Gamma-Hydroxybutyrate Overdose

Key Features

• A popular drug of abuse and for sexual assault

• Consumed as a liquid

• Other related chemicals with similar effects include butanediol and gamma-butyrolactone (GBL)

• A prolonged withdrawal syndrome has been described in some heavy chronic users

• Sodium oxybate, the sodium salt of gamma hydroxybutyrate, is legitimately used in treatment of narcolepsy

Clinical Findings

• Drowsiness

• Lethargy

• Coma with respiratory depression

• Muscle twitching and seizures are sometimes observed

• Recovery is usually rapid, with patients awakening within a few hours

Diagnosis

• Urine gamma-hydroxybutyrate (GHB) analysis can be obtained from National Medical Labs and some forensic laboratories

Treatment

• Activated charcoal if co-ingestion suspected

  • Administer 60–100 g orally or via gastric tube, mixed in aqueous slurry for recent ingestions

  • Do not use for comatose patients unless it can be given by gastric tube and the airway is first protected by a cuffed endotracheal tube

• 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