[Main Page][GHB FAQ][Meta-FAQ][Supply FAQ][Therapy FAQ] [References][Glossary][Link To the Outside World]

A new FAQ is up on the web, which promotes and vectors many inaccurate and misleading statements about GHB, as well as some that are self-righteous and just plain wrong. Reprinted here is my letter written in response to that page's author. You can also view this letter next to her document, if you prefer.

Dear Mrs. Shortridge,

I'm terribly sorry to hear about your son's death. I heard about it in your internet paper on GHB, a subject I am quite interested in. Several months ago, I began on the same path as you. I eschewed the www's partisan reports and went straight to the medical journals, seeking to avoid the known sensationalism of popular press accounts. I've even developed my own online FAQ! You seem to have some information that I missed, and to have missed some that I have. Perhaps we can collaborate.
Below, I've quoted and discussed some excerpts from your page. Numbers in brackets refer to my references, which are documented at the end.

{{{amnesia}}}

I have seen this mentioned in several popular press accounts, but have not been able to track down the research (either medical or from collected reports of users) from which it comes. Can you help me?

{{{respiratory problems}}}

My research has revealed no evidence that even doses leading to the well-known 2-4 hour coma induced by GHB pose any actual threats due to depressed breathing. EMTs, through no fault of their own, seem to assume arrest and intubate simply because when they find an unconscious patient breathing slowly, the have no time to do blood-oxygen counts or to gauge the depth of each breath, both of which have demonstrated that GHB users are not in any danger of hypoxia [45].

{{{being conscious but unable to move}}}

I have heard this reported only as "sleep paralysis," which occurs briefly upon awakening or before falling asleep, and only in narcoleptics [4]. I have heard nothing about paralysis while fully conscious, except in the petit mal seizures induced at doses of about .5_grams_/kg (about 20 effective doses) [5], which as far as I know has only been tested on lab animals.


{{{death}}}

Every death I have heard of involving GHB was either a drug interaction or a forensic mix-up. I agree with you the GHB can be deadly when mixed with alcohol, but other than that (and a case involving coingestion of heroin) I do not know of any deaths associated with it. Chin and Kreutzer's article on "acute poisoning from GHB," one of the best anti-GHB studies of which I know, still concludes that subjects, when given the respiratory support C&K believe they require, universally recover within hours and experience no aftereffects [52]. The famous Hillory Farias death occurred in a manner completely inconsistent with known accounts (GHB's onset is almost always within the hour, and if she were going to die she should have at least fallen unconscious rather than finishing her night at the club, driving home, and going to bed), both favorable and unfavorable, of GHB's effects on any other human being, and was found to be a case of coronary thrombosis [151]. Additionally, I have come upon fascinating new evidence that the GHB that was found in her system was actually endogenous, despite the fact that it was far higher than any normal levels [140]. For an explanation and a more detailed synopsis, please read http://members.tripod.com/~laboritFarias.html


{{{Your body manufactures enough GHB for it's normal metabolism. The only reason people take GHB at a party is to get high, not for their health. People are kidding themselves if they imagine they're taking a vitamin supplement or amino acid, even though GHB has been marketed as such. }}}

I agree that irregular, recreational use of GHB isn廠 going to do much good to anyone's health, except insofar as most of America doesn廠 get enough sleep and probably does benefit from a quick stress release.
However, your explanation is disingenuous, the equivalent of claiming that because vitamins A and D occur naturally in the body's metabolism, people taking supplements aren廠 getting any benefit from them.


{{{GHB proponents often speak and write with educated tongues, which makes it easy to accept their words. They often call GHB a "dietary supplement." }}}

I think calling it so is reasonable, when it is used by narcoleptics or bodybuilders on a regular, supervised dosage schedule. What is a nutrient, except a chemical which is used by the body to supply or regulate its natural chemical processes?

People taking GHB as a party drug and calling it a supplement are dissembling, yes.

