DEA/OD/ODE
Introduction:
Gamma-Hydroxybutyric acid
(GHB) is a schedule I depressant while the GHB-containing
product, Xyrem, is a schedule III drug. GHB has been encountered
in nearly every region of the country. It is used the
same reason as recreational drugs; for their euphoric and
sedative effects. GHB abuse became popular among
teens and young adults at dance clubs and "raves" in
the 1990s, and gained notoriety as a date rape drug.
Licit Uses:
On July 17, 2002, the Food
and Drug Administration approved Xyrem (sodium oxybate) with
Orphan Drug Status and limited distribution through a central
pharmacy. Xyrem oral solution is approved as a treatment to
reduce the incidence of cataplexy and to improve daytime
sleepiness in patients with narcolepsy
Chemistry and
Pharmacology:
GHB is a solid substance
but is generally dissolved in liquid. In liquid form, GHB is
clear and colorless, and slightly salty in taste.
GHB occurs naturally in
the central nervous system in very small amounts. Scientific
data suggest that GHB can function as a neurotransmitter or
neuromodulator in the brain. It produces dose-dependent
depressant effects similar to those of the barbiturates and
methaqualone. Low doses of GHB produce drowsiness, nausea, and
visual distortion. At high doses, GHB overdose can result in
unconsciousness, seizures, slowed heart rate, severe respiratory
depression, decreased body temperature, vomiting, nausea, coma,
or death. Sustained use of GHB can lead to addiction. Chronic
abuse of GHB produces a withdrawal syndrome characterized by
insomnia, anxiety, tremors, marked autonomic activation (i.e.,
increased heart rate and blood pressure) and occasional
psychotic thoughts. Currently, there is no antidote available
for GHB intoxication.
Illicit Uses:
GHB is abused for its
euphoric and sedative effects. GHB is mainly self-ingested
orally in a liquid mixture. It is
sometimes mixed with alcohol to intensify its effects resulting
in respiratory depression and coma. The average oral dose range
from 1 to 5 grams (depending on the purity of the compound this
can be 1-2 teaspoons mixed in a beverage). The saturation and
concentrations of these "home-brews" have varied so
that the user is not usually aware of the actual dose they are
drinking. The onset of action after oral ingestion is 15 to 30
minutes and the effects last 3 to 6 hours.
The most recent data from
poison control centers, a high school survey, and forensic
laboratory analyses of seized samples from System to Retrieve
Information on Drug Evidence (STRIDE) and National Forensic
Laboratory Information System (NFLIS) all suggest illicit
activities with GHB and its analogues are declining although
remaining a significant threat to the public safety.
GHB analogues are often
abused in place of GHB. Both GBL and BD metabolize to GHB upon
ingestion. The ingestion of analogs produces physiological
effects similar to GHB.
User Population:
GHB is abused by teens and
young adults at all-night parties and "raves."
Monitoring the Future Survey indicated that in 2005, 0.5% of 8th
graders, 0.8% of 10th graders, and 1.1% of 12th graders reported
past year use of GHB.
Illicit Distribution:
GHB is produced illegally
in both domestic and foreign clandestine laboratories. The major
source of GHB on the street is through clandestine synthesis by
local operators. GHB is sold usually as a white powder or as a
clear liquid. GHB is packaged in vials or small bottles. At bars
or "rave" parties, GHB is sold in liquid form by the
capful or "swig" for $5 to $25 per cap.
There has been almost no
diversion or abuse of the pharmaceutical product, Xyrem.
Control Status:
On March 13, 2000, GHB,
including its salts, isomers, and salts of isomers, were made a
schedule I controlled substance (65 FR 13235-13238). On March
20, 2001, GHB was added in schedule IV of the 1971 Convention of
Psychotropic Substances.
GBL became a list I
chemical, subject to the criminal, civil and administrative
sanctions of the Controlled Substances Act, on February 18, 2000
under the provisions of the "Hillary Farias and Samantha
Reid Date-Rape Prohibition Act."
Xyrem is a schedule III
controlled substance. However, trafficking of Xyrem is subject
to schedule I penalties.
Comments and additional information are welcomed by the
Drug and Chemical Evaluation Section, FAX 202-307-1263 or telephone