Gamma-Hydroxybutyric Acid (GHB)

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What is it?

Basically, it is a degreasing solvent or floor stripper, mixed with drain cleaner. It also happens to be a central nervous system depressant (a designer drug) that was available over-the-counter in health food stores during the 1980s who sold it as a 'safe' alternative to steroids, until it emerged as a serious health issue and was taken off the shelves in 1992. A number of GHB-related deaths in combination with its addiction potential led to it being made illegal in 1999.

People talking about GHB can be referring to a number of substances. These substances have a similar chemical structure and effect on humans. They are:

• 1,4-butanediol (1,4-B)
• gamma-butyrolactone (GBL)
• gamma-aminobutyric acid (GABA)
• sodium oxybate

What Are the Common Street Names?

GHB, Grievous Bodily Harm, Rinse, Fantasy, Liquid Ecstasy.

How Is It Used?

GHB is a colourless, odourless liquid that abusers drink. It looks just like water. It can also come in powder and capsule form however this is not as common. It is known for its ability to induce a short (several hour) coma-like sleep at high doses, which is why it became known as a date-rape drug.

What Are the Common Effects?

Before we look at the damage GHB can do, let's have a look at reality. For some people, within minutes of taking GHB, it makes them feel good. An abuser may notice a high or pleasurable sensations, reduced inhibitions, talkativeness and drowsiness, and then the drug is metabolised and broken down into carbon dioxide and water within five hours, causing the release of dopamine. The unseen effects on the body carry on long into the next day, and for some people even weeks later. Abuse of the drug can lead to elevated levels of dopamine (the "feel good" chemical) the next day leading people to think it's a health food.

Is GHB Addictive?

Here's the thing: Once dopamine starts flowing, a user feels the urge to use GHB again, and then again, and then again. Repeated use could lead to addiction, and addiction is a brain disease.

GHB can produce withdrawal symptoms in some people after more than a few days of consecutive use. Symptoms can include edginess, chest pain and tightness, muscle and bone aches, sensitivity to external stimuli (sound, light, touch), confusion, depression, anxiety, trouble sleeping, intense fear, the inability to enjoy anything and mental dullness.

In regular abusers, some of these side effects can last for days or weeks after taking GHB, as the drug has altered their brain chemistry. This can make coming off the drug very difficult, as the person feels the only thing that will make them feel better is having more GHB, and the combination of mental habituation and physical withdrawal symptoms can lead to heavy use with great difficulty stopping.

Long Term Effects

As yet, there is little research available on the effects of GHB on the long-term effects on the body. However it has been around long enough for people to start to report the damaging effects of regular high abuse of this drug. Trinka Porrata, of Project GHB says "As I continue my extensive research on GHB, the news only gets worse. For so long the info was that this isn't an addictive drug and no big deal. Now it is readily apparent that it is highly addictive and, worse yet, getting off of it is tougher than many other drugs. Addicts stand by---you are looking at two weeks in intensive care to shake it. Going into a regular drug withdrawal program without a doctor specifically experienced in GHB is dangerous. I recently interviewed a man who takes 20-30 capfuls per day just to MAINTAIN. He gets no buzz from that dosage. But anything less sends him into the violent shakes and horrible withdrawal pains associated with this drug."

Other Effects On the Body

Each of the GHB-related substances converts into GHB in the human body. GHB also occurs naturally in the human body, however there is a big difference between something produced naturally and needed by the body, and a synthetic drug created in a science lab and abused for its mood altering effects. Scientists have not yet discovered the exact function of the naturally occurring GHB.

Effects On the Mind

GHB has been shown to affect many neurotransmitter systems in our brain, but most notably, dopamine, glutamate and acetylcholine1. Dopamine is the neurotransmitter that is responsible for giving us a feeling of pleasure. Glutamate is a major stimulatory neurotransmitter in the brain involved with excitement and acetylcholine has an excitory effect on neurons and is associated with memory and learning.

GHB use alters the natural functioning of the brain, and can result in confusion, depression, sleep problems, intense fear, and anxiety. In regular abusers, some of these side effects can last for days or weeks after taking GHB.

Dangers

Even a small dose of GHB can produce short-term amnesia and a coma-like sleep. They may also feel dizzy and have reduced co-ordination due to reduced muscle tone (to other people they can appear to look drunk). Mixed with alchohol it is extremely dangerous.

The same dose can affect different people in different ways - for example, a euphoric dose for one person could sedate another person. In the last 2-3 years in New Zealand, there have been an increasing number of people admitted to accident and emergency departments who have had life threatening overdoses. Higher doses might produce general anaesthesia, can stop people breathing and produce seizures, spasms and coma.

References

1. Castelli MP, Ferraro L, Mocci I, Carta F, Carai MA, Antonelli T, Tanganelli S, Cignarella G, Gessa GL. Selective gamma-hydroxybutyric acid receptor ligands increase extracellular glutamate in the hippocampus, but fail to activate G protein and to produce the sedative/hypnotic effect of gamma-hydroxybutyric acid. J Neurochem. 2003 Nov. 87(3):722-32.
2. [Chin and Kreutzer, 1992]
3. Other information obtained from www.erowid.org and www.projectghb.org/what_is_ghb.htm