Podcast
Questions and Answers
What is the primary legal medical use of GHB?
What is the primary legal medical use of GHB?
- Treatment for narcolepsy (correct)
- Treatment for anxiety disorders
- Pain relief for surgery
- Management of diabetes
Which of the following is a common form in which GHB is sold?
Which of the following is a common form in which GHB is sold?
- Opaque cream
- Dark powder
- Clear and colorless liquid (correct)
- Solid tablet
What substance do users often turn to as an alternative to GHB after it became illegal?
What substance do users often turn to as an alternative to GHB after it became illegal?
- GBL (correct)
- Caffeine
- Methamphetamine
- Nicotine
What does GBL convert to within the body?
What does GBL convert to within the body?
What is the potential risk associated with high doses of GHB?
What is the potential risk associated with high doses of GHB?
Which product is NOT a source of GBL?
Which product is NOT a source of GBL?
What is 1,4-butanediol commonly known as?
What is 1,4-butanediol commonly known as?
Which of the following terms is NOT used as a name for GHB?
Which of the following terms is NOT used as a name for GHB?
What is a potential consequence of GHB withdrawal lasting two weeks or longer?
What is a potential consequence of GHB withdrawal lasting two weeks or longer?
Which of the following symptoms are associated with GHB withdrawal?
Which of the following symptoms are associated with GHB withdrawal?
What dangers are associated with GHB overdose?
What dangers are associated with GHB overdose?
What can daily use of GHB lead to?
What can daily use of GHB lead to?
What is the typical form of overdose seen with GHB?
What is the typical form of overdose seen with GHB?
What was one of the initial medical applications studied for GHB?
What was one of the initial medical applications studied for GHB?
Why did GHB lose popularity as an anesthetic?
Why did GHB lose popularity as an anesthetic?
What medical condition was GHB approved to treat in 2002?
What medical condition was GHB approved to treat in 2002?
What is the trade name under which GHB is sold as a prescription medication?
What is the trade name under which GHB is sold as a prescription medication?
How did bodybuilders misconceive GHB's effects?
How did bodybuilders misconceive GHB's effects?
What classification did the DEA assign to GHB on March 13, 2000?
What classification did the DEA assign to GHB on March 13, 2000?
What effect of GHB contributed to its popularity as a sleep aid?
What effect of GHB contributed to its popularity as a sleep aid?
What concern arose from GHB's use in dance clubs?
What concern arose from GHB's use in dance clubs?
What happens to BD when ingested?
What happens to BD when ingested?
What enzyme metabolizes BD?
What enzyme metabolizes BD?
What is the original purpose for synthesizing GHB?
What is the original purpose for synthesizing GHB?
How does GHB interact with dopamine at high doses?
How does GHB interact with dopamine at high doses?
Which receptors does GHB primarily bind to?
Which receptors does GHB primarily bind to?
Where in the brain is GHB most prominently active?
Where in the brain is GHB most prominently active?
What is a consequence of taking BD with alcohol?
What is a consequence of taking BD with alcohol?
What is the relationship between GABA and GHB in the body?
What is the relationship between GABA and GHB in the body?
What is a potential consequence of taking excessive doses of GHB?
What is a potential consequence of taking excessive doses of GHB?
What symptoms can be experienced at moderate doses of GHB?
What symptoms can be experienced at moderate doses of GHB?
How does GHB affect respiratory function?
How does GHB affect respiratory function?
What effect can combining GHB with alcohol or other drugs have?
What effect can combining GHB with alcohol or other drugs have?
What is a characteristic ECG finding in many GHB users?
What is a characteristic ECG finding in many GHB users?
Which of the following symptoms indicates a severe impairment due to high doses of GHB?
Which of the following symptoms indicates a severe impairment due to high doses of GHB?
What is a possible long-term consequence of severe GHB overdose?
What is a possible long-term consequence of severe GHB overdose?
What happens to breathing after GHB is mixed with alcohol?
What happens to breathing after GHB is mixed with alcohol?
What is a potential effect of poorly mixed GHB?
What is a potential effect of poorly mixed GHB?
What serious health risk is associated with mixing GHB/GBL with alcohol or opioids?
What serious health risk is associated with mixing GHB/GBL with alcohol or opioids?
Which substances can cause unpredictable effects when combined with GHB/GBL?
Which substances can cause unpredictable effects when combined with GHB/GBL?
How long can GHB be detected in urine after ingestion?
How long can GHB be detected in urine after ingestion?
What condition might develop from using GHB/GBL to alleviate the come down from stimulants?
What condition might develop from using GHB/GBL to alleviate the come down from stimulants?
What is a potential consequence of contamination in homemade GHB?
What is a potential consequence of contamination in homemade GHB?
What is a common withdrawal symptom for those dependent on GHB?
What is a common withdrawal symptom for those dependent on GHB?
Which of the following statements about the effects of GHB/GBL is false?
