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In the Grip of GHB

The illegal supplement is popular with fitness buffs, insomniacs and partyers--and is highly addictive. Many doctors are grappling with how to treat people who are hooked.


Despite reports linking it to dozens of deaths and thousands of overdoses, the illegal supplement GHB just won't disappear.

First banned in this country more than a decade ago by federal regulators, the substance--best known as a party drug used on the rave scene--remains popular with fitness buffs, insomniacs and the depressed, who buy it on the Internet and from underground sources.

Now medical experts report another troubling problem: GHB is highly addictive and can be more difficult to kick than heroin. But unlike opiate addiction, most doctors are unaware of the stranglehold that GHB has on users. Consequently, medical treatment is often ineffective.

GHB, which severely depresses the nervous system, has sent more people to emergency rooms than a more highly publicized club drug, Ecstasy--about 12,900 at last count--and has been blamed for 71 GHB-related deaths since 1990, according to federal statistics.

"This is the most addictive drug I've ever seen," says Dr. Stephen W. Smith, an emergency room doctor at Hennepin County Medical Center in Minneapolis who has treated about 50 patients for GHB addiction problems since 1998. "People are desperate to get off of it because it's destroying their lives," he says, yet only about one in 10 of his patients has successfully kicked the habit.

No one knows exactly how many Americans are addicted to GHB, or gamma hydroxy butyrate, because the federal government did not begin monitoring GHB abuse until after the drug was declared illegal in March 2000. No statistics have yet been released. GHB use is also difficult to track because the chemical is excreted from the body within 12 hours, and most emergency rooms don't test for the presence of the drug. Consequently, GHB use often goes undetected.

Trinka Porrata, a retired Los Angeles Police Department narcotics detective who has investigated GHB for more than five years, believes that the statistics on emergency room visits and deaths linked to GHB understate the problem. "These figures are just the tip of the iceberg and the actual numbers are probably much higher," says Porrata, who advises law enforcement officials on GHB's dangers.

Most GHB abusers are not street junkies looking for a new high, however. Typically, they are people who have turned to the drug, which is promoted as a natural, nutritional supplement, to build buff bodies, lose weight or to fight insomnia, premenstrual pain and depression. Some professional athletes have used the substance--usually sold as a salty-tasting liquid--to improve performance. Phoenix Suns basketball player Tom Gugliotta, for instance, nearly died in 1999 after ingesting a GHB supplement to help him sleep.

Some users know the drug is illegal and buy bootleg brews over the Internet or from the back rooms of health food emporiums. Others stumble across ads on the Internet and purchase what they believe is a natural remedy to beat the blues or get in shape. While there's no evidence that it helps increase muscle mass, "GHB seems to help users sleep better," says Smith, an assistant professor of clinical emergency medicine at the University of Minnesota School of Medicine. "If they suffer from depression, they tell me that GHB makes them feel normal for the first time in their lives."

Medical experts don't have a clear idea of how GHB affects the body because no definitive research has been done. Based on physicians' observations of how it affects people, however, they speculate that it alters levels of brain chemicals like dopamine and serotonin, which regulate mood and impulse control. In small doses, GHB is a mild stimulant that produces a feeling of intoxication or euphoria and releases inhibitions, which is why it's a popular party drug.

In higher doses, however, anecdotal reports indicate it seriously depresses the central nervous system. Even a small increase in the dosage can push the sedative effects to a lethal level, causing unconsciousness, slowed heart rate, respiratory depression and coma, doctors say.

And habitual use, even for just a few weeks, can cause people to become physically and psychologically addicted, according to doctors who've treated GHB addicts.

"These are often not people with an addiction history," says Dr. Karen Miotto, a psychiatrist at UCLA School of Medicine. "They stumble on GHB and have the hardest time staying off. I've had people cry, 'I've never abused drugs. I'm a monster. What happened to me?"'

Tony Young, 39, of Seattle, saw an ad in a bodybuilding magazine for a product touted as an all-natural supplement that would help boost muscle mass. He ordered a two-month supply for $75. The supplement, whose active ingredient is a form of GHB, made him feel more relaxed and improved his sleep. But if he missed a dose, "I'd get cranky and severely depressed."

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