GBL/GHB deaths rise dramatically in the UK year on year
GBL/GHB deaths rise dramatically in the UK year on year
GBL related deaths and injury in the UK continue to rise exponentially. GBL (short for gamma butyrolactone) is currently a legal drug in the UK although illegal in the USA and Canada.
GBL is a “precursor drug” and is swiftly metabolised in the human body into it’s active form, GHB (short for gamma hydroxybutyrate). In essence the two are interchangeable.
GBL is a caustic chemical solvent available in the UK through the Internet in 10 litre containers which come with a neat 2ml pipette.
Just for an indication of scale one litre of fluid is equivalent to 1000 mls. So a ten litre container contains enough for 5000 doses. Its intended use is in the manufacture of plastics and also as for example, an alloy wheel cleaner. 10 litres costs around £500GBP.
I see patients on a very regular basis with GBL/GHB addiction problems. With the banning of GHB in the UK GBL has taken its place instead.
Formulae are available on the internet to convert GBL to GHB in the kitchen. This is perceived by many users to be a safer option. It is unlikely to be safer since one of the essential chemicals required in the kitchen to make GHB from GBL is caustic soda.
GHB was originally formulated in the 1960’s and was used therapeutically for a brief period as both an anaesthetic agent and in the treatment of alcoholism. However, it swiftly became a problematic club-drug and use, in the USA was banned.
GBL is problematic because it is metabolised very swiftly into GHB by a naturally occuring human enzyme.
It competes for space for naturally occuring GABA receptors in the brain, but it also seems to attach specifically to GHB receptors in the brain. This duality of function and receptor attachment is likely to be responsible for both it’s euphoric and disinhibiting effects and also the physical withdrawal syndrome associated with it (Snead et al,
Gamma Hydroxybutyric Acid Volume 352:2721-2732 June 30, 2005 Number 26). Snead et al list a range of physiological effects on the body after dosing including
low body temperature (hypothermia); flash hypertension (sudden peaks of blood pressure); racing heart beat (tachycardia);electrical changes in the brain leading to seizure activity.
A careful study from Barcelona (by Miro et al Trends in illicit drug emergencies: the emerging role of gamma-hydroxybutyrate. Trends in illicit drug emergencies: the emerging role of gamma-hydroxybutyrate.) documented changes in causes of
emergency admissions to hopsital emergency departments. They noted that since 1989 when they had undertaken a simialr toxicological study there had been a very significant change in type of drug use. In fact GHB/GBL overdosesbecame the second most common reason for illicit drug admission. They identified a profile which was of a young person of approximately 23 +/-5 years 64% of whom were male, 73% of whom had drunk alcohol and 86 % of whom had used other illicit drugs at the same time.
The only feature which differs from patients presenting to me in my practice is the age range which for me tends to be from late teens to late 50’s.
Detecting GHB or GBL is difficult and requires great vigilance in the attending medical team as it is swiftly broken down in the body to inert compounds. The half life (the time it takes to lose half its effectiveness) is very short, being only around 20 or so minutes. Plasma levels will reach their peak at around 40 minutes. People who become addicted to GBL/GHB will frequently dose with 1-2 mls every 40 to 60 minutes through the day.
GBL/GHB is a particularly dangerous substance because it has a very steep dose-response curve which means that it has a very small margin of safety and as the dose increases, by even very small amounts, the move from safe levels to
lethal levels is tiny. Mixing GBL/GHB with alcohol will result in a massive alteration of the safe dose of GBL/GHB and often result in respiratory depression, vomiting, depressed cardiac output, seizure and death.
Combining GBL/GHB with other dance or club drugs will magnify the toxicity of all compounds in an unpredictable way. GBL/GHB is used particularly to cause euphoria and sexual disinhibition and compliance. In personal correspondence with one physician operating in this field he identifies GBL/GHB use as being used
in the absence of a normal attractive personality.
Snead et al, in the paper referred to above emphasise the point that whilst GBL/GHB induces a deep and unrousable coma, the recovery time is short. This produces a misplaced feeling of security in the patient.
This is certainly borne out anecdotally in my patients who are removed to hospital and recover either en route or in the resus room and then return to the environment they came from. I have had several patients die of GBL/GHB overdose with and without alcohol and other substances and there are numerous reports in
Pages: 1 2