Drugs: Are you familiar with GBL, the new chemical?

Sexual aggressors use various compounds to drug their victims: alcohol, anxiolytics such as benzodiazepines (better known by their trade names: rivotril, xanax, rohypnol…), analgesics such as ketamine, even antihistamines. But one commonly used substance is gamma-hydroxybutyric acid (gamma-hydroxybutyrate or GHB), also called “G” or “liquid ecstasy.”

This banned chemical agent has been replaced by another molecule, gamma-butyrolactone (GBL), which converts to GHB when ingested. But in both cases, the health consequences can be serious beyond the attack itself.

From operating room to gym

GHB was first synthesized in 1874 by the Russian chemist Alexander Mikhailovich Zaitsev, but it was not until the 1960s that surgeon and neuroscientist Henri Laborie began to study its effects. At that time, the scientist was working on the neurotransmitter gamma-aminobutyric acid (GABA) (a chemical messenger) present in the brain of mammals, one of the functions of which, as we now know, is to suppress brain activity.

For the purpose of their work, Laborit and its employees produce GHB. Researchers quickly realized that it alters brain activity due to its structure, which is similar to that of the neurotransmitter GABA. In 1963, Samuel P. Bessman and William N. Fishbein discovered that GHB is naturally present in the brain at low concentrations.

GHB then attracts considerable interest from the medical community because it has anesthetic properties and is free from serious side effects. Its use is spreading in hospitals, but only for a while: after making an undeniable contribution to anesthesia, it is slowly disappearing from the operating theater scene because its analgesic properties are relatively weak and because more effective molecules are being developed.

But the story of GHB doesn’t end there. Since the 1980s, to circumvent the ban on the sale of anabolic steroids to the public, labs have begun selling GHB. Marketed to people looking to lose weight for its pseudo-fat-burning properties, it is also touted for its alleged growth hormone-stimulating, hypnotic properties, or its “anti-aging” effects, which may be related to its antioxidant properties.

Then in the United States and Europe, GHB became a widely available product at gyms, parapharmacies, or by mail order.

From Party Drugs to Sexual Assault Drugs

A few years later, a new use of GHB, celebratory, develops. It accompanies the rise of the electronic music movement, especially in the gay scene. Easy to inject, has amnesic and sexual disinhibition properties, depresses the central nervous system… The characteristics of GHB, enhanced by the action of alcohol, make it an ideal chemical agent. The public then became aware of its existence through the media: GHB hit the headlines as a “date rape drug”.

Classified as a drug since 1999, GHB was added in March 2001 to Schedule IV of the United Nations Convention on Psychotropic Substances. Then the member states of the European Union are obliged to control this molecule. As long as the GHB market remains very open, it is limited: the molecule is no longer legally available for sale. It also becomes very difficult to get online since its an international ban.

But this is not the case for another compound, gamma-butyrolactone. Used as an industrial solvent, this molecule is a precursor to GHB. In other words, after absorption, it is transformed in the body mainly into GHB under the influence of metabolism. Thus, taking GBL has the same effects as taking GHB.

Since 2006, the abuse of GBL has gradually replaced the abuse of GHB: between 2005 and 2011, more than 200 cases of GBL poisoning were identified in France by the networks of toxicology and drug abuse surveillance.

Currently, GBL is not classified as a narcotic drug, but in France, by a decree of September 2, 2011, it was decided to ban its sale and distribution to the public (as well as 1,4-butanediol (1,4-BD)1, which is also used in produced by GHB).

What do these substances look like?

GHB is most commonly available in liquid form, but it also exists as a powder. Odorless, colorless, bitter in taste, it is usually washed down with water, mixed with syrup or fruit juice.

Two drugs contain GHB: Gamma-OH, used in addition to general anesthesia, and Xyrem, indicated in the treatment of narcolepsy.

GBL is a colorless viscous liquid. It is a highly acidic chemical used in industry as a paint thinner or remover and as a hardwood floor cleaner.

Searched products and effects

It is important to note that the effects of GHB are dose dependent.

