GHB Abuse

Despite the bleak statistics, young people are freely experimenting with GHB. Cities reporting widespread GHB abuse include Boston, Honolulu, Los Angeles, Baltimore, Detroit, Phoenix, Miami, New York, Atlanta, Minneapolis/St. Paul, Dallas, Seattle, San Francisco, San Diego, New Orleans, and Newark, according to the National Institute on Drug Abuse. Around Florida State University, says 20-year-old junior Debbie Mallard (not her real name), GHB abuse is "Very popular; at clubs they go around and sell it to you in a shot."

One of Mallard's friends uses it as an alternative to drinking when she goes out because she doesn't like the taste of alcohol. "With GHB, you can get the same effect [as alcohol] with such a small amount," says Mallard. And compared to other drugs, GHB is cheap--$5 to $10 for a capful or teaspoonful dose, according to the Office of National Drug Control Policy.

Usually made as a clear liquid or a light-colored powder that the user mixes with water, alcohol or soda, GHB abuse is easily masked. At night clubs and raves, partiers often carry the drug around in Visine bottles or simple water bottles. The drug hasn't been dubbed salty water for nothing, "It looks just like water. It's scary." Scary, because people can accidentally drink it, or be tricked into drinking it when someone secretly laces their drink with the so-called "date-rape drug."

For those who deliberately experiment with GHB abuse, the objective is to hit the "right level, where you get the out-of-body buzz, like you're watching yourself on T.V." But, it's a goal that many overshoot, risking deadly overdose.

Kids think passing out is just a part GHB abuse. Student Mallard agrees: "When you're in college, you don't think anything's going to happen to you. I've seen people pass out. People are always falling down at clubs, but you're in your own world and you don't really care. You think, 'Oh, that's a bummer.'"

And what about when someone dies from a condition called pulmonary edema, the symptoms of which have been described as "blood frothing out of their nose and mouth all over the place?" Well, then they rationalize that the person just took too much.

"They all think they'll be more careful, but you can't be careful about a drug like this with no predictability," drug specialist and former narcotics detective Trinka Porrata says. "The dose that might make a 150-pound girl high could kill a 300-pound man. And the dose that made you high yesterday might kill you today." The fact that the drug is made in clandestine laboratories--often in people's homes--compounds its unpredictability, according to the Drug Enforcement Administration.

GHB is especially dangerous when mixed with alcohol or taken with ecstasy or other drugs. But contrary to common misrepresentations on the Internet, GHB also often kills or injures all by itself.

To curb GHB abuse and production, FDA's Office of Criminal Investigations has participated in numerous investigations and prosecutions related to the drug's illegal manufacture and distribution. So far, the government has won more than 33 GHB-related convictions. Based on GHB abuse potential, at press time, Congress was considering GHB for "scheduling" under the Controlled Substances Act. If GHB is classified as a controlled substance, the act would set forth federal penalties, including imprisonment and fines, for marketing the drug illegally.

In addition to the extent of a drug's abuse potential, the decision whether to schedule a drug and how strictly to control it depends on factors such as:

The drug's capacity for producing physical and psychological dependence. GHB has been shown to cause addiction with sustained use. Withdrawal symptoms can include insomnia, muscle cramps, tremor, and anxiety.
Whether the drug has an accepted medical use. At press time, GHB was not approved for any use in the United States but was being studied to treat the symptoms of a sleep disorder called narcolepsy. In Europe, GHB has been used as an anesthetic and experimentally to treat alcohol withdrawal.

More than 20 states have already classified GHB as a controlled substance. And some other states impose criminal penalties for the drug's possession though they haven't scheduled it. Today, GHB is Schedule I in the United States, except when in the form of the prescription drug Xyrem.