AKA: Alcover, 4-hydroxybutyrate, gamma hydrate, gamma-hydroxy-butyrate, gamma-hydroxybutyrate sodium, Gamma OH, Liquid Ecstasy, Liquid X, sodium oxybate, sodium oxybutyrate, Somatomax PM.

A natural component of every cell in the body, GHB is found in the greatest concentrations in the kidneys, heart, skeletal muscles, brown fat, hypothalamus, and basal ganglia. It is a precursor to the neurotransmitter GAB A, and may be a neurotransmitter itself. Unlke GABA, it can cross the blood/ brain barrier. It rapidly metabolizes to carbon dioxide and water.

Food Sources: Meat.

Effects: It produces a mild high, with feelings of bliss, placidity, euphoria, and sensuality. It stimulates the release of growth hormone in the body and, unlike drugs with a similar effect, GHB also increases levels of prolactin. Other physiological effects include a slight elevation of blood sugar, a significant decrease in cholesterol, a mild slowing of the heart, a slight lowering of body temperature, and a stimulation of the release of acetylcholine in the brain (which may improve memory and cognition, though this is, as yet, unproven). Sleep induced by GHB tends to be slightly deeper and somewhat shorter than sleep attained without the use of drugs; unlike other remedies for insomnia, it often does not produce grogginess upon waking.

It may be useful in treating alcoholism, anxiety, and sleep disorders. Anecdotal evidence indicates it may reduce fat and help build lean muscle tissue, possibly because of its effect on growth hormone. Some speculate it may have aphrodisiac and life-extension properties.

Precautions: It should not be used by anyone suffering from epilepsy, convulsions, slowed heartbeat arising from conduction problems, Cushing's syndrome, severe cardiovascular disease, severe hypertension, hyperprolactinemia, or any kind of severe illness.

Before it was banned by the FDA in 1990, it had been studied for 25 years, with the result that it has shown extremely low toxicity. Of 10 known cases of individuals who have suffered side effects, the dosages taken were not known; four of those cases involved combining it with alcohol, two involved individuals with a history of epilepsy or grand mal seizures, and two involved combining it with tranquilizers or such central nervous system depressants as Vicodin and diphenhydramine hydrochloride. Bodybuilders who had taken GHB switched to GABA after the ban. It remains a popular "rave" drug, with many deaths attributed to it, though how many of these are due to impurities, misidentification, and combining with other drugs is unknown.

Common side effects include abrupt sedation, loss of coordination, sleepwalking, unarousability, and decreased inhibition in those taking 2 to 6 teaspoons (approximately 5 to 15 grams) twice nightly over a period of several years. Mild side effects include a numbness of the legs, headache, lethargy, dizziness, a tightness in the chest, extreme ebullience, intense drowsiness, breathing difficulties, and uncontrollable muscle twitches. Severe side effects include confusion, nausea, diarrhea, incontinence, temporary amnesia, sleepwalking, uncontrollable shaking, vomiting, seizures, and brief (one to two hours) non-toxic coma. Complete recovery from even the most severe side effects, however, appears to occur within a few hours and with no apparent long-term side effects. In a 1992 report, epidemiologist Ming-Yan Chin and Richard A. Kreutzer, M.D., both working for the California Department of Health Services, concluded, "there are no documented reports of long-term [adverse] effects. Nor is there any evidence for physiological addiction." Others report that there has been one documented case of addiction, though there is no evidence of withdrawal symptoms.

Because it may deplete levels of potassium in the body, GHB is often administered with a potassium supplement in which the elemental form is equal to 10 percent of the weight of the GHB consumed. It is not combined with central nervous system depressants such as benzodiazepines (e.g., Valium, Xanax), phenothiazines (e.g., Thorazine, Stellazine), various painkillers (e.g., opiates, barbiturates), alcohol, or over-the-counter allergy and sleep remedies. Food can dissipate or delay its effects, and caffeine can block its dopamine-related effects.

Dosage: In various studies doses of 6 to 8 g/day for eight to ten days, 20 to 30 g/day for a week, and 2.5 g/day for several years produced no adverse side effects. The initial dosage is small —an eighth to a fourth of a gram — and dissolved in water, increasing gradually to the desired dose (one level teaspoon equals approximately 2.5 grams). The dosage is adjusted according to body weight, though Ward Dean, M.D., etal, published the following general doserelated expectations: less than 1 gram gives rise to mild relaxation, reduced anxiety, and increased sociability; 1 to 2 grams, strong relaxation; 2 to 4 grams, sleep of three to four hours; 4 to 8 grams — very deep sleep of three to four hours; 10 to 30+ grams, a prolonged, very deep sleep of up to 24 hours. It is taken on an empty stomach (preferably three to four hours after the last meal) to avoid nausea, vomiting, and a delayed onset of effects. About three-quarters to one and a half grams produces a high, while 2.5 grams induces sleep.

Illicit GHB invariably contains dangerous — even toxic — impurities. Pure GHB powder has a salty/ licorice taste, turns from a chalky texture to a greasy one when rubbed between the fingers, will fully dissolve in water, and will easily absorb water and turn liquid overnight.

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