About 0.5 g of GHB acts like alcohol and benzodiazepines: people who take it feel warm, relaxed and relaxed.

Between 1 and 2 g there is intoxication, a feeling of well-being, as well as great ease in communication. Increases erectile ability, as well as the duration and quality of orgasms. Users taking GHB aim to stimulate sexual desire as well as enhance the sensations of sexual intercourse. But at these doses, GHB intake changes the level of consciousness and leads to a loss of control. These effects lead to amnesia, hypersensitivity or even intolerance to light (photophobia), loss of coordination in the muscles of the arms and legs (ataxia), and dizziness.

From 2 to 4 g the user falls into a mild coma. Over 4 g is a deep coma and the risk of overdose or “G-Hole”. This deep unconscious coma is associated with a decrease in heart rate (bradycardia) and body temperature (hypothermia), vomiting, respiratory distress syndrome, and neurological manifestations.

Taking GHB also enhances the negative effects of other psychostimulant drugs. The effects of GHB begin 15 to 30 minutes after consumption and last 2 to 4 hours. GBL has the same psychoactive effects as GHB, but they come on faster, in 15-20 minutes, and last a little shorter (about 1-2 hours).

One of the reasons for the success of these drugs is the absence of the phenomenon of “descent”. Between 2014 and 2017, the proportion of GHB/GBL-related coma in all drug-related coma cases (excluding alcohol) doubled from 13% to 27%.

Risks and harms associated with GHB/GBL

Many deaths have been reported directly related to GHB or GBL ingestion.

The vast majority of voluntary GBL intakes are among young people who use these products not only in various festive places, but also at home. Apart from the fact that GBL can cause skin irritation upon skin contact, the consequences of such ingestion are numerous.

They are manifested, in particular, by neurological symptoms such as headaches, impaired consciousness, dizziness, decreased reflexes, speech disorders, loss of coordination, abnormal movements, convulsions, double vision, dilated or constricted pupils.

The digestive system also suffers, with consumers experiencing accelerated intestinal transit, vomiting, and inflammation of the stomach lining (gastritis). They also have trouble breathing and may experience a transient increase in blood pressure and a decrease in heart rate (bradycardia).

As mentioned earlier, GHB (and therefore GBL) exacerbates the sedative effects of other drugs. Deaths have mostly been described following polyintoxications, such as alcohol or benzodiazepines. For this reason, always look for traces of other drugs in case of GBL/GHB poisoning.

The use of these substances is also associated with psychiatric risks. People who eat them can become victims of acute anxiety attacks, acute delusional disorders, cognitive disorders. They may also develop depressive, suicidal or paranoid tendencies, behave aggressively… Finally, they risk becoming addicted, which is accompanied by a withdrawal syndrome that can reach delirium tremens.

Moreover, the consumption of GBL, like GHB, exposes consumers to numerous dangers. This increases the risk, and therefore the likelihood, of becoming a victim of sexual violence or contracting sexually transmitted infections. It can also lead to decreased adherence to the antiretroviral treatment regimen designed to fight HIV. In this regard, some drugs (antiretroviral drugs, protease inhibitors) can interact with the metabolism of GBL and significantly increase its concentration in the blood, which increases the risk of overdose.

How to reduce risks and complications?

The main measure to reduce the risk of inadvertent consumption of GBL and GHB is to never leave your drink unattended at a party.

For people who voluntarily consume these substances, in addition to the treatment of dependence and withdrawal symptoms, certain risk reduction measures should be applied: never use alone, correctly dose the product with an open syringe (no needle) or GHB dispenser, catches for at least two hours, do not mix these substances with alcohol or other drugs. And, of course, take the necessary measures to prevent sexual relations and make sure (before accepting …) the sexual consent of your partners …

Keep in mind that recreational use of GHB is illegal from a forensic standpoint and puts you at risk of litigation. The same applies to GBL, a legal but controlled product. The criminal penalty for the sale or distribution of GBL or GHB to the public is three years in prison and a fine of €45,000.

Article originally published in “The Conversation France”

Leave a Comment

Your email address will not be published.