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Forensic Science Update: Gamma-Hydroxybutyrate (GHB)

ghostcorps

Bluelighter
Joined
May 20, 2001
Messages
267
there is currently a massive campaign of misinformation about GHB.. the SAY 'NO' TO G .. campaign.... While I personally do not liek G. I have taken on the task of countering the reams of bulls#*T these guys are putting out. In the course of my research i finnally found a clinical study of GHB rather than relying of fact sheets that tend to be biased one way or the other. I have included an excerpt below with a brief glossary.. for the full report click this link HERE

Because GHB can be administered peripherally to induce sleep, it has been employed clinically in Europe in the field of anesthesia. As it has no analgesic properties, GHB must be used in combination with an opiate analgesic. Its long half-life, compared with newer agents, and its association with myoclonus have substantially reduced its use in anesthesia, although it has been shown to protect tissues from the damaging effects of hypoxia and ischemia (reviewed in Li et al. 1998).

Hypoxia: means an absence of oxygen reaching living tissues.

Ischemia: is a condition where the oxygen-rich
blood flow to a part of the body is restricted.

Clinical effects

During clinical trials, therapeutic doses of GHB have produced adverse reactions that were generally minor and consisted mainly of dizziness, headache, and nausea. Recreational users have reported euphoria, relaxation, disinhibition, and increased libido; however, the doses were not specified (Galloway et al. 1997).

With acute overdose, the central nervous system depressant effects are much more evident, and sedation, ranging from lethargy to coma, has been reported. Other central nervous system effects include nystagmus, miosis, ataxia, combativeness, respiratory depression, apnea, and seizure-like activity (myoclonus). Additional effects include vomiting, hypothermia, bradycardia, atrial fibrillation, and urinary and fecal incontinence (Chin et al. 1998; Dyer 1991). In one case series, hypotension was associated with concomitant ethanol ingestion (Chin et al. 1998). Similar effects have been reported with GBL (Hardy et al. 1999; LoVecchio et al. 1998) and 1,4-BD (Cisek et al. 1999; Dyer et al. 1997).

In a series of 88 patients intoxicated with GHB and related compounds seen in a major metropolitan hospital over a 3-year period, 34 had also ingested ethanol. Other illicit drugs are also common coingestants (Chin et al. 1998; Garrison and Mueller 1998).

Abrupt cessation in GHB abusers has produced withdrawal symptoms. This has been associated with frequent (every 1-3 hours) and excessively high daily doses for several weeks to 3 years (Dyer and Andrews 1997; Dyer et al. 2001; Galloway et al. 1997). Reported symptoms have included anxiety, dizziness, confusion, tremor, insomnia, paranoid behavior, auditory and visual hallucinations, psychosis, tachycardia, and hypertension (Dyer and Andrews 1997; Galloway et al. 1997; Sanguinetti et al. 1997). Withdrawal symptoms have persisted for up to 15 days (Dyer et al. 2001). In a case series of 8 patients suffering GHB withdrawal, one patient died on the 13th day of hospitalization, although the relationship to GHB withdrawal remains unclear (Dyer et al. 2001). At least one case of withdrawal has been reported following the abrupt cessation of a GBL-containing product (Green et al. 1999). Because 1,4-BD is also converted in vivo to GHB, it is not surprising that cases of withdrawal have also been reported following cessation of 1,4-BD-containing products (Zvosec et al. 2001).

The illicit home synthesis from gamma-butyrolactone and sodium hydroxide, sold together in kits, has been the source of numerous cases of GHB overdose (Henretig et al. 1998). Several cases of adverse events secondary to improper manufacture from kits have also been reported (Dyer and Reed 1997; Wiley et al. 1998).
------------------------------
glossary: sorted as they appear in the text.

Nystagmus: is characterized by an involuntary movement of the eyes

Miosis: Contraction of the pupil

Ataxia: Inability to coordinate muscle control resulting in irregularity of movements.

Apnea: A condition in which a person momentarily stops breathing during sleep.

Myoclonus: sudden, involuntary jerking of a muscle or group of muscles. Distinct from a seziure.

Hypothermia: A decrease in the body temperature

Bradycardia: A slow heart rate (less than 60 beats per minute).

Atrial fibrillation: rapid, irregular contractions of the heart muscle fibres.

Hypotension: Low blood pressure.

Tachycardia: very rapid heartbeat.
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sure the big words sound scary.. concert.. but I notice a distinct lack of death, Brain damage or any other permanant damage.

-------

=^_^=
 
saynotog2.jpg


Drugs are bad mmm K...
 
why not say no to K? or say no to E?? or say no to H?? or say no Speed? Or sa no to alchohol? all of hte above are more damaging than G... why pick on G? did you even read the report?
 
Interesting reading Ghostcorps, Thank you.

I do hope this isnt going to rehash the old arguement of what/who is more to dangerous, the nature of 1,4b, or the people who take it?

