Literature DB >> 18203723

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

D M Wood1, C Warren-Gash, T Ashraf, S L Greene, Z Shather, C Trivedy, S Clarke, J Ramsey, D W Holt, P I Dargan.   

Abstract

BACKGROUND: Gamma-hydroxybutyrate (GHB) is used as a recreational drug, with significant associated morbidity and mortality; it is therefore a class C drug under the Misuse of Drugs Act (1971). However, its precursors gamma-butyrolactone (GBL) and 1,4-butanediol (1,4BD) remain legally available despite having similar clinical effects. AIM: The aim of this study was to determine whether the relative proportions of self-reported ingestions of GHB or its precursors GBL and 1,4BD were similar to those seen in analysis of seized drugs. DESIGN AND METHODS: Retrospective review of our clinical toxicology database to identify all cases of self-reported recreational GHB, GBL and 1,4BD use associated with ED presentation in 2006. Additionally all seized substances on people attending local club venues were analysed by a Home Office approved laboratory to identify any illicit substances present.
RESULTS: In 2006, there were a total of 158 ED presentations, of which 150 (94.9%) and 8 (5.1%) were GHB and GBL self-reported ingestions respectively; 96.8% (153) were recreational use. Of the 418 samples seized, 225 (53.8%) were in liquid form; 85 (37.8%) contained GHB and 140 (62.2%) contained GBL. None of the seized samples contained 1,4BD and there were no self-reported 1,4BD ingestions.
CONCLUSION: Self-reported GHB ingestion was much more common than GBL ingestion, whereas GBL was more commonly found in the seized samples. These differences suggest that GBL use may be more common than previously thought and we suggest that there should be further debate about the legal status of the precursors of GHB.

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Year:  2008        PMID: 18203723     DOI: 10.1093/qjmed/hcm117

Source DB:  PubMed          Journal:  QJM        ISSN: 1460-2393


  10 in total

1.  The Impact of Gamma Hydroxybutyrate (GHB) Legal Restrictions on Patterns of Use: Results from an International Survey.

Authors:  Ib Anderson; Sy Kim-Katz; Je Dyer; Pd Blanc
Journal:  Drugs (Abingdon Engl)       Date:  2010-10

2.  The first reported UK fatality related to gamma-butyrolactone (GBL) ingestion.

Authors:  Paul I Dargan; Jenny Button; Susie Davies; John Ramsey; Simi George; David W Holt; David M Wood
Journal:  J R Soc Med       Date:  2009-12       Impact factor: 5.344

Review 3.  Illicit gamma-hydroxybutyrate (GHB) and pharmaceutical sodium oxybate (Xyrem): differences in characteristics and misuse.

Authors:  Lawrence P Carter; Daniel Pardi; Jane Gorsline; Roland R Griffiths
Journal:  Drug Alcohol Depend       Date:  2009-06-02       Impact factor: 4.492

4.  Self-administration of gamma-hydroxybutyric acid (GHB) precursors gamma-butyrolactone (GBL) and 1,4-butanediol (1,4-BD) in baboons.

Authors:  Amy K Goodwin; Barbara J Kaminski; Elise M Weerts
Journal:  Psychopharmacology (Berl)       Date:  2012-09-04       Impact factor: 4.530

5.  Temporal differences in γ-hydroxybutyrate overdoses involving injecting drug users versus recreational drug users in Helsinki: a retrospective study.

Authors:  James J Boyd; Markku J Kuisma; Tarja T Randell
Journal:  Scand J Trauma Resusc Emerg Med       Date:  2012-02-01       Impact factor: 2.953

6.  Improvement in the pre-hospital care of recreational drug users through the development of club specific ambulance referral guidelines.

Authors:  David M Wood; Shaun L Greene; Graham Alldus; Denise Huggett; Michelle Nicolaou; Kerry Chapman; Fionna Moore; Kim Heather; Nicola Drake; Paul I Dargan
Journal:  Subst Abuse Treat Prev Policy       Date:  2008-06-06

Review 7.  GHB pharmacology and toxicology: acute intoxication, concentrations in blood and urine in forensic cases and treatment of the withdrawal syndrome.

Authors:  Francesco P Busardò; Alan W Jones
Journal:  Curr Neuropharmacol       Date:  2015-01       Impact factor: 7.363

8.  Symptoms and signs in interpreting gamma-hydroxybutyrate (GHB) intoxication - an explorative study.

Authors:  Margareta Warrén Stomberg; Kai Knudsen; Henrik Stomberg; Ingela Skärsäter
Journal:  Scand J Trauma Resusc Emerg Med       Date:  2014-04-23       Impact factor: 2.953

9.  Presentations to an urban emergency department in Switzerland due to acute γ-hydroxybutyrate toxicity.

Authors:  Evangelia Liakoni; Fabio Walther; Christian H Nickel; Matthias E Liechti
Journal:  Scand J Trauma Resusc Emerg Med       Date:  2016-08-31       Impact factor: 2.953

10.  Intoxication with GHB/GBL: characteristics and trends from ambulance-attended overdoses.

Authors:  Desiree Madah-Amiri; Lars Myrmel; Guttorm Brattebø
Journal:  Scand J Trauma Resusc Emerg Med       Date:  2017-09-22       Impact factor: 2.953

  10 in total

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