Medical and legal confusion surrounding gamma-hydroxybutyrate (GHB) and its precursors gamma-butyrolactone (GBL) and 1,4-butanediol (1,4BD)

QJM: An International Journal of Medicine

Volumn 101, Issue 1, 2008, Pages 23-29

  Wood, David M ^a   Warren Gash, C ^b   Ashraf, T ^c   Greene, S I ^a   Shather, Z ^a   Trivedy, C ^a   Clarke, S ^d   Ramsey, J ^e   Holt, D W ^f   Dargan, P I ^a  

^a GUY'S AND ST THOMAS' NHS FOUNDATION TRUST   (United Kingdom)

^b UNIVERSITY COLLEGE LONDON   (United Kingdom)

^c QUEEN MARY UNIVERSITY OF LONDON   (United Kingdom)

^d FRIMLEY PARK HOSPITAL   (United Kingdom)

^e TICTAC Communications Ltd   (United Kingdom)

^f ST GEORGE'S UNIVERSITY OF LONDON   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

1,4 BUTANEDIOL; 3,4 METHYLENEDIOXYMETHAMPHETAMINE; 4 HYDROXYBUTYRIC ACID; ALCOHOL; AMPHETAMINE DERIVATIVE; COCAINE; GAMMA BUTYROLACTONE; ILLICIT DRUG; KETAMINE; RECREATIONAL DRUG;

ADULT; AGE DISTRIBUTION; ARTICLE; CLINICAL FEATURE; DATA BASE; DISEASE SEVERITY; DROWSINESS; DRUG USE; EMERGENCY WARD; FEMALE; GLASGOW COMA SCALE; HUMAN; INGESTION; LENGTH OF STAY; LIQUID; MAJOR CLINICAL STUDY; MALE; MEDICOLEGAL ASPECT; OUTCOMES RESEARCH; PRIORITY JOURNAL; RECREATION; RETROSPECTIVE STUDY; SEIZURE; SELF POISONING; SELF REPORT; SEX DIFFERENCE; TOXICOLOGY; VOMITING;

EID: 38349185843     PISSN: 14602725     EISSN: 14602393     Source Type: Journal    
DOI: 10.1093/qjmed/hcm117     Document Type: Article

References (33)

