Evaluating the risk of toxicity and adverse drug interactions involving recreational GHB use and prescribed drugs
Source : https://www.tandfonline.com/doi/abs/10.1080/17425255.2021.2029404?journalCode=iemt20
ABSTRACT GHB is a small molecule and is present in the human CNS. Exogenously, GHB is administered orally in the form of sodium oxybate to treat cataplexy and excessive daytime sleepiness in patients with narcolepsy, and to manage alcohol withdrawal and detoxification in alcoholics.
Expert opinion: Due to its dual nature, interpreting and distinguishing GHB concentrations in biological fluid represents a challenge in forensic toxicology. To demonstrate recent exposure, a quick collection of samples is necessary to maximize the chance of detecting an exogenous GHB intake, especially in cases of GHB-facilitated sexual assaults.
• Source: Expert Opinion in Drug Metabolism & Toxicology
• Conclusions. “Due to its dual nature, interpreting and distinguishing GHB concentrations in biological fluid represents a challenge in forensic toxicology. To demonstrate recent exposure, a quick collection of samples is necessary to maximize the chance of detecting an exogenous GHB intake, especially in cases of GHB-facilitated sexual assaults.”
• GHB is a small molecule found in the CNS and given orally as sodium oxybate to treat cataplexy and excessive daytime sleepiness in those with narcolepsy.
• According to results of this review, a knowledge of potential reactions between GHB and its analogues with prescribed drugs is needed to decrease potential GHB toxicity. These drug-drug interactions typically involve hypnotics, sedatives, opioids, opiates, and antiepileptics.
• CNS depression is the main symptoms seen with GHB-prescribed drugs overdose.
• Polypharmacy is an additional risk factor in recreational GHB users and can obfuscate the perceived cause of death.