Ghb And What It Essay Research Paper

GHB, or gamma-hydroxybutyrate, is a nutrient that is part of the metabolism

process in mammalians. It can be found in every cell of the human body. The

greatest quantities can be found in the kidney, heart, skeletal muscles, and

brown fat tissues (Chin and Kreutzer, 1992). Chin and Kruetzer also believe it

to be a neurotransmitter, however that has not yet been proven. GHB is known to

be a metabolite and also a precursor of the inhibitory neurotransmitter GABA

(gamma-aminobutyric acid). GHB and GABA have a close structural relationship,

but GHB does not act on GABA receptor sites.

GHB was first synthesized about thirty years ago. A french researcher, Dr. H.

Laborit, was exploring the effects of GABA in the brain. Laborit had to

synthesize GHB because very little or no GABA crosses the blood-brain barrier.

The difference in the two allowed GHB to cross this barrier where some of it is

metabolized into GABA (Vickers, 1969).

What happened was GHB exhibited a range of effects beyond what was expected

from GABA. In the years to follow, the effects of GHB have been extensively

researched. It has come to be used in Europe as a general anesthetic, a

treatment for narcolepsy, an aid in child birth, and also as a treatment for

alcoholism and withdrawal syndrome. Then in the 80’s, it was available over the

counter in health food stores. It was used by body builders for its ability to

stimulate growth hormone release which aided in fat reduction and muscle

building. However, in the last few years it has become a popular recreational

drug. It gives a pleasant, alcohol like, hangover free "high" with

prosexual effects.

For the thirty years prior to 1990, all research papers on GHB were unanimous

in reporting numerous beneficial physiological effects and the absence of long

term negative effects. Vickers called it "a truly nontoxic hypnotic"

and emphasized its "lack of toxicity." Vickers also showed evidence

that GHB demonstrates "no toxic effects on the liver and kidney." As

recent as 1989, the consensus was unchanged. Gallimberti’s study from that year

on its uses in treating alcohol withdrawal in humans notes that "GHB’s

action…seems to be without serious side effects." Gallimberti’s reference

to the "safety of GHB" shows how well-established this property of the

nutrient had become.

Then, on November 8, 1990, the FDA banned the over the counter sale of GHB in

the United States. In 1991, two scientists from the California Department of

Health Services wrote a report on ten "poisonings" associated with GHB.

Chin and Kreutzer had warned of GHB’s potential for abuse. They observed that

"all interviewed patients reported a pleasurable sensation or a ?high’.

Several of them..continued taking [GHB] because it made them ?feel

good’."

If the ten "poisonings" are looked at more closely, four involved

"unknown doses," four featured the "coingestion" of other

drugs, (usually alcohol), one involved unmedicated epilepsy, and another a

history of grand mal seizures. Since alcohol and other central nervous system

depressants are not recommended with GHB, and because it is contraindicated for

epileptics, such cases are not unexpected.

One point of the of the poisonings needs to be addressed–the use of the

terms "coma" and "seizures" are used in the description of

these ten cases. If a high dose of GHB is consumed it can cause clonus, a rapid,

rhythmic contraction and relaxation of muscles which would be better described

as muscle spasm or uncontrollable twitching than a seizure. GHB has also been

known to cause intense drowsiness, abrupt sedation, and deep sleep which is

probably better described as unarrousability or deep sedation rather than coma.

The authors of these ten reports confirmed that "there have not been any

reported deaths" and that "if product use is discontinued, full

recovery with no long term side effects is universal."

Some of the concerns that are related with GHB are some of the side effects

that are present when large doses are consumed. A dose twice the recommended for

relaxation can put you to sleep in a very short amount of time after

consumption. In this respect it is similar to alcohol: if you drink twice as

much as you normally would, you probably wouldn’t function very well.

Most of the people that take it find that it gives a pleasant state of

relaxation and tranquility. There can also be feelings of placidity, sensuality,

mild euphoria, and can also give a tendency to talk. Worries tend to fade into

feelings of emotional warmth, well being, and pleasant drowsiness. The morning

after is unlike that of alcohol or other drugs that induce similar feelings.

Most people claim to feel refreshed and even energized the next day. The effects

can be felt in as quick as five minutes to as long as twenty minutes after

ingestion. It lasts for anywhere from an hour to three hours. These feelings can

be prolonged by more doses when it starts to wear off. Higher levels can be

reached by just small doses after the initial dose. One may experience

giddiness, silliness, trouble walking and speaking, and may become dizzy. Even

higher doses can induce sleep in just a matter of minutes.

