GHB is an endogenous short-chain fatty acid that is a naturally occurring metabolite in many tissues. It induces both NREM and REM, anesthesia, hypothermia, and a trance-like state and has been considered a model for petit mal epilepsy. GHB increases brain dopamine. It is found in the CNS, kidney, heart, skeletal muscle and brown fat.
In the 1960s, studies revealed that GHB had a structure similar to gamma-amino butyric acid (GABA), but that it penetrated the blood-brain barrier much better than GABA when administered peripherally. In the 1970s GHB was advocated for narcolepsy. GHB was said to enhance the effects of steroids and release growth hormone (GH). GHB facilitates slow-wave sleep which is the period of sleep in which there is the greatest release of GH. Although GHB-induced release of GH was never validated, health food stores began to sell GHB to athletes to build muscles because it released GH. GHB was also sold as a dieting aid, and sleep inducer. It was known as “nature’s Quaalude” secondary to the relaxation and euphoria that it induced.
GHB is used as a date-rape drug due to its’ ability to produce muscle relaxation and hypotonia as well as amnesia. At selected gyms, night clubs and rave halls, GHB is sold pre-mixed in small glass jars.
In 1990, GHB was first reported as a drug of abuse and the FDA banned OTC sales. Due to deaths, seizure and coma associated with the drug, the FDA issued a voluntary recall of GHB and gamma-butyrlactone (GBL) containing nutritional supplements. The Attorney General subsequently enacted the emergency scheduling authority of the Controlled Substances Act, making illicit GHB schedule I and medical GHB schedule III. Currently GHB is approved for the treatment of Narcolepsy.
As always, if there any questions, call the MTPC.
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donna.seger@vanderbilt.edu
Donna Seger, M.D.
Medical Director, Middle Tennessee Poison Center