GHB: Un análisis

Louisa Degenhardt

Resumen


Se revisa la naturaleza, efectos y daños asociados al GHB (gamma-hidroxibutirato), una droga con efectos depresores sobre el sistema nervioso central y se resumen las investigaciones realizadas para analizar los efectos sobre consumidores recreativos. El consumo ilegal de GHB se ha extendido, en la última década, en ciertos países desarrollados, especialmente entre consumidores de otras drogas ilegales. Las personas que utilizan GHB suelen consumir también otras drogas, ingiriendo ambas de una manera combinada, lo que puede incrementar los daños asociados. La existencia de un importante número de informes sobre casos de sobredosis de GHB y el elevado número de casos de sobredosis referidos por los propios consumidores, indican que el riesgo de sobredosis con esta droga es muy alto. La mayoría de las sobredosis no tienen consecuencias fatales y muchas finalizan con una total recuperación, pero también se han indicado algunas muertes, además de los posibles daños que pueden aparecer mientras los consumidores se encuentran inconscientes. El consumo regular de GHB genera dependencia y ésta es común en consumidores habituales de larga duración. El tratamiento de la dependencia generada por GHB se encuentra aún en fase de desarrollo, pero se han descrito tratamientos para el síndrome de abstinencia, lo que parece relevante dada la gravedad de dicho síndrome.


Palabras clave


Gamma-hidroxibutirato (GHB); consumo recreativo; efectos adversos; sobredosis; dependencia

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Referencias


Nicholson, K. & Balster, R. (2001) GHB: A new and novel drug of abuse, Drug and Alcohol Dependence, 63, 1-22.

Bessman, S. & Fishbein, W. (1963) Gamma hydroxybutyrate - a new metabolite in brains, Federal Proceedings, 22, 334-342.

Colombo, C., Agabio, R., Lobina, C., Reali, R. & Gessa, G. L. (1998) Involvement of GABAa and GABAb receptors in the mediation of discriminative stimulus effects of gammahydroxybutyric acid, Physiology and Behavior, 64, 293-302.

Metcalf, B., Stahl, J., Allen, J., Woolfok, D. & Soto, P. (2001) Discrimination of gammahydroxybutyrate and ethanol administered

separately and as a mixture in rats, Pharmacology, Biochemistry and Behavior, 70, 31-41.

Snead, O. & Morely, B. (1981) Ontogeny of gamma-hydroxybutyric acid. Regional concentration in developing rat, monkey and human brain, Brain Research, 227, 579-589.

Galloway, G., Frederick, S., Staggers, F., Gonzales, M., Stalcup, S. & Smith, D. (1997) Gammahydroxybutyrate: An emerging drug of abuse that causes physical dependency, Addiction, 92, 89-96.

Kam, P. & Yoong, F. (1998) Gamma-hydroxybutyric acid: An emerging recreational drug, Anaesthesia, 53, 1195-1198.

Bernasconi, R., Mathivet, P., Bischoff, S. & Marescaux, C. (1999) Gamma-hydroxybutyric acid: An endogenous neuromodulator with

abuse potential?, Trends in Pharmacological Science, 20, 135-141.

Fattore, L., Martellotta, M., Cossu, G. & Fratta, W. (2000) Gamma-hydroxybutyric acid: An evaluation of its rewarding properties in rats and mice, Alcohol, 20, 247-256.

Snead, O. (1977) Gamma-hydroxybutyrate, Life Sciences, 20, 1935-1944.

Gessa, G., Agabio, R., Carai, M., Lobina, C., Pani, M., Reali, R. & Colombo, G. (2000) Mechanism of anti-alcohol effect of gamma

hydroxybutyric acid (GHB), Alcohol, 20, 271-276.

Colombo, G. & Gessa, G. L. (2000) Gammahydroxybutyric acid in alcohol preference, dependence and withdrawal, Addiction Biology,

, 389-403.

Colombo, G., Agabio, R., Lobina, C., Reali, R., Fadda, F. & Gessa, G. (1995) Symmetrical generalisation between the discriminative stimulus effects of gamma-hydroxybutyric acid and ethanol: Occurrence within narrow dose ranges, Physiology and Behavior, 57, 105-111.

Vickers, M. (1969) Gammahydroxybutyric acid, International Anaesthesia Clinics, 7, 75-89.

Mamelak, M. (1989) Gammahydroxybutyrate: An endogenous regulator of energy metabolism, Neuroscience and Biobehavior Review, 13, 187-198.

Mack, R. (1993) Love potion number 8 1/2, North Carolina Medical Journal, 54, 232-233.

Chin, M., Kreutzer, R. & Dyer, J. (1992) Acute poisoning from gamma-hydroxybutyrate overdