184 GHB
other drugs as well, so using such a population to evaluate GHB’s particular
abuse potential is treacherous.
GHB has been used successfully to reduce or even eliminate withdrawal
symptoms in alcohol addicts. One alcohol withdrawal study found GHB as
effective asdiazepam, a standard drug given to aid alcohol withdrawal; in
addition, GHB worked faster than diazepam at alleviating sadness, restless-
ness, and anxiety among patients. GHB has also reduced craving for alcohol
on a long-term basis. One group of researchers administering GHB for this
purpose observed no troublesome unwanted effects, and barely 1% of patients
began abusing GHB—a disturbing percentage in a general population but a
very low rate for a drug addict population. Tightly controlled dispensing con-
ditions, however, may be the reason for that low rate; abuse might be heavier
among persons with ready access to the drug. GHB is cross-tolerant enough
withheroinandmethadoneto diminish their withdrawal symptoms. Animal
experiments have found modest cross-tolerance withmorphine,dextroam-
phetamine, andLSD.
In studies measuring GHB’s usefulness for treating narcolepsy, no tolerance
was observed even though some patients had been taking the drug for up to
nine years. Dispute exists about whether tolerance develops in nonmedical
usage. GHB dependence can emerge after taking large doses for a long time.
Diazepam can ease GHB withdrawal symptoms. Tremors, uneasiness, dif-
ficulty with sleep, visual and auditory hallucinations, high blood pressure,
faster heartbeat, sweating, nausea, and vomiting can be part of the withdrawal
syndrome. Symptoms may last for over two weeks. GHB withdrawal can in-
clude psychosis so severe that people have to be restrained, but how much of
that reaction is caused by the drug and how much is caused by the individ-
ual’s underlying personality may be unclear. Dosage affects severity of with-
drawal, with heavy users having the most trouble.
Drug interactions.The HIV (human immunodeficiency virus) drugs saqui-
navir and ritonavir can have serious and potentially fatal interactions with
GHB. Simultaneous use of alcohol or other depressants with GHB increases
risk of overdose. The drug has a high sodium content, which might be a
problem for persons needing to limit their intake of sodium.
Cancer.Tests on rats and mice indicate GHB does not cause cancer.
Pregnancy.Whether the drug causes birth defects is unknown. It passes into
the fetus if a pregnant woman takes a dose and can reduce fetal respiration.
When the substance was still a legal medical drug, GHB was used as an aid
to childbirth.
Additional scientific information may be found in:
“Adverse Events Associated with Ingestion of Gamma-butyrolactone—Minnesota,
New Mexico, and Texas, 1998–1999.”MMWR. Morbidity and Mortality Weekly
Report. 48 (1999): 137–40.
Bernasconi, R., et al. “Gamma-hydroxybutyric Acid: An Endogenous Neuromodulator
with Abuse Potential?”Trends in Pharmacological Sciences20 (1999): 135–41.
Dyer, J.E. “Gamma-hydroxybutyrate: A Health-Food Product Producing Coma and
Seizurelike Activity.”American Journal of Emergency Medicine9 (1991): 321–24.
Ferrara, S.D., et al. “Effects of Single Dose of Gamma-hydroxybutyric Acid and Lora-
