Abstract

CURRENT DEVELOPMENTS REGARDING GHB AND GBL INCIDENTS, TREATMENT AND DETECTION: A QUALITATIVE REVIEW

Aron T. E. Veerman and *Selene R. T. Veerman

Abstract

In this qualitative review we address the neuropharmacological properties of gamma-hydroxybutyric acid (GHB) and its precursor gamma-butyrolactone (GBL), which explain why these drugs are highly addictive, and cause serious symptoms of intoxication and withdrawal. In various countries the medicinal use of the sodium salt of GHB is approved for narcolepsy, cataplexy, treatment of opioid and alcohol withdrawal, and sedation as an anaesthetic. The abuse of illicit GHB and GHB-related drug incidents have increased in the past decade in the Netherlands, other European countries, Australia, and the USA. Treatment of GHB and GBL intoxication involves appropriate supportive care and monitoring. A serious withdrawal syndrome can be prevented by titration tapering with pharmaceutical GHB. This alternative to benzodiazepines proves to be effective and safe, especially in patients who have developed resistance to benzodiazepines. At present, a high relapse rate remains a permanent complication. In addition, GHB is used in drug-facilitated sexual assault (DFSA). Boron-dipyrromethene (BODIPY) dyes are used as fluorescent sensors: GHB Orange for GHB detection and Green Date for GBL detection. We examine whether GHB Orange is a reliable, real-time detection test to prevent nonintentional ingestion of GHB. Our findings highlight the limitations of BODIPY dyes as drug detection tests. Finally, we conclude that the core of prevention of date rape remains education to increase public awareness of DFSA by both medical health professionals and parents.

Keywords: Gamma-hydroxybutyric acid. Gamma-butyrolactone. Intoxication. Withdrawal. Date rape. Detection.