Ghb

GHB, or gamma-hydroxybutyric acid, is a naturally occurring compound in the human nervous system and a synthetic drug used both medically and recreationally. It is a weak CNS depressant that can produce euphoria, increased sociability, relaxation, or sedation depending on the dose. Endogenously, small amounts of GHB are formed in the brain from the neurotransmitter GABA.

Medical use: The pharmaceutical form, sodium oxybate, is approved in many countries for the treatment of narcolepsy with cataplexy under strict controls. It is supplied through a restricted-distribution program because of abuse potential. Dosing is supervised by a clinician due to the risk of adverse effects and interactions.

Pharmacology: GHB acts as a ligand at a specific GHB receptor and also modulates GABA-B receptors. It is also produced in small amounts in the brain from GABA. The onset after ingestion is typically within 15 to 60 minutes, with a duration of 2 to 6 hours, and clearance occurs through standard hepatic metabolic pathways.

Safety and risks: GHB can lead to dependence and withdrawal with long-term use. Overdose signs include extreme drowsiness, confusion, slowed or stopped breathing, loss of consciousness, and sometimes coma. Combined with alcohol or other depressants, the risk of severe respiratory depression increases. GHB has been associated with sexual assault due to its sedative and amnestic effects when misused.

Legal status: In many countries GHB is a controlled substance and possession or distribution without a prescription is illegal. The pharmaceutical form sodium oxybate is regulated and prescribed for approved medical indications. Enforcement and scheduling vary by country.