GHB description, production, forms n consumption methods.
- Active Chemical: Gammahydroxybutyrate
- Other names: GBH, liquid ecstasy, liquid x, gamma OH, rape drug
- GHB forms: A colourless liquid sold in small bottles or capsules.
- consumption: The liquid is measured out in capfuls and then swallowed.
What is GHB?
gamma-hydroxybutyrate powderNon-medically, GHB is a CNS depressant used as an intoxicant. It has many street names, including Easy Lay, Gina, Gay Home Boy, Georgia Home Boy, Soap, G, GB, GBH, Juice, Fantasy, Liquid Ecstasy, Liquid X, Gamma-OH, Scoops, Cherry Meth and Jungle Juice.
gamma-Hydroxybutyric acid (4-hydroxybutanoic acid, C4H8O3) is a therapeutic drug, an illegal drug, and a naturally occurring substance found in the central nervous system, wine, beef, small citrus fruits and almost all other living creatures in small amounts.
In a medical setting, GHB is used as a general anesthetic, to treat conditions such as insomnia, clinical depression, narcolepsy, and alcoholism, and to improve athletic performance. It is also used illegally under the street names Juice or Liquid Ecstasy, either as an intoxicant, or as a date rape drug. As well, the human body’s cells naturally produce GHB. GHB is structurally related to the ketone body beta-hydroxybutyrate. As a drug it is used most commonly in the form of a salt.  GHB is also produced as a result of fermentation and so is found in small quantities in some beers and wines.
GHB salt dissolved in water is notoriously dangerous as the concentration of GHB may not be known, and so the actual dose of GHB being consumed can be difficult to judge accurately. Since GHB sold for recreational use is subject to no standardisation it can be impossible to verify the actual concentration of GHB solution bought on the illicit market. More than 1 gram of sodium GHB can be dissolved in 1 mL of water, and so sodium GHB solution can actually be stronger than pure GHB liquid. Other salt forms such as potassium GHB, calcium GHB and magnesium GHB have also been reported, but the sodium salt is by far the most common.
Some chemicals convert to GHB in the stomach and blood. GBL, or gamma-butyrolactone, is one such prodrug. Other prodrugs include 1,4-butanediol. There may be additional toxicity concerns with these precursors. 1,4-B and GBL are normally found as pure liquids, although they may be mixed with other more harmful solvents when intended for industrial use, e.g. as paintstripper or varnish thinner.
Endogenous production by the body
Cells produce GHB by reduction of succinic semialdehyde. People with the disorder known as succinic semialdehyde dehydrogenase deficiency, also known as gamma-hydroxybutyric aciduria, have elevated levels of GHB in their urine, blood plasma and cerebrospinal fluid.
The precise function of GHB in the body is not clear. It is an immediate precursor to GABA, a neurotransmitter which regulates awakeness, physical activity and sleep. As GABA cannot cross the blood-brain barrier, GHB obtained from food may be used for converting to GABA. GHB protects cells from oxygen starvation, which might explain presence of the compound in vital organs. GHB was also found to have neuroprotective capabilities.
GHB has been used as a general anesthetic, as a hypnotic in the treatment of insomnia, to treat depression, and to improve athletic performance. In Italy, under the trade name Alcover (ATC code N07BB), GHB is used in the treatment of alcoholism (50 to 100 milligrams per kilogram per day, in 3 or more divided doses), both for acute alcohol withdrawal and medium to long term detoxification.  In the United States, the Food and Drug Administration permits the use of GHB under the trade name Xyrem to reduce the number of cataplexy attacks in patients with narcolepsy
When GHB is used in its sodium or potassium salt form, a significant quantity of excess sodium or potassium may be consumed, which should be taken into consideration by people with heart conditions, hypertension or compromised renal function. The bioavailability of sodium GHB is considerably reduced when it is consumed with food, and so it is advised to wait at least two hours after eating before consuming the dose. Because of its strong sedative effects, patients should not drive or operate heavy machinery for at least six hours after taking sodium GHB.
Adverse effects from Xyrem in clinical trials included: headache, nausea, dizziness, nasopharyngitis, somnolence, vomiting, urinary incontinence, confusion, dyspnea, hypoesthesia, paresthesia, tremor, vertigo, and blurred vision. Out of the 717 patients and 182 healthy volunteers who took part in the trials (899 total), two of them died from drug overdoses, although only one of these involved GHB.
As a recreational drug
Like these other “club drugs”, GHB is taken because users believe that it can enhance the experience of being in a dance club; GHB is sometimes referred to as liquid ecstasy due to its tendency to produce euphoria and sociability and its use in the dance party scene. However, the effects of GHB are quite different from those of MDMA.
Use As a Date Rape drug
The drug has been referred to in the media as a date rape drug, in much the same way as alcohol and Rohypnol. It is often claimed that when mixed in a drink it may be difficult to detect. However, some recreational GHB users have disagreed with that claim, pointing out that “GHB is, in fact, quite salty. When mixed in a drink, it ruins the drink (like dumping bicarb in a drink).”
GHB prodrugs such as GBL or 1,4-B tend to have a strong solvent smell and taste, somewhat reminiscent of glue or petrol, and similarly would give a characteristic smell and taste to a spiked drink. Nevertheless, GHB has been used in cases of drug-related sexual assault, usually when the victim is already intoxicated with alcohol and is unlikely to notice a strange taste to their drink.
Use by bodybuilders
Some athletes and bodybuilders also use GHB, as GHB is thought to increase the release or production of growth hormone. While there is some evidence supporting these claims, the actual efficacy of GHB for this purpose is unclear.
One possible explanation is that growth hormone is secreted increasingly when blood glucose levels are low in a condition called hypoglycemia. The use of GBL, GHB, some depressants, and insulin, all of which are notable of use by bodybuilders, lowers blood glucose, thus causing the secretion of growth hormone.
-  e.g., sodium gamma-hydroxybutyrate (Na.GHB, sodium oxybate) or potassium gamma-hydroxybutyrate (K.GHB)
-  An author/scientist Gian Luigi Gessa has been researching alcoholism and the effects of various drugs to persons afflicted with said disease for the past ten years. His studies in 1998 note that GHB, as a pharmaceutical aid, can be much less toxic and much more effective than the leading pharmaceutical compound (disulfiram).
-  in clinical trials Xyrem significantly reduced cataplexy attacks at a dose of 6000–9000mg per night. This is around three times the dose used recreationally, but almost all narcolepsy patients in the clinical trials were already stabilized on CNS stimulants such as modafinil; in patients not prescribed modafinil this dosage could be dangerous and should be reduced appropriately. Also the prescribing information for Xyrem states that patients should take the dose immediately before going to bed, and then a second dose 3–4 hours later. The maximum dose taken at one time should not exceed 4500 mg. Patients with hepatic insufficiency (compromised liver function) have slower clearance of GHB and require reduced doses, typically half the normal dose. Xyrem oral solution is standardised to 500 mg Na.GHB / 1 mL water, buffered to pH 7.5 with malic acid.
^ Xyrem drug data sheet
-  Elliott S, Burgess V. The presence of gamma-hydroxybutyric acid (GHB) and gamma-butyrolactone (GBL) in alcoholic and non-alcoholic beverages. Forensic Science International. 2005 Jul 16;151(2-3):289-92.