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2023/09/19

GHB And What You Don't Know

 

GHB and the Brain



  • GHB, found endogenously in the brain, is a precursor of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) (Le & Richards, 2019).
        • GHB affects both GABA-B and GHB receptors.


GHB influences dopamine in a two-phase manner. At lower doses, it triggers the release of dopamine by interacting with GHB receptors. On the other hand, higher doses initially suppress dopamine release due to their agonist effects on GABA-B receptors, which results in neuro-inhibition and depression of the central nervous system (CNS). However, following this initial suppression, there is an increase in dopamine release via the GHB receptor.

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  • This dual action of GHB explains its sedative and excitatory effects. The primary concern with GHB toxicity is the depression of the central nervous system and respiratory system.

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Substitutes for GHB, namely Gamma-butyrolactone and 1,4-butanediol, were previously marketed as industrial solvents or dietary supplements. Upon oral consumption, these substances quickly transform into GHB, thereby replicating the same clinical impacts associated with GHB toxicity. (Le & Richards, 2019)

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  • GHB is rapidly absorbed into the body
  • Average time of five to fifteen minutes for onset of action.
  • Initially, The user experiences a wave of euphoria (Le & Richards, 2019).
  • Symptoms typically peak within thirty to sixty minutes after administration.
  • You can usually count on the effects lasting for two to four hours.
  • Its half-life elimination ranges from twenty to sixty minutes.

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According to Le and Richards (2019) here are some dosing considerations:

  • Lower doses of GHB (10 mg/kg) can cause memory loss and varying degrees of sedation.
  •  Doses ranging from 20 mg/kg to 30 mg/kg induce cycles of rapid eye movement (REM) sleep.
  • Higher doses (50 mg/kg) can lead to slower heart rate, respiratory depression, and even coma. 

    The presence of other intoxicants, particularly alcohol, can enhance the effects and prolong the duration of symptoms.

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So how much are you actually taking??

The typical dosage of the substance falls between 1 and 5 grams, which equates to about 1-2 teaspoons mixed into a drink, depending on the purity of the compound. However, the concentrations in these homemade concoctions can vary significantly, often leaving users uncertain about the actual dosage they are consuming. (WHAT IS GHB?, n.d.)

Analogues

  • Substances often used as alternatives to GHB include GBL (gamma-butyrolactone) and 1,4 BD (also known as “BD”), which stands for 1,4-butanediol.

 

These analogues are legally available as industrial solvents used in the production of various products such as polyurethane, pesticides, elastic fibers, pharmaceuticals, and coatings on metal or plastic.


  • Illegally, they are also sold as supplements for purposes like bodybuilding, fat loss, reversing baldness, improving eyesight, and combating aging, depression, drug addiction, and insomnia. GBL and BD are marketed under innocuous labels like “fish tank cleaner,” “ink stain remover,” “ink cartridge cleaner,” and “nail enamel remover,” with a price tag of approximately $100 per bottle — a cost significantly higher than similar products. (WHAT IS GHB?, n.d.)




References

Le, J. K., & Richards, J. R. (2019, January 20). Gamma-Hydroxybutyrate (GHB, “G”, Liquid X, Liquid E, Juice, Mils, Fantasy) Toxicity. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430781/

‌WHAT IS GHB? (n.d.). https://www.dea.gov/sites/default/files/2020-06/GHB-2020.pdf



 

A New Study Illuminates A Need for GHB Overdose Education

 GHB Overdose: Education Can Save Lives



Objective 

The objective of this study was to understand how bystanders respond to Gamma-hydroxybutyrate (GHB) overdose. This situation is frequently found within sexuality and gender diverse communities carrying a high risk of fatality.


Methods

  • This qualitative study involved interviewing 31 Australian residents who reported using GHB on three or more occasions in the previous twelve months.
  • These participants were asked about their experiences witnessing GHB overdose more specifically:
    1. Their actions
    2. Their decision-making processes throughout the overdose.

  • Their responses were analyzed according to dominant themes.

Results 

  • All of these participants witnessed the overdoses in private settings and were involved in sexual situations.
  • These participants reported their situations as ranging from GHB-induced symptoms of distress (Freestone et al., 2023) to comatose intoxication.
  • These participants reported their drastic actions to keep someone alert and responsive after their GHB ingestion (Freestone et al., 2023). 
  • Most of these participants reported many variables that influenced their decision to call or not call for EMS.
  • The majority of these participants did not call the EMS and resorted to interventions that deviated from established first-aid protocols (Freestone et al., 2023).

Conclusions

The study illuminated an urgent need for GHB overdose prevention and how to respond to these situations for people who use GHB. According to Freestone and colleagues (2023), educational interventions need to address the following:

  1. Addressing inaccuracies that inform street remedies for GHB overdose
  2. Techniques for safely checking someone's breathing and responsiveness.
  3. They should promote basic first-aid principles
  4. They should address perceived barriers to contacting EMS.


References


 Freestone, J., Ezard, N., Bourne, A., Brett, J., Roberts, D., Hammoud, M., Nedanoski, A., Prestage, G., & Siefried, K. (2023). Understandings, attitudes, practices and responses to GHB overdose among GHB consumers [Review of Understandings, attitudes, practices and responses to GHB overdose among GHB consumers]. Harm Reduction Journal, 20(1). https://doi.org/10.1186/s12954-023-00857-z


2023/09/15

Splendor In The Grass

 A Coming of Age






Alcohol addiction has been around for centuries, and its early days were marked by a lack of understanding about the nature of addiction. Alcohol was often seen as a social lubricant and a way to relax and unwind. It was not until the 20th century that alcohol addiction began to be recognized as a serious problem.

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Video gaming addiction is a more recent phenomenon, and its early days were marked by a similar lack of understanding. Video games were often seen as harmless entertainment, and there was little concern about the potential for addiction. However, in recent years, there has been growing awareness of the dangers of video gaming addiction.

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Video gaming addiction is becoming a serious problem. To validate its seriousness, I want to compare the coming-of-age of alcohol addiction to where video gaming addiction is at now.


  1. Availability: Alcohol has always been readily available, but video games have become increasingly accessible in recent years. With the advent of handheld consoles, smartphones, and tablets, people can now play video games anywhere, at any time.
  2. Social acceptance: Alcohol use has always been socially acceptable, but video gaming addiction is still stigmatized. Many people still view video games as a waste of time, and they may not take the addiction seriously.
  3. Symptoms: The symptoms of alcohol addiction and video gaming addiction are similar, but there are some key differences. For example, people with alcohol addiction may experience withdrawal symptoms such as sweating, tremors, and nausea. People with video gaming addiction may experience withdrawal symptoms such as anxiety, irritability, and difficulty sleeping.
  4. Treatment: There are a variety of treatment options available for alcohol addiction, including counseling, medication, and 12-step programs. There are also a growing number of treatment options available for video gaming addiction, but they are not as well-established as those for alcohol addiction.

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  1. Both alcohol addiction and video gaming addiction are serious problems that can have a devastating impact on individuals and families. It is important to be aware of the risks of addiction and to seek help if you or someone you know is struggling.



988

 


Suicide Prevention:




If you ever have a chance to intervene and help someone going through a suicide crisis and have surveyed the scene for safety, do not worry about not knowing what to do or say. Follow your heart to that person.  988 on your phone will connect you to someone who is trained and they will guide you.


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