Acute Toxicity From Home-Brewed Gamma Hydroxybutyrate

Abstract

Gamma hydroxybutyrate (GHB) has become an increasingly dangerous, illicitly marketed substance with numerous potential health hazards. 1-8 GHB was originally developed as an anesthetic but was withdrawn as a result of unwanted side effects.4 Marketed for the treatment of narcolepsy and alcohol withdrawal, it was used illicitly as a growth hormone and fat-burning drug by body builders. It has also been used as a date-rape drug.1,Z,9,10 In 1990 the Food and Drug Administration banned the sale of GHB in the United States. Common street names for gamma hydroxybutyrate include GHB, Liquid E, Liquid X, and Scoop. It is also referred to as gamma hydroxy, 4-hydroxybutyrate, gamma hydroxybutyrate sodium, and sodium oxybate. This drug, reported to stimulate growth hormone release, body building, and weight loss, as well as act as a sleeping potion,I-5 is also associated with a number of serious neurologic, cardiovascular, respiratory, and gastrointestinal side effects.IO-IS We describe a case of GHB abuse from a home-brewed preparation resulting in toxicity, withdrawal symptoms, and rhabdomyolysis. The withdrawal symptoms included insomnia, anxiety, and tremors, which resolved within 9 days.13,16 This case is the first reported describing GHB overdose associated with withdrawal symptoms and rhabdomyolysis. GHB became popular as a drug to help assault women. 1,2,IO Several properties of this drug account for its popularity as an tool in sexual assault. First, although no longer legally accessible, GHB is easily and cheaply manufactured in the home. Second, the drug is colorless, tasteless, and odorless, and it mixes well with all liquid and foods; as a result, it is easy for an unaware person to consume this drug. Third, shortly after consumption of