1. Miotto K, Darakjian J, Basch J, Murray S, Zogg J, Rawson R. Gamma-hydroxybutyric acid: Patterns of use, effects and withdrawal. Am J Addict 2001; 10:232-41.
2. Entholzner E, Mielke L, Pichlmeier R, Weber F, Schneck H. EEG changes during sedation with gamma-hydroxybutyric acid. Anaesthesist 1995; 44:345-50.
3. Nicholson KL, Balster RL. GHB: A new and novel drug of abuse. Drug Alcohol Depend 2001; 63:1-22.
4. Degenhardt L, Darke S, Dillon P. GHB use among Australians: characteristics, use patterns and associated harm. Drug Alcohol Depend 2002; 67:89-94.
5. Louagie HK, Verstraete AG, De Soete CJ, Baetens DG, Calle PA. A sudden awakening from a near coma after combined intake of gamma-hydroxybutyric acid (GHB) and ethanol. J Toxicol Clin Toxicol 1997; 35 591-4.
6. Li J, Stokes SA, Woeckener A. A tale of novel intoxication: Seven cases of gamma-hydroxybutyric acid overdose. Ann Emerg Med 1998; 31 723-8.
7. Ross TM. Gamma hydroxybutyrate overdose: Two cases illustrate the unique aspects of this dangerous recreational drug. J Emerg Nurs 1995; 21:374-6.
8. James C. Another case of gamma hydroxybutyrate (GHB) overdose. J Emerg Nurs 1996; 22:97.
9. Liechti ME, Kunz I, Greminger P, Speich R, Kupferschmidt H. Clinical features of gamma-hydroxybutyrate and gamma-butyrolactone toxicity and concomitant drug and alcohol use. Drug Alcohol Depend 2006; 81 323-6.
10. Liechti ME, Kupferschmidt H. Gamma-hydroxybutyrate (GHB) and gamma-butyrolactone (GBL): Analysis of overdose cases reported to the Swiss Toxicological Information Centre. Swiss Med Wkly 2004; 134:534-7.
11. Chin RL, Sporer KA, Cullison B, Dyer JE, Wu TD, Clinical course of gamma-hydroxybutyrate overdose. Ann Emerg Med 1998; 31 716-22.
12. Miro O, Nogue S, Espinosa G, To-Figueras J, Sanchez M. Trends in illicit drug emergencies: The emerging role of gamma-hydroxybutyrate. J Toxicol Clin Toxicol 2002; 40:129-35.
13. Gonzalez A, Nutt DJ. Gamma hydroxy butyrate abuse and dependency. J Psychopharmacol 2005, 19:195-204.
14. Thai D, Dyer JE, Jacob P, Haller CA. Clinical pharmacology of 1,4-butanediol and gamma-hydroxybutyrate after oral 1,4-butanediol administration to healthy volunteers. Clin Pharmacol Ther 2007; 81:178-84.
15. Centers for Disease Control and Prevention (CDC). Adverse events associated with ingestion of gamma-butyrolactone - Minnesota, New Mexico, and Texas, 1998-1999. MMWR. Morb Mortal-Wkly Rep 1999; 48:137-40.
16. Dupont P, Thornton J. Near-fatal gamma-butyrolactone intoxication - first report in the UK. Hum Exp Toxicol 2001; 20:19-22.
17. Ingels M, Rangan C, Bellezzo J, Clark RF. Coma and respiratory depression following the ingeston of GHB and its precursors: Three cases. J Emerg Med 2000; 19:47-50.
18. Zvosec DL, Smith SW, McCutcheon JR, Spillane J, Hall BJ, Peacock EA. Adverse events, including death, associated with the use of 1,4-butanediol. N Engl J Med 2001; 344:87-94.
19. Theron L, Jansen K, Skinner A. New Zealand's first fatality linked to use of 1,4-butanediol (1,4-B, Fantasy): No evidenoe of coingestion or comorbidity. N Z Med J 2003; 116:U650.
20. Degenhardt L, Darke S, Dillon P. The prevalence and correlates of gamma-hydroxybutyrate (GHB) overdose among Australian users. Addiction 2003; 98:199-204.
21. Halkitis PN, Palamar JJ. GHB use among gay and bisexual men. Addict Behav 2006; 31:2135-9.
22. Kelly BC, Parsons JT, Wells BE. Prevalence and predictors of club drug use among club-going young adults in New York city. J Urban Health 2006; 83:884-95.
23. Halkitis PN, Palamar JJ, Mukherjee PP. Poly-club-drug use among gay and bisexual men: A longitudinal analysis. Drug Alcohol Depend 2007; 89:153-60.
24. The paint stripper drug that kills. 7th October 2005. http:// news.bbc,co.uk/1/hi/magazine/4261788.stm (last accessed 29th October 2007).
25. Warning on Internet 'party drugs'. 12th May 1999. http://news.bbc.co.uk/ 1/hi/health/341843.stm (last accessed 29th October 2007).
26. Fears over lethal drug cocktail as clubbers seek fresh thrills. 16th April 2007. http://edinburghnews.scotsman.com/index.cfm?id=583842007 (last accessed 29th October 2007).
27. Clubs employ medics to fight new drug craze. 5th September 2004. http:// news.independent.co.uk/health/article40471.ece (last accessed 29th October 2007).
28. Kenyon SL, Ramsey JD, Lee T, Johnston A, Holt DW. Analysis for identification in amnesty bin samples from dance venues. Ther Drug Monit 2005; 27:793-8.
29. Sporer KA, Chin RL, Dyer JE, Lamb R. Gamma-hydroxybutyrate serum levels and clinical syndrome after severe overdose. Ann Emerg Med 2003; 42:3-8.
30. Mazarr-Proo, S, Kerrigan S. Distribution of GHB in tissues and fluids following a fatal overdose. J Anal Toxicol 2005; 29:398-400.
31. Knudsen K, Greter J, Verdicchio M, Cederquist T. GHB, GBL and butanediol poisonings - a serious problem in Western Sweden. Lakartidningen 2005; 102:3294-6.
32. Caldicott DG, Chow FY, Burns BJ, Felgate PD, Byard RW. Fatalities associated with the use of gamma-hydroxybutyrate and its analogues in Australasia. Med J Aust 2004; 181:310-3.
33. Ferrara SD, Tedeschi L, Frison G, Rossi A. Fatality due to gamma-hydroxybutyric acid (GHB) and heroin intoxication. J Forensic Sci 1995; 40:501-4.