GHB temporarily inhibits the release of dopamine in the brain. This leads to

a build up of dopamine and later increased dopamine release when the GHB wears

off (Chin and Kreutzer, 1992). This releasing of the dopamine may explain the

middle-of- the-night wakings which are common with higher doses, and for the

energized feeling the next day.

GHB also stimulates pituitary growth hormone release. One rigorous Japanese

study reported nine-fold and sixteen-fold increases in growth hormone 30 and 60

minutes respectively after an intravenous administration of 2.5 grams of GHB in

six healthy men between the ages of twenty five and forty (Takahara, 1977).

Growth hormone levels were still at seven-fold higher at two hours.

GHB induces muscle relaxation and is growing in France and Italy as an aid to

child birth. It causes "spectacular action on the dilation of the

cervix," decreased anxiety, greater intensity and frequency of uterine

contractions, increased sensitivity to oxytocic drugs, which are used to induce

contractions, preservation of reflexes, a lack of respiratory depression in the

fetus, and protection against fetal cardiac anoxia (Vickers, 1969; Laborit,

1964).

GHB is completely metabolized onto carbon dioxide and water, leaving

absolutely no residue of toxic metabolites (Vickers, 1969; Laborit, 1972). It is

so efficient that it can no longer be detected in the urine four to five hours

after injected (Laborit, 1964).

It also activates a metabolic process known as the "pentose

pathway" which plays an important role in the synthesis of protein within

the body (Laborit, 1972). GHB also creates a "protein sparing" effect

(Laborit, 1964) which reduces the rate at which the body breaks down its own

proteins. It is because of this and its effect on the growth hormone, that it is

used in muscle building and fat loss.

At extremely large doses GHB is used as an anesthetic. The large doses are

followed by a small increase in blood sugar levels, and a significant decrease

in cholesterol. Respiration becomes slower and deeper. Blood pressure may rise

or fall slightly, or remain stable, but a mild slowing of the heart is

consistent (Vickers, 1969; Laborit, 1964).

Smart Drugs II called GHB "almost an ideal sleep inducing

substance." Due to the relaxation experienced from small doses it is easier

to fall asleep naturally. Then from larger doses sleep will be induced within

five to ten minutes (Laborit, 1964). Most other hypnotics interfere with the

various stages of the sleep cycle and prevents the body from getting a complete

rest. GHB induced sleep is characterized by increased levels of carbon dioxide

in the arteries, as in normal sleep (Vickers, 1969). During normal and GHB

sleep, the central nervous system continues to be responsive to pain and other

stimuli, which limits GHB’s use as an anesthetic (Vickers, 1969). It also

facilitates REM sleep, and non-REM (slow-wave) sleep, the stage of sleep

featuring increased release of growth hormone (Laborit, 1972). And unlike the

unconsciousness produced by other anesthetics, that triggered by GHB does not

feature a systemic decrease in oxygen consumption (Laborit, 1964).

In laboratory rats that are addicted to alcohol, withdrawal symptoms closely

resemble those that are exhibited by humans. These symptoms include: tremors,

convulsions, and hypersensitivity to sound. All symptoms were blocked by large

doses of GHB (Fadda, 1989). Administration of GHB has also been found to prevent

alcohol consumption among rats that voluntarily ingest alcohol (Fadda, 1989;

Gallimberti, 1989).

In a rigorous, double-blind, placebo-controlled study conducted of human

alcoholics, "nearly all withdrawal symptoms disappeared within two to seven

hours" after administration of GHB. On a severe-moderate-mild-or-none

scale, withdrawal symptoms remained below moderate during the entire period. The

only side effects observed was slight, occasional, and transient dizziness. The

researchers concluded, "the results clearly indicated that GHB is effective

for the suppression of withdrawal symptoms in alcoholics" (Gallimberti,

1989).

GHB’s efficacy for treating anxiety has been positively demonstrated in tests

involving schizophrenic subjects (Laborit, 1964). Its sedative properties have

earned it a role as a pyschotherapeutic adjunct (Vickers, 1969). It has also

been used to assist the process of "abreaction," or the release,

usually through verbalization, of repressed emotion (Vickers, 1969). Unlike

other anti-anxiety drugs, it’s effect is non-toxic. And it encourages

verbalization, and the typical lack of fear during the GHB experience would seem

to provide and ideal context for the verbal exploration of difficult emotions

during therapy.

