Neuroscience for Kids - Gamma hydroxybutyrate (GHB) = Bad News

Gamma hydroxybutyrate (GHB)

Gamma hydroxybutyrate: An Overview

Have you heard of GHB?

You may not have yet, but its use is increasing. Once limited to large warehouse scenes such as "raves," GHB is showing up at parties, perhaps in neighborhoods like yours. It gives the user a feeling of euphoria, that everything is fine. GHB, like alcohol, is a central nervous system depressant that takes only minutes to make a user lose control, forget what is happening, or lose consciousness. GHB is colorless, odorless, and has a slightly salty taste. The synthetic form of GHB contains some of the same ingredients as floor stripper and industrial cleaners.

The same dose of GHB can have variable effects in different people. A dose that makes one person feel euphoric can make another person sick. The US Drug Enforcement Agency has linked GHB to 58 deaths since 1990 and there have been at least 5,700 overdoses recorded since then. Moreover, there are some reports that GHB can cause dependence. Treatment of GHB overdoses is difficult because it is difficult for emergency room doctors to detect the drug.

Possible symptoms of GHB use:

Dizziness | Vomiting | Seizures | Coma | Drowsiness

GHB was first developed as a general anesthetic, but because it did not work very well to prevent pain, its use as an anesthetic declined. The observation that GHB may cause the release of growth hormone led some people, especially athletes and body-builders, to take it because they thought it would increase muscle development. At the time, GHB was available as a dietary supplement and as such was not regulated by the US Food and Drug Administration. In 1990, after numerous reports that GHB caused illness, the FDA began investigating the drug. It is now classified as an illegal substance. Research is being conducted to investigate the use of GHB in the treatment of the sleep disorder called narcolepsy.

GHB has been grouped with other drugs in the "date-rape drug" category such as Rohypnol, because it can be slipped easily into a drink and given to an unsuspecting victim, who often does not remember being assaulted. GHB is especially dangerous when combined with alcohol.

GHB and the Brain

Although GHB can be made in the laboratory, it is also produced normally in the brain through the synthesis of a neurotransmitter called GABA. Some of the greatest concentrations of GHB are found in the substantia nigra, thalamus and hypothalamus. When GHB is ingested by a user, it affects several different neurotransmitter systems in the brain:

GHB can increase acetylcholine levels.
GHB can increase serotonin levels.
GHB can reduce dopamine activity, especially in the basal ganglia. This action is probably the result of the inhibition of the release of dopamine from synaptic terminals. Some studies show that GHB first inhibits the release of dopamine, then causes the release of dopamine. The effect on the dopamine system may depend on the dose of GHB.
GHB can activate GHB receptors and GABA receptors on neurons in the brain.

Unfortunate Events Lead to a Tragedy
One case of GHB use ended in tragedy. On January 16th, 1999, three girls told their parents they were going to a movie, but instead they ended up at a party at someone's house. Some kids were drinking alcohol and some were smoking marijuana. One of the girls, ninth-grader Samantha, asked for a Mountain Dew. A 19-year old boy got it for her. At one point, she told her friend the soda tasted "gross," but she drank it. A few minutes later she vomited and passed out. She was moved onto the bathroom floor, beside another 14-year-old girl, Melanie, who also passed out after having a drink. Once the boys became concerned that they could not wake the girls, they took them to the hospital. Both girls fell into comas. Melanie recovered, but Samantha never regained consciousness and died in the hospital.
In February 2000 the four males involved (ages 18, 19, and 26) went on trial for the death of Samantha and the poisoning of the other girls, one of whom ingested some GHB but had no symptoms. This was the first trial of a GHB-related death. The younger males were found guilty of involuntary manslaughter and lesser charges of poisoning. The 26-year-old was convicted of being an accessory to manslaughter, poisoning, and possession of marijuana and GHB. The jail time for the manslaughter convictions is up to 15 years; the jail time for the poisoning convictions can be up to 5 years.

Law Enacted
On February 18, 2000, President Clinton signed federal legislation (H.R. 2130) making the possession of GHB illegal. It was a controlled substance, a so-called Schedule 1 drug, just like heroin. However, in July 2002, a form of GHB was designated as a Schedule III Controlled Substance. A Schedule III substance can be used for medical purposes, but it cannot be sold, distributed, or provided to anyone other than for its prescribed use. The Controlled Substances Act ranks drugs from 1 to 5 based on how harmful they are; a ranking of 1 means that the drug has a high potential for abuse. The new scheduling of GHB was made in response to new research showing that GHB may help treat some symptoms of narcolepsy.