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Liquid ecstasy - a significant drug problem.

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    Gamma-hydroxybutyric acid (GHB) and its pro-drugs are increasingly used recreationally, causing severe intoxication. Treatment is supportive, as no antidote exists for GHB overdose.

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    Area of Science:

    • Toxicology
    • Pharmacology

    Background:

    • Gamma-hydroxybutyric acid (GHB), gamma-butyrolactone, and 1,4-butanediol are increasingly prevalent as recreational drugs in Germany.
    • Their effects mimic alcohol or benzodiazepines, leading to frequent physician encounters with intoxication cases.

    Purpose of the Study:

    • To review the clinical presentation, diagnosis, and management of GHB and its pro-drug intoxications.
    • To raise awareness among healthcare professionals regarding the potential for GHB abuse.

    Main Methods:

    • Selective literature review.
    • Inclusion of authors' clinical experience.
    • Data from the GIZ-Nord Poisons Centre.

    Main Results:

    • High-dose GHB or pro-drug consumption results in severe intoxication, characterized by respiratory depression and coma.
    • Only supportive therapy is available; no specific antidote exists.
    • Chemical detection of GHB is feasible via specific analytical methods within 12 hours.

    Conclusions:

    • GHB intoxication should be considered in patients with unexplained impaired consciousness.
    • Despite a short half-life and rare complications in intensive care, fatalities have occurred.
    • The potential for GHB as a date rape drug warrants consideration.