GHB is growing in popularity and seems to be widely available in the

underground "gray market." Since most of the GHB available through

such means is of the "bootleg" variety, made by those other than

professionals. So there are concerns about quality and purity.

As has been emphasized, the overall safety of GHB is well established, and no

deaths linked to GHB have been reported in over the thirty years that it has

been in use (Vickers, 1969; Chin and Kreutzer, 1992). Actually, as of 1990,

there had only been forty six adverse reactions that had been reported in the

United States. All which were followed by a rapid and complete recovery (Chin

and Kreutzer, 1992). Unlike a large number of other drugs, GHB has no toxic

effects on the liver, kidney, or other organs (Vichers, 1969; Chin and Kreutzer,

1992). Vickers in 1969 even reports that doses as high as twenty to thirty grams

per twenty four hour period have been used for several days without negative

consequences. Canadien studies of narcolepsy there is a use of roughly 2.5 grams

for several years which resulted in no reports of long term adverse effects, or

problems with issues of addiction or dependence. And in France, sub-anesthetic

oral doses were used by "a large number of patients for about six

years" without unfavorable effect (Laborit, 1972).

The most common side effects are dizziness, nausea, and sometimes vomiting.

Also there may be muscle spasms, headache, moderate slowing of the heart rate,

and small changes in blood pressure can occur. And at higher doses cardiac and

respiratory depression can occur. Also at these higher doses sudden sedation and

loss of consciousness are expected. Some of the more unusual adverse reactions

may include: diarrhea, lack of bladder control, temporary amnesia, and sleep

walking.

Vickers reports that there are "remarkably few" contraindications.

However, those who suffer from any of the following conditions should not use

GHB: severe illness of any kind, epilepsy, convulsions, slowed heart rate due to

conduction problems, Cushing’s syndrome, severe cardiovascular disease,

hyperprolactinemia, and severe hypertension (Gallimberti, 1989; Vickers,1969).

GHB should not be used with benzodiazepines, phenothiazines, various

painkillers (barbiturates and opiates), alcohol, anticonvulsants, and even many

other over the counter allergy and sleep remedies.

The amount required for a given level of effect will vary from person to

person. Once the amount is found it will stay the same, in that a tolerance does

not build up. Most people find that a dose in the range of .75-1.5 grams is

suitable for the prosexual effects, and that a quantity around 2.5 grams will be

sufficient to force sleep.

So should GHB be used for uses such as a sleep aid for those with mild sleep

disorders, those in therapy sessions, those with alcoholism, and possibly those

with anxiety disorders. If a drug comes along that has so many good uses and is

for the most part safe, why shouldn’t it be used. There are many more drugs out

there that are on the shelves in the pharmacy that can not do even half of what

this drug can do and that are much more dangerous. This is not a plea to

legalize the drug, but instead a plea just to look at the possibilities of the

drug. With no toxicity and uses that range from anesthesia to child birth to

weight loss to sleep aids, how can one just label it as a "date rape"

drug and forget about it. It has too much to offer on the good side than it does

on the bad. New studies are coming out all the time. Possibly more is truly

known about the drug than what they are telling us. However, from the

information that I have gathered it seems that this could be a renaissance drug

of sorts. GHB was recently put on the control list as a schedule 1 drug.

Possibly now some of its uses can be examined a little more closely, for

possible use in the abnormal psychology as well as other areas of medicine.

REFERENCES

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Britain]. 24(5): 447-51, 1989.

Gallimberti L, Gentile N, Cibin M, Fadda F, Canton G, Ferri M, Ferrara SD and

Gessa GL. Gamma-hydroxybutyric acid for treatment of alcohol withdrawal

syndrome.

The Lancet, 787-9, 30 September 1989.

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activities of the central nervous system (slow and desynchronized sleep,

learning and memory, sexual activity, morphine tolerance, aggressiveness, and

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in Chemical Pathology and Pharmacology 3(1): January 1972.

Laborit H. Sodium 4-Hydroxybutyrate. Int J Neuropharmacology [Great Britain].

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Takahara J, Yunoki S, Yakushiji W, Yamauchi J and Ofuji T. Stimulatory

effects of gamma-hydroxybutyric acid on growth hormone and prolactin release in

humans. J Clin Endocrinal Metab 44: 1014, 1977.

Vickers MD. Gamma-hydroxybutyric Acid. Int Anaethesia Clinic 7:75-89, 1969.