Which of the following statements about the effects of GHB/GBL is false?
Flashcards
What is GHB?
What is GHB?
A depressant drug that can lead to coma and death in high doses.
What is Sodium Oxybate (Xyrem)?
What is Sodium Oxybate (Xyrem)?
A drug that is prescribed for narcolepsy and has also been used to treat addiction to alcohol and opiates.
What are some other names for GHB?
What are some other names for GHB?
Common slang names for GHB.
How is GHB usually sold?
How is GHB usually sold?
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What is GBL?
What is GBL?
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Where is GBL found?
Where is GBL found?
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What is BD (1,4-butanediol)?
What is BD (1,4-butanediol)?
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Why is the use of GBL as an herbal remedy dangerous?
Why is the use of GBL as an herbal remedy dangerous?
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GHB's initial use in medicine
GHB's initial use in medicine
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GHB's popularity as a sleep aid
GHB's popularity as a sleep aid
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GHB's misuse in the US
GHB's misuse in the US
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GHB's association with party life
GHB's association with party life
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GHB's legal status
GHB's legal status
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GHB's FDA approval
GHB's FDA approval
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GHB's current medical applications
GHB's current medical applications
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GHB's potential dangers
GHB's potential dangers
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What is Butyrate (BD)?
What is Butyrate (BD)?
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What is Alcohol Dehydrogenase?
What is Alcohol Dehydrogenase?
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What is the origin story of GHB?
What is the origin story of GHB?
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What are the Chemical Characteristics of GHB?
What are the Chemical Characteristics of GHB?
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How is GHB naturally produced in the body?
How is GHB naturally produced in the body?
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How does GHB work in the brain? (MOA)
How does GHB work in the brain? (MOA)
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What is the effect of GHB on Dopamine?
What is the effect of GHB on Dopamine?
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Where are GHB binding sites in the brain?
Where are GHB binding sites in the brain?
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What is the main effect of GHB on consciousness?
What is the main effect of GHB on consciousness?
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How does GHB affect the heart?
How does GHB affect the heart?
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How does GHB affect breathing?
How does GHB affect breathing?
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How quickly can GHB cause unconsciousness?
How quickly can GHB cause unconsciousness?
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What is the effect of a moderate dose of GHB?
What is the effect of a moderate dose of GHB?
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What happens after ingesting a high dose of GHB?
What happens after ingesting a high dose of GHB?
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Why is mixing GHB with other drugs dangerous?
Why is mixing GHB with other drugs dangerous?
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How long does the effect of GHB typically last?
How long does the effect of GHB typically last?
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What are some common symptoms of GHB withdrawal?
What are some common symptoms of GHB withdrawal?
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Can GHB cause addiction?
Can GHB cause addiction?
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What are the dangers of GHB overdose?
What are the dangers of GHB overdose?
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What are the potential risks of GHB use?
What are the potential risks of GHB use?
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GHB Burns
GHB Burns
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GHB and Bowel Movements
GHB and Bowel Movements
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GHB Contamination
GHB Contamination
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Mixing GHB/GBL with Depressants
Mixing GHB/GBL with Depressants
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GHB/GBL and Stimulants
GHB/GBL and Stimulants
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GHB and Nitrous Oxide
GHB and Nitrous Oxide
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GHB Detection
GHB Detection
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GHB Withdrawal
GHB Withdrawal
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Study Notes
GHB Overview
- GHB, gamma-hydroxybutyric acid, is a depressant drug, recently added to the list of illegal substances.
- High doses can cause a coma-like state leading to fatalities.
- It's available as sodium oxybate (Xyrem) as a treatment for narcolepsy in adults.
- Also used therapeutically for alcohol and opiate dependency.
- Other names include cherry meth, scoop, eclipse, fantasy, growth hormone booster, liquid ecstasy.
GHB Outline
- GHB is a depressant.
- High doses are dangerous and can cause fatalities.
- GHB is available as sodium oxybate (Xyrem).
- It has been used therapeutically to treat narcolepsy, alcohol and opiate dependence.
- There are various street names for GHB, making identification difficult.
GHB Appearance
- GHB is often sold as a liquid or a white powder dissolved in liquids like water, juice, or alcohol.
- Liquid GHB is usually clear and colorless, with a slightly salty taste.
- GHB in liquid form is often packaged in small vials or water bottles.
GBL and BD as Alternatives
- When GHB became illegal, users switched to related substances with similar effects.
- GBL, gamma-butyrolactone, is a prodrug of GHB and converts to GHB in the body.
- GBLs can be found in cleaning products, nail polish, and glues.
- It quickly became popular as an herbal remedy.
- One example is Tom Gugliotta, an NBA player who almost died due to improper use of GHB.
BD (1,4-Butanediol)
- BD-1,4-butanediol is an industrial solvent that converts to GHB in the body.
- When ingested, it's quickly converted into GHB.
