Related Experiment Videos
GHB. Club drug or confusing artifact?
S B Karch1, B G Stephens, G V Nazareno
1Assistant Medical Examiners, City and County of San Francisco, CA 94103, USA. fdaa@batnet.com
The American Journal of Forensic Medicine and Pathology
|September 21, 2001
Summary
Gamma-hydroxybutyrate (GHB) can be a postmortem artifact. Proper blood preservation with NaF is crucial for accurate GHB detection and determining its role in fatalities.
Area of Science:
- Forensic Toxicology
- Postmortem Analysis
- Drug Metabolism
Background:
- Gamma-hydroxybutyrate (GHB) is a substance that can be detected in postmortem samples.
- Determining whether GHB is a pre- or postmortem artifact is critical in forensic investigations.
Observation:
- Two cases are presented where GHB was detected in decedents. Case 1 involved a methamphetamine abuser with myocardial fibrosis and GHB levels similar to subanesthetic doses. Case 2 showed higher GHB concentrations along with cocaine and MDMA.
- Both decedents had consumed alcohol and were in a postabsorptive state, indicated by blood to vitreous ratios below 0.90.
Findings:
- GHB can be produced artifactually if blood is not preserved with sodium fluoride (NaF).
- In Case 1, GHB levels could be consistent with therapeutic doses, and myocardial fibrosis may have been the primary cause of death.
- In Case 2, the history suggests significant GHB ingestion, and ethanol interference with GHB metabolism likely contributed to respiratory arrest, indicating GHB as the cause of death.
Implications:
- Accurate determination of GHB's role in fatalities requires analyzing both blood and urine, using NaF-preserved blood, and obtaining a detailed case history.
- Postmortem GHB production can occur even in antemortem blood samples preserved with citrate.
- Without proper collection and preservation methods, GHB detection alone is insufficient to establish causality.