 year old girl who died of cardiac arrest was found to have 27mg/l of GHB in her blood. "Of the 56 reports from the poison control centers, 34 involved males; 10 reports involved teenagers aged 16-18 years. Nineteen persons were treated in and re-leased from hospital EDs, and 25 were admitted to intensive-care units with severe clinical symptoms, including coma (15), respiratory depression (three), and agitation (one); six required intubation. Of the 56 reports, 12 included ingestion of both alcohol and GHB, and three included the use of GHB with other drugs." They also warned of the dangers of illicit GHB preparations "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."

3.3 Vayer et al reported the symptoms of acute GHB toxicity to include "coma, seizures, respiratory depression, and vomiting... 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." A Hungarian paper reported respiratory paralysis, whereas Miglani et al reported a case of GHB withdrawal delirium.