- Alcohol dehydrogenase metabolizes both alcohol and BD; combining them increases the effect, potentially damaging the liver or kidneys.
GHB History
- GHB was first synthesized in France in 1960 by Dr. Henri Laborit, a researcher seeking a better anesthetic.
- Laborit was inspired by GABA (gamma-aminobutyric acid) as the major inhibitor in the central nervous system and believed GHB could mimic its effects.
- GHB's chemical structure is similar to GABA, allowing it to penetrate the brain, although GABA is not directly produced by the body from GHB
- This chemical similarity is important because it affects mood, behavior and more.
GHB: Chemical Characteristics and Mechanism of Action (MOA)
- GHB is a simple substance chemically similar to the neurotransmitter GABA.
- Naturally found in animal & human bodies. It can be a byproduct of breaking down GABA or reformed back into GABA.
- It's also made from naturally-occurring GBL in the body.
- GHB binds to GABA-B receptors, interfering with dopamine transmission, hindering noradrenaline release in the hypothalamus, and mediating the release of an opiate-like substance in the striatum.
GHB MOA (continued)
- GHB produces a biphasic dopamine response, increasing release at high doses and inhibiting it at lower doses.
- Binding sites for GHB are present in areas crucial for memory formation (hippocampus).
GHB Medical Uses
- In 2002, the FDA approved GHB (renamed sodium oxybate, and scheduled under Schedule III) for narcolepsy treatment under the trade name Xyrem.
- It's still used in Europe for general anesthesia, sleep aid, anxiety, and stress relief.
- Also often used as a treatment for alcohol and opiate addiction and withdrawal.
- It has shown promise in aiding the process of childbirth, especially in cases of anxious mothers.
GHB Administration & Dosage
- Often consumed by dissolving the powder in water or juice.
- Typical doses range from 1-3 grams.
- Some users take larger doses (4-5 grams), often leading to tolerance.
Pharmacokinetics (PK)
- GHB is rapidly absorbed, especially on an empty stomach, reaching maximum blood concentration in 20-30 minutes.
- The major effects last for 1-2 hours, followed by a period of subtle effects lasting around two hours.
- The elimination half-life is 27 minutes, meaning GHB is metabolized to carbon dioxide and exhaled.
Effect on Central Nervous System (CNS)
- GHB similarly impacts the CNS, like alcohol or MDMA (often referred to as "liquid ecstasy" or "liquid X").
- Initial effect is often euphoria, quickly followed by a rapid decline in consciousness.
- Overdoses can result in unconsciousness, leading to a coma, or respiratory arrest.
- Mild symptoms include drowsiness, blurred vision, dizziness.
- Coma, respiratory failure, and death are serious consequences.
GHB Effects on Heart & Lungs
- Studies show that GHB can cause ECG abnormalities, possibly arising from altered blood potassium levels that strongly affect the heart.
- GHB slows & deepens respiration, with effects lasting up to five hours when combined with alcohol or other drugs.
- Overdose can severely slow breathing or even stop breathing entirely.
Other Effects
- Concentrated GHB can cause caustic burns to the lips and mouth, and poorly mixing it can create the same problem.
- There's a high risk of GHB contamination with substances like solvents, heavy metals, or polyester derivatives, all potentially toxic.
Mixing GHB/GBL with other Drugs
- Mixing GHB/GBL with other drugs can cause unpredictably harmful side effects.
- Examples include: Increased risk of heart strain and respiratory arrest with MDMA/methamphetamine.
- Combining GHB/GBL with nitrous oxide can lead to coordination issues and loss of consciousness.
- Use with alcohol, opioids, ketamine, or benzodiazepines puts individuals at high risk of breathing difficulty, loss of consciousness, and even death.
GHB Testing
- GHB can be detected in urine and blood using gas chromatography-mass spectrometry.
- Test results will show positive for 4-8 hours in blood, and up to 12 hours in urine.
GHB Withdrawal Signs
- GHB dependence can make stopping use difficult, manifesting as withdrawal symptoms lasting up to two weeks, or even longer.
- Symptoms can include confusion, agitation, anxiety, panic attacks, insomnia, shakiness, muscle cramps, perspiration, hallucinations, racing heart, seizures, delusions, paranoia, psychosis, sweats, high blood pressure, nausea, and vomiting.
- Severe withdrawal can also lead to bowel and bladder incontinence.
GHB Addiction
- Daily use of GHB can lead to physical and mental dependence, although this is not a common attribute of the drug itself.
GHB Overdose
- High doses can result in both unconsciousness and vomiting , a dangerous combination leading to suffocation.
- The most typical consequence of GHB overdose is an unresponsive coma.
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Description
Test your knowledge on gamma-Hydroxybutyric acid (GHB) and its medical uses. This quiz covers its legal applications, common forms, and alternatives used by individuals. Additionally, explore the risks and related substances in the context of GHB.
