GHB and Its Medical Uses

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

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?

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?

GBL (correct)

Caffeine

Methamphetamine

Nicotine

What does GBL convert to within the body?

GHB Signup and view all the answers

What is the potential risk associated with high doses of GHB?

Coma-like state and fatalities Signup and view all the answers

Which product is NOT a source of GBL?

Energy drinks Signup and view all the answers

What is 1,4-butanediol commonly known as?

BD Signup and view all the answers

Which of the following terms is NOT used as a name for GHB?

Liquid codeine Signup and view all the answers

What is a potential consequence of GHB withdrawal lasting two weeks or longer?

Bowel and bladder incontinence Signup and view all the answers

Which of the following symptoms are associated with GHB withdrawal?

Seizures or convulsions Signup and view all the answers

What dangers are associated with GHB overdose?

Unconsciousness and vomiting Signup and view all the answers

What can daily use of GHB lead to?

Addiction with physical dependence Signup and view all the answers

What is the typical form of overdose seen with GHB?

Unresponsive coma Signup and view all the answers

What was one of the initial medical applications studied for GHB?

Anesthetic Signup and view all the answers

Why did GHB lose popularity as an anesthetic?

It caused neurological problems. Signup and view all the answers

What medical condition was GHB approved to treat in 2002?

Narcolepsy Signup and view all the answers

What is the trade name under which GHB is sold as a prescription medication?

Xyrem Signup and view all the answers

How did bodybuilders misconceive GHB's effects?

As a muscle mass booster Signup and view all the answers

What classification did the DEA assign to GHB on March 13, 2000?

Schedule I Signup and view all the answers

What effect of GHB contributed to its popularity as a sleep aid?

Deep sleep Signup and view all the answers

What concern arose from GHB's use in dance clubs?

The potential for abuse Signup and view all the answers

What happens to BD when ingested?

It is quickly converted to GHB. Signup and view all the answers

What enzyme metabolizes BD?

Alcohol dehydrogenase Signup and view all the answers

What is the original purpose for synthesizing GHB?

To find a better anesthetic. Signup and view all the answers

How does GHB interact with dopamine at high doses?

It increases its release. Signup and view all the answers

Which receptors does GHB primarily bind to?

GABA-B receptors Signup and view all the answers

Where in the brain is GHB most prominently active?

Hippocampus Signup and view all the answers

What is a consequence of taking BD with alcohol?

It enhances the effects and risks associated with both. Signup and view all the answers

What is the relationship between GABA and GHB in the body?

GABA is a precursor to GHB. Signup and view all the answers

What is a potential consequence of taking excessive doses of GHB?

Unconsciousness within 15 minutes Signup and view all the answers

What symptoms can be experienced at moderate doses of GHB?

Blurred vision and dizziness Signup and view all the answers

How does GHB affect respiratory function?

It slows and deepens respiration Signup and view all the answers

What effect can combining GHB with alcohol or other drugs have?

It may lead to fatal outcomes Signup and view all the answers

What is a characteristic ECG finding in many GHB users?

U waves Signup and view all the answers

Which of the following symptoms indicates a severe impairment due to high doses of GHB?

Uncontrolled movements Signup and view all the answers

What is a possible long-term consequence of severe GHB overdose?

Prolonged coma Signup and view all the answers

What happens to breathing after GHB is mixed with alcohol?

It slows and can last up to five hours or longer Signup and view all the answers

What is a potential effect of poorly mixed GHB?

Caustic burns to the lips and mouth Signup and view all the answers

What serious health risk is associated with mixing GHB/GBL with alcohol or opioids?

Difficulty breathing and possible death Signup and view all the answers

Which substances can cause unpredictable effects when combined with GHB/GBL?

MDMA and methamphetamine Signup and view all the answers

How long can GHB be detected in urine after ingestion?

12 hours Signup and view all the answers

What condition might develop from using GHB/GBL to alleviate the come down from stimulants?

Dependence on both drugs Signup and view all the answers

What is a potential consequence of contamination in homemade GHB?

Toxic component presence Signup and view all the answers

What is a common withdrawal symptom for those dependent on GHB?

Severe difficulty in stopping use Signup and view all the answers

Which of the following statements about the effects of GHB/GBL is false?

They exclusively enhance performance. Signup and view all the answers

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.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

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.