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GHB is a popular drug of abuse. It originated as a short-acting general anesthetic and is occasionally used in the treatment of narcolepsy. It gained popularity among bodybuilders for its alleged growth hormone stimulation and found its way into social settings, where it is consumed as a liquid. It has been used to facilitate sexual assault (“date-rape” drug). Symptoms after ingestion include drowsiness and lethargy followed by coma with respiratory depression. Muscle twitching and seizures are sometimes observed. Recovery is usually rapid, with patients awakening within a few hours. Other related chemicals with similar effects include butanediol and gamma-butyrolactone (GBL). A prolonged withdrawal syndrome has been described in some heavy users.

TREATMENT

Monitor the airway and assist breathing if needed. There is no specific treatment. Most patients recover rapidly with supportive care. GHB withdrawal syndrome may require very large doses of benzodiazepines; baclofen has also been used.

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Liakoni  E  et al. Presentations to an urban emergency department in Switzerland due to acute γ-hydroxybutyrate toxicity. Scand J Trauma Resusc Emerg Med. 2016 Aug 31;24(1):107.
[PubMed: 27581664]
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Lingford-Hughes  A  et al. Improving GHB withdrawal with baclofen: study protocol for a feasibility study for a randomised controlled trial. Trials. 2016 Sep 27;17(1):472.
[PubMed: 27677382]
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Miró  Ò  et al. Intoxication by gamma hydroxybutyrate and related analogues: clinical characteristics and comparison between pure intoxication and that combined with other substances of abuse. Toxicol Lett. 2017 Aug 5;277:84–91.
[PubMed: 28579487]

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