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GHB is a popular recreational drug. 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-rapedrug). 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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Busardò  FP  et al. Interpreting γ-hydroxybutyrate concentrations for clinical and forensic purposes. Clin Toxicol (Phila). 2019;57:149.
[PubMed: 30307336]  
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Marinelli  E  et al. Gamma-hydroxybutyrate abuse: pharmacology and poisoning and withdrawal management. Arh Hig Rada Toksikol. 2020;71:19.
[PubMed: 32597141]  

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