Liquid Ecstasy – A Significant Drug Problem

Abstract

In any patient with impaired consciousness of unknown cause, the possibility of intoxication with GHB must be considered. Chemical detection of GHB in blood or urine is possible only using specific analytical methods and only within a short time frame (<12 h). Because of the short half-life of GHB, intoxications treated in intensive care units rarely show any complications. However, a number of fatalities have occurred. The potential abuse of GHB as a date rape drug must be borne in mind.

Estimation of gamma-hydroxybutyrate (GHB) co-consumption in serum samples of drivers positive for amphetamine or ecstasy

“…The irregularities reported in the six samples identifying GHB levels above the cut-off coincide closely to the described effects of high doses of GHB, such as confusion, impaired or loss of consciousness [19][20][21]. Table 3 gives an overview of age, sex, time until blood samples were taken and the substances found in all cases.…”

“…In total, 196 serum samples, collected by police during road side testing and already found to be positive for amphetamine, methamphetamine, MDMA, MDA and/or MDEA, were retrospectively analysed for GHB. Moreover, concurrently consumption of cannabinoids (124), alcohol (19), cocaine (8), opiates (2), benzodiazepines (1) and methadone (1) was ascertained in the 196 samples. Blood samples were collected 10-180 min (mean 68 min) after driving and sent to our institute.…”

Toxicology of Specific Substances

“…A benzodiazepine or opioid overdose is usually suspected at first, but neither flumazenil nor naloxone is an effective antidote to GHB. The possible reversibility of the effects of GHB with physostigmine is currently a matter of debate (Andresen et al 2008). Butyro-1,4-lactone, also called γ-butyrolactone (GBL), is a colourless liquid with a faint intrinsic odour.…”

Determination of gamma-hydroxybutyric acid in dried blood spots using a simple GC-MS method with direct “on spot” derivatization

“…Most commonly reported effects of GHB abuse are euphoria, increased sexuality, wellbeing and tranquillity, while an overdose results in seizures, respiratory depression, coma and sometimes even death [15][16][17]. The range between the desired effects and an overdose is narrow, frequently resulting in (non-) fatal intoxications in humans, as described in several case reports [18][19][20][21][22][23][24].…”