In the bluelight community, I think this is something that we are never going to agree on :)
 
Whatever you might read, the fact remains that st. vincents hospital has 4 people at any given time due to a ghb overdose (according to paul dillon). The only reason there haven't been more deaths from ghb is because we have an amazing health care system in Australia and ghb overdoses are easy to treat. It's true that it's non toxic and natural in the body but if you have ever seen someone overdose on ghb, it's not the "deep restoritive sleep" some websites talk of.

You said "in the course of my research". What research was that?? If it was just browsing the web then I hardly think you are qualified to say that you are "countering the reams of bulls#*T". The media definately preaches a lot of rubbish when it comes to ghb such as calling it gbh or liquid ecstasy, but as most people will admit, g is hard to use safely due to problems of dosage. I think it is necessary to make the distinction between pure ghb administered by doctors in a controlled environment, and street ghb/gbl/1,4-b which can have anything in it.

My personal opinion is that the "say no to g" campaigns are good because most people who take ghb do not have the proper information and if it keeps people out of hospital, that is a positive thing. The fact there is no way to tell the potency of what you are taking means using ghb at events becomes very dangerous. Maybe there should be a bigger focus on harm minimization which tries to educate people on dose etc rather than just saying "no". But with all the websites out there saying ghb is perfectly safe, harm minimisation becomes difficult.
 
Dvah: there is no argument.. the danger is stupidity and lack of knowledge.

cult33: Deaths involving GHB are just that... not deaths caused by GHB. Show me your data if you are to prove the lethal nature of GHB Please try to avoid anecdotal stories if you can help it). Heres mine, its in MERCK, The LD50 of GHB is between 1600-2000 mg/K in otherwords a 50kg Girl has a 50/50 chance of dying if she takes 82Gs of pure GHB powder. Complications involving other drugs are no longer a GHB issue but rather a Drug issue and should be treated as such not simply focussing on G because it has a bad rep.

Finally.. my point is "KNOW" G, not "ABUSE" G

Education beats demonisation any day.
 
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ghostcorps, Im not saying people die from ghb necessarily but a lot of people overdose on it. This creates a social problem because it costs society money and ambulance drivers and hospitals time, as well as space. And a lot of other things too. I think if people are falling down unconscious and having to be put on respirators, then ghb is a problem.
you might find this interesting. Its written by Buck Reed, the chief medic of home. It outlines more the social problem.

http://www.inthemix.com.au/p/np/viewnews.php?id=14640
 
SO the problem is overreaction to a symptom of a drug that was initially designed as a general anesthetic.

i know we argee that ppl need to be educated as to:

a) the concept of personal thresholds

and

b) the fact that an overdose on G does not imediatly require hospitalisation...

As I said before I mnot a fan of G.. my real concearn is that by taking the easyroad and demonising it.. we are shooting our selves in the foot when it comes to taking steps towards regulation of rec drugs.
 
I agree that simply demonizing it will not solve the problem, but the argument remains on whether ghb can be used safely. A topic which everybody has an opinion on. I think what people like paul dillon and others leading the campaigns are trying to say, is that we know so little about ghb and testing potency, that until further info is gathered, people should just say no.
It's all well and good to know all the facts, but at the end of the day the only way to see how potent your g is, is by ingesting it and waiting for the effects. This is hardly harm minimization in comparison to the testers we have for other drugs and forums like this with reports.

check out this study by ndarc. Very scary, especially the part of 50% of people losing consciousness after using ghb. Of this 50%, 43% received medical attention.

http://notes.med.unsw.edu.au/ndarc....afc00097c53/3fff5cb12801545eca256b4b00822902/$FILE/GBH%20Project%20sheet.pdf
 
ghostcorps said:
why not say no to K? or say no to E?? or say no to H?? or say no Speed? Or sa no to alchohol? all of hte above are more damaging than G... why pick on G? did you even read the report?

Because the safety margins of over dose of G are much smaller then the drugs you have mentioned. And the majority of people out there don't appreciate just how fine the margins are.

Hence the say no to G campaign is far more effective and simpler to impletment, then a campaign of trying to educate all the irresponsible drug abuses who don't really know what they are dealing with, and even if they did they would continue to ignore the advice because as far as they are concerned they are super-man/women.
 
cult33: In the FAQ on this site it suggests 1g of ghb can dissolve into one ml... so then if liquid ghb was at its most concentrated then 5ml would be the least amount that you could pass out on. albeit not a passout that would put you in any danger. so going by this, I would expect a one or two ml test to be safe. ?

regarding the study, losing conciousness and being hospitalised do not directly correspond to being in danger. A better survey would be how many hospitalisations were necessary. .and how many were dangerous because of GHB ingestion only.
 
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sllip: saftey margins? or you mean the point at which you pass out. remembering that OD'ing on GHB does not cause brain damage, MDMA does.. and that MDMA's LD50 is 49 mg/kg in rats compared to GHB 1650-2000 mg/kg.

As for being easier to implement... I would rather put more effort into education on all drugs rather than making a token effort that will more likley result in heros trying to prove themselves than anything else.
 
ghostcorps said:
Dvah: there is no argument.. the danger is stupidity and lack of knowledge.
Finally.. my point is "KNOW" G, not "ABUSE"
G Education beats demonisation any day.

