γ—Hydroxybutyric Acid (GHB), γ-Butyrolactone (GBL), and 1,4-Butanediol (BD)

Abstract

γ-hydroxybutyric acid (GHB) was synthesized in 1960 by the French physician Henry Labroit (Ropero-Miller and Goldberger, 1998). Because of its then reported low toxicity and lack of side effects, the use of GHB in anesthesia and psychiatry was initially endorsed (Labroit, 1964), but it soon fell out of favor as an anesthetic owing to its unpredictable actions and adverse effects (Ropero-Miller and Goldberger, 1998). GHB has also been studied as a treatment for opioid and ethanol withdrawal; as a treatment for narcolepsy; and in the management of shock. In the 1980s, GHB was promoted in the United States as a growth hormone stimulator (Chin et al., 1998). After the Food and Drug Administration (FDA) banned the over-the-counter sales of l-tryptophan in 1989, GHB was promoted as a replacement sleep aid (Ropero-Miller and Goldberger, 1998). Beginning in 1990, the FDA began an investigation into several reports of GHB-associated vomiting, dizziness, tremors, and seizures resulting in hospitalization and death (FDA, 1997). GHB gained public notoriety with the death of actor River Phoenix, which was purportedly associated with GHB use. At that time, GHB was popular in Los Angeles nightspots, where it was commonly found in powder form. GHB then began appearing on college campuses, first in Florida and Georgia (Minai, 2001). The FDA and the Department of Justice took action against several manufacturers, distributors, and promoters of GHB. Through these actions and the use of embargos and public education campaigns, the distribution and abuse of GHB began to decrease. There was then a resurgence in the use of GHB and accompanying reports of GHB-associated adverse effects and deaths with the creation of clandestine labs (FDA, 1997). Subsequently, the GHB precursors γ-butyrolactone (GBL) and 1,4-butanediol (BD) began to be marketed as natural, nontoxic dietary supplements (FDA 1999a, b).