Gamma-hydroxybutyric acid and analogues

Gamma-hydroxybutyric acid (GHB) (Fig. 3.19) is a substance endogenously present in the brain. It was originally developed as an anaesthetic drug and is still used for that purpose in some countries. It acts as a CNS depressant and hypnotic and is chemically related to the brain neurotransmitter GABA. It is believed that GHB acts via a so-called ‘GHB-receptor’

As well as the GABAA receptor. Synonyms for GHB include sodium oxybate, gamma-OH, Somotomax, ‘GBH’ and ‘liquid ecstasy’.

The effects of GHB have been likened to those produced by alcohol and there are claims that it has anabolic properties. It has gained notoriety for its use in drug-facilitated sexual assault (see Chapter 10). GHB is manufactured easily by adding aqueous sodium hydroxide to gamma-butyrolactone (GBL) to leave a weakly alkaline solution. Not only is the precursor GBL widely used as an industrial solvent, but it can also be ingested directly to produce the same effects as GHB. Although it occurs as a white powder in pure form, illicit GHB is normally sold in solution as a clear liquid in 30 mL opaque plastic bottles. The typical dose is around 10 mL, equivalent to about 1 g or more of GHB. The sodium and potassium salts of GHB are hygroscopic, so GHB is almost never found as a powder or in tablets. GHB is readily soluble and the fact that it is available in liquid form and is odourless and more or less tasteless makes it relatively simple for someone to spike into another person’s drink without their notice.

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