I TOTALLY agree :)
This is my opinion with any chem, but especially with 1,4b, because of the respect it demands.
 
Dvah: exactly.. its all about respect.. respect yourself enough to respect the drug.. its not liek G is the most potent drug on the street.. easily demonstrated that its not the most dangerous.. heck, if your going to demonise G or its analogues/precursors cos they are potent.. you might as well declare ragnarok on DMT.
 
Thanks for the post ghostcorps - loved the glossary!

I do think the "Know G" is the key the point.

Education is much more important thatn the blantanly having a say no policy. Same with all drugs. We all know that.
 
the govt knows its just say no campaigns have never worked... we know cos we still drink, smoke, and take drugs. Why would we expect it to work now... does being hypocritical make it more effective?
 
and that MDMA's LD50 is 49 mg/kg in rats compared to GHB 1650-2000 mg/kg.

How is it that this is correct? Unless you are saying that 1,4 BD is completely different to GHB? Plenty of people would suffer complications from 1,4 BD and GBL without mixing it with other drugs? Im just curious where this figure comes from? When it is clear that a certain amount of GHB will kill people - and it is far far less than than 120 grams or 20grams with the traditional factor of 6 division for humans. You forgot that it your 50kg girl example - there are NO LD50 results in the world for human beings for ANY substance.

I thought around 10 grams was sufficent to kill. Which could be 2-3 measured doses. It is doubtful 2-3 x 100mg MDMA pills will kill a person without extraneous factors. 10 grams of GHB I was under the impression could kill without any other factors, simply by supressing breathing.

The average dose of MDMA is AT LEAST 20 times less than that of GHB. e.g. 100mg to 2 grams. Therefore the LD50 of GHB needs to be factored to 100mg before you start if you compare "danger per dose". Granted though on your figures MDMA per average dose would still be twice as lethal as GHB. Clearly it is not though so it cannot be all about LD50s.

Cyanide has a lethal dose of 200mg. Morphine or heroin would be less than that I would have thought. But I think we would all agree that cyanide is an insidious poison whereas morphine is a medicine. Therefore lethal doses are not always what it is about. Physiological effect and what the drug does is a consideration.

Any LD50's for Monkeys? With GHB naturally occurring, perhaps the situation in a human or primate is very different from a rat - a greater difference than typically seen with synthetic drugs?

I'm not necessarily disputing anything just seeking to develop this claim further. Anecdoctal evidence is not always accurate, granted. But neither is the amount of GHB it takes to kill a sample quantitiy of rats in a laboratory. Nothing is that black and white, especially when it comes to drugs we often do not understand as well as we as people like to think we do.
 
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ghostcorps said:
the govt knows its just say no campaigns have never worked... we know cos we still drink, smoke, and take drugs. Why would we expect it to work now... does being hypocritical make it more effective?

Its funny that you say that..... coz if you look around the 'party scene' right now you may notice that it *has* to an extent worked. Infact there was an article in the Herald Sun a few months ago stating how the whole "Say NO to G" campaign actually appeared to work a lot more effectively than any other government-instituted campaign.

And I think thats where the important factor is.. no one listens to the government, but everyone listens to their peers. If people in your social group say that something is uncool, then a majority of people will agree. There will always be those who dont, but in an overall view, ravers themselves saying that G is bad appears to have worked quite effectively in curbing what could have been a very serious drug problem.


On the whole death topic, I did a bit of journal research and came up with some interesting info. One journal that I found was very informative relating to 1,4-Butanediol toxicity (which I think is extremely relevant as prettymuch everyone I know that uses "G" actually ingests 1,4-B). Unfortunately my access to it was through uni, but if interested I can summarise the article and highlight the important parts.

Adverse events, including death, associated with the use of 1,4-butanediol
Deborah L Zvosec, Stephen W Smith, J Rod McCutcheon, Joe Spillane, et al.
The New England Journal of Medicine. Boston: Jan 11, 2001. Vol. 344, Iss. 2; pg. 87, 8 pgs
 
Biscuit: these figures came from MERCK they are applicable to Rats and do not show the factual LD50 for humans which we would expect to be less in this case for a number of reasons including the fact that rats do not have a gag reflex and thus would not asphyxiate as quickly.

The bluelight FAQ says 1ml of 1-4B (LD50 in rats=1525)
is equivalent to 1g (approx) of GHB so the above assumption of safe testing doses would still apply.

nt: 1ml of GBL LD50 in rats = 1000 mg/kg and is is equivalent to 1.6 g's of GHB. PLEASE CONSIDER THIS WHEN TESTING.

But we were talking about the relative toxicity of MDMA compared to GHB. The LD50's indicate quite clearly that MDMA is approximatly 40 times more lethal than GHB.

Stacyrox: i would be very interested in a summary if you could.. I agree that peers would seem to be a more trusted source of info.. but the fact remains the majority of the info put out is still incorrect.. or at least very biased. To the point of misinformation.. which is quite simply dangerous.
 
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