{{{QUESTION: If you wanted correct, objective, neutral information regarding Mental Illness, would you choose to get your information from Charles Manson? }}}

Ad hominem. On the other hand, I suffered the same qualms as you at the beginning of my quest, which is why none of the claims I make are stated without recourse to peer-reviewed scientific journals. No digests, few drug websites, and a bare minimum of popular press. If you examine my full bibliography at http://members.tripod.com/~laborit/references.html, you will see that I also include the famous anti-GHB articles by Chin and Kreutzer [52], Dyer [34], Galloway [33], Friedman [70], and others as well, and cite them repeatedly.

{{{Many of these Internet reports and information ds not mention the many, many deaths attributed to GHB use and abuse. In fact, they will deny that these deaths were from GHB. They downplay the GHB found in the body or on the scene. They will claim and do claim that it was the use of other substances that caused the deaths or overdoses. }}}

What are your cites for these many deaths? I attribute the alcohol coingestion deaths to both drugs, through a well-known synergy between the two [46]. I simply submit that this is no more a reason to demonize GHB than it is to demonize alcohol. If you examine my GHB site at http://members.tripod.com/~laborit/contents.html, you will see that I
make no bones about the importance of avoiding alcohol and other CNS depressants.

{{{They claim that it is unlikely to die or OD on GHB without another substance in the body.This is false. }}}

Please provide citations from medical journals. Specifically, please explain why decades of experiments on human patients, often using IV administration which is faster-onset and up to twice as powerful, have
not reported a single death or even significant injury even as they continue to the present day. [17], [20], [21], [28], and [75] were all published in 1997 or 1998. [17], for example, lists no side effects at all. Subjects in [21] reported an increase in such sensations as "sluggish" and "high" but experienced "no significant physiological effects at the doses administered" (up to 70mg/kg, which for many people is a deep sedative dose).

{{{As far as claims about medical use of GHB: whether or not any substance has medical benefit, this does not make it safe to use on a personal or social basis. There are MANY substances that ARE used in hospitals and treatment centers for various purposes, but these same substances are illegally and unsafely being sold and used on the street. }}}

True, but neither does it mean that they are dangerous. Aspirin, caffeine, and antihistamines are all potentially imparing drugs (from hypotension, jitteriness and inattention, and drowsiness, respectively)
which alter some aspect of the mind or body, yet we have few fears about people using these at their own discretion.

{{{Whether or not GHB has ANY medical benefit is not the issue here. People are making this stuff like mixing ingredients for science experiments. The claim that "if it was legal and regulated, then there would not be a problem, so the argument that "it's the establishment's fault," is erroneous and outrageous!! }}}

Well, it certainly is if you think GHB causes death! However, if one believes that GHB qua GHB is safe, then the rules change entirely. Feel free to accuse your opponents of poor research, but save allegations of malice and madness for those who deserve them.

{{{Even if there were a DOUBT that ANY substance was dangerous or deadly, wouldn廠 common sense urge you to avoid it? How much more caution is needed with a substance that is definitely linked to and is the cause of death in some people. }}}

I _know_ cars are deadly, but I drove one for years. The toxicity of everything from aspartame (nutrasweet®) to naproxin sodium (Alieve®) is not completely investigated, but consumers "take" such risks every day. A bottle of salysillic acid (Aspirin®) will kill you via stroke, a bottle of acetominiphen (Tylenol®) will eat your liver, a mix of ammonia (Comet®) and chlorine bleach (Clorox®) will asphyxiate you, sodium hydroxide (Drano®) will dissolve your skin, and a Happy Meal® with fries won廠 do you much good either; do we prohibit even a five-year old from the purchase of any of these?

And I ask you again, which people?

{{{The facts show that GHB IS dangerous. It is unstable, just like the research about it. Many people have been put on life support while on a GHB overdose. }}}

That doesn廠 mean they needed it (see above). Note that I do not blame any medical malpractice or conspiracy, but rather the users stupid enough not to know their proper dose and tell a friend what they were doing.

{{{Yes, deaths do ocurr due to GHB. These deaths are often not documented. One of the reasons for this is that GHB leaves the system very quickly, with no trace, and there are no modern quick ways to test for GHB Overdose. Not even every coroner's department has the testing capability. So, yes, people die from GHB. It is just very hard to test for. }}}

Again, please give me your source! If this is true, I must add it to my
site IMMEDIATELY!

I do appreciate your desire to help keep uneducated youth safe. Please take my comments as a constructive effort to combine the best aspects of both our works into a valuable and factually informative whole.

Michael Cohn
Proprietor of the GHB FAQ at http://members.tripod.com/~laborit

REFERENCES:

4. Mamelak, Mortimer; Escriu, Joseph; Stokan, Olga. "The effects of
Gamma-hydroxybutyrate on sleep". Biological Psychiatry. 1977. 12(2). 273-288.

5. Snead, O.. "Gamma Hydroxybutyrate in the monkey - I: electroencephalographic,
behavioral, and pharmacokinetic studies". Neurology. 1978. 28. 636-642.

17. Mendels, J.; Hawkins, D.R.. "Effect of bytyrolactone and
gamma-hydroxybutyrate on the EEG and sleep cycles in man".
electroencephalography and clinical neurophysiology. 1967. 22. 558-562.

20. Cauter, Eva; Plat, Laurence; Scharf, Martin; Leproult, Rachel; et al..
"Simultaneous stimulation of slow-wave sleep and growth hormone secretion by
gamma-hydroxybutyrate in normal young men". Journal of clinical investigation.
1997. 100(3). 745-753.

21. Rosen MI. Pearsall HR. Woods SW. Kosten TR.. "Effects of
gamma-hydroxybutyric acid (GHB) in opioid-dependent patients". Journal of
Substance Abuse Treatment. 1997. 14(2). 149-54. RC 563 J687.

28."Helping alcohol misusers abstain". Nursing Standard. 1998. 12(18). 25.

33. Galloway, Grantt; Frederick, S L; Gonzales, Marco; et al .
"Gamma-hydroxybutyrate: an emerging drug of abuse that causes physical
dependence". Addiction . 1997. 92(1). 98-96.

34. Dyer, Jo Ellen. "Gamma-Hydroxybutyrate: A health food product producing
coma and seizurelike activity". American Journal of Emergency Medicine . 1991. 9. 321-4.

45. Mamelak, Mortimer. "Gamma-hydroxybutyrate: and endogenous regulator of
energy metabolism". Neuroscience and Biobehavioral Reviews . 1989. 13. 187-98.

46. McCabe, E R; Layne, E C; Sayler, D F; et al . "Synergy of ethanol and a natural soporific - Gamma-hydroxybutyrate". Science . 1971. 171. 404-6.

52. Chin, Ming-yan, Kreutzer RA and Dyer JE . "Acute poisoning from
gamma-hydroxybutyrate in California". Western Journal of Medicine (United
States). 1992. 156(4). 380-384.

68. Dillmann, Joseph. "GHB-A drug you should know". Nursing. 1997. september.
32cc15-16.

69. Sanguineti, Vincenzo; Angelo, Anita; Frank, Marion. "GHB: A home brew".
American Journal of drug and alcohol abuse. 1997. 23(4). 637-642.

70. Friedman, Joseph; Westlake, Robert; Furman, Martin. ""Grevious Bodily
Harm:" Gamma hydroxybutyrate abuse leading to a Wernike-Korsakoff syndrome".
Neurology. 1996. 46. 469-471.

75. Addolorato, G. et al.. "Maintaining abstenence from alcohol with
gammahydroxybutyric acid". Lancet. 1998. 351(9095). 38.

140. Fieler, Erin; Coleman, Daniel; Baselt, Randall. "Gamma-hydroxybutyrate
concentrations in pre- and postmortem blood and urine". Clinical Chemistry. 1998. 44(3). 692.

151. Dean, Ward; Morgenthaler, Joy; Fowkes, Steven. GHB: The Natural Mood
Enhancer. 1998. Smart Publications, Petaluma CA

[Main Page][GHB FAQ][Meta-FAQ][Supply FAQ][Therapy FAQ]
[References][Glossary][Link To the Outside World]


Created and maintained by Michael Cohn - michaelc@medscape.com  © 1998