GHB is responsible for ED mystery comas
Is this drug the Mickey Finn of the ’90s?
Rohypnol is getting all the press, but the real date-rape culprit out there may be gamma hydroxybutyrate, known on the street as GHB.
So says a chemist with the Georgia Bureau of Investigation (GBI) in Atlanta. Terry Mills, MS, supervisor of the GBI’s chemistry lab says it only makes sense, given that GHB comes in a liquid form that’s undetectable when mixed with a drink.
"It’s colorless, odorless, and mixes with alcohol easily," Mills says. "It’s a very dangerous drug. They talk about roofies’ [Rohypnol] being the date-rape drug, but this is real popular and real easy to make."
Georgia hospitals and law enforcement officials have plenty of experience dealing with GHB. The state was the first to classify the drug as a banned substance after a spate of GHB overdoses hit metro Atlanta in 1992. But despite the fact the drug is banned, Mills says the GBI knows of at least 50 cases of GHB overdose that occurred in the past few months. In one well-publicized poisoning, a 19-year-old female became comatose, apparently after she was slipped a dose of GHB. She may not recover.
Outbreaks of GHB poisoning tend to be regional in nature, with the drug apparently most popular in the Southeast and on the West Coast. About the same time the Georgia GHB incidents were occurring, similar problems were reported in the San Francisco Bay area. Law enforcement officials there eventually confiscated nearly 2,000 bottles of GHB. Georgia police first became aware of GHB in 1992, when teen-agers in rural Fayette County, some 40 miles south of Atlanta, began slipping into comas after events such as football games.
Allan McCullough, RN, an emergency medical technician in Fayette County says his crew eventually responded to about 40 cases of GHB poisoning; all with similar symptoms. "Most patients presented with altered mental status from lethargy all the way to a coma," says McCullough. "Some had seizures, as well as hypotension, bradycardia, and respiratory depression."
What puzzled both McCullough and emergency departments at first was the propensity for the GHB victim to suddenly wake up and become combative when stimulated for example, when ambulance crews attempted intubation and to lapse back into coma when the stimulation stopped.
McCullough suspected GHB when a container was found near one victim. McCullough later discovered GHB could be purchased at health food stores where it was being sold as a bodybuilding supplement and dieter’s "health aid." Health fanatics’ fascination with GHB stemmed from the apparent belief that GHB stimulated release of growth hormone, and that more growth hormone led to more muscles.
Even though GHB may be involved in date rapes, GHB victims still tend to be young, extremely healthy males who have some association with bodybuilding. GHB illegally distributed in weightlifting circles is usually billed as an "amino acid powder" that’s also good for sleep. Street names include scoop, homeboy, and southern boy.
Mills says now that GHB is illegal in some states, consumers are making it on their own. The two ingredients needed for the drug sodium hydroxide and butyrol lactone are both readily available and legal. In 1995, two brothers in Rhode Island became intoxicated from home-brewed GHB prepared by one of their parents. Each slipped into a coma but recovered.
And that’s the predominant sign of GHB intoxication: a coma that lasts anywhere from two to 10 hours, with residual drowsiness sometimes hanging on for days. Deaths from the drug itself are rare, but McCullough says one Fayette teen-ager nearly died from aspiration pneumonitis after vomiting while passed out on GHB. There is no antidote to GHB poisoning; supportive care is the mainstay of therapy.
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