GHB was introduced in the United States' over-the-counter market in the spring of 1990.
It was introduced as a dietary supplement, as well as a sedative and for body-building effect (Maxwell, 2005).
This introduction was rapidly followed by reports of severe adverse effects at doses ranging from approximately 1 teaspoon to 4 tablespoons. Right away, there were widespread reports of poisonings.
In November 1990, this led to a U.S. Food and Drug Administration ban on the distribution of GHB for human use, outside approved clinical trials.
Adverse effects reported included: vomiting, nausea, dizziness, weaknesses, seizure-like activity, tonic-clonic, loss of peripheral vision, agitation, confusion, hallucinations, bradycardia, decreased respiratory effort, unconsciousness, and coma. These adverse effects were reported in as little as 15 minutes from oral ingestion. Acute symptoms appeared to remit after 7 hours. However, some patients reported lingering dizziness for up to 2 weeks. "Respiratory arrest occurred in one healthy 24-year-old male who reportedly ingested 'several' beers and a 'small' amount of GHB; he was intubated, mechanically ventilated and recovered without sequelae" (Galloway, Frederick, Staggers, Gonzales, Stalcup, & Smith, 1997).
Maxwell (2005) notes that the National Institute on Drug Abuse categorized GHB as a 'club drug', along with several others, including ecstasy (MDMA) ketamine, Rohypnol, methamphetamine, and lysergic acid diethylamide (LSD).
These drugs were described as being used primarily in all-night dance parties, such as raves. However, in 2003, the National Institute on Drug Abuse's Community Epidemiology Work Group doubted the appropriateness of the term 'club drugs' since the use of drugs, such as GHB, had dispersed beyond the club culture. Although GHB is commonly used in clubs (McGinn, 2005), it was argued that each of these drugs had very different pharmacologic properties, as well as different physiological and psychological effects and potential consequences. In addition, these drugs, like GHB, are being used outside the club venues, by a greater variety of people.
One of GHB's precursors, gamma butyrolactone (GBL) can be converted to GHB by endogenous lactonases. GBL is an industrial solvent and has been marketed as both a cleaner for computer parts and a dietary supplement. GBL is a List 1 chemical in the United States and requires justification for all purchase and sales, as well as documentation.
GBL is considered a controlled-substance analogues, when intended for human consumption (Maxwell, 2005).
1,4 - butanediol (1,4-BD) is another precursor to GHB. This Class I health hazard is an industrial solvent. It is metabolized in the body by alcohol dehydrogenase to GBL, which is then metabolized to GHB.
During this conversion, 1,4-BD possess a higher potency than GHB. 1,4-BD, as well as GBL and GHB, can be purchased via the Internet, and are sometimes marketed as ink jet printer fluid and solvents. They are also often found as GHB alternatives in health food stores, gyms, raves, and nightclubs. The Internet also offers chemistry kits, reagents and recipes to convert the precursors to GHB. and, lastly, Maxwell (2005) notes that GHB itself can be ordered online from some foreign countries.
GHB is currently deemed a Schedule 1 drug in the United States, due to its use to commit assault and its use as a club drug, and Schedule IV of the 1971 UN Convention. However, when used under an FDA-approved protocol, it is a Schedule III drug,...
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