Title:GHB, GBL and 1,4-BD Addiction
Volume: 20
Issue: 25
Author(s): Tibor M. Brunt, Jan G. C. van Amsterdam and Wim van den Brink
Affiliation:
Keywords:
GHB, GBL, 1, 4-BD, GABA, dopamine, illicit drugs, addiction, dependence, withdrawal.
Abstract: A growing body of evidence shows that gamma-hydroxybutyric acid (GHB) is an addictive substance. Its precursors gammabutyrolactone
(GBL) and 1,4-butanediol (1,4-BD) show the same properties and may pose even more risks due to different pharmacokinetics.
There are indications that problematic GHB use is increasing in the European Union. This review investigates the existing literature
on the neurochemistry of GHB and its precursors, their acute toxicity, addiction potential and withdrawal, the proposed molecular
mechanism underlying addiction and the treatment of withdrawal and addiction. Current evidence shows that GHB and its precursors are
highly addictive, both in humans and animals, probably through a GABAB receptor related mechanism. Severity of withdrawal symptoms
can be considered as a medical emergency. Recent studies suggest that benzodiazepines are not very effective, showing a high treatment
resistance, whereas detoxification with pharmaceutical GHB proved to be successful. However, relapse in GHB use is frequent and more
research is warranted on relapse prevention. This might aid medical practitioners in the field and improve general understanding of the
severity of addiction to GHB, GBL and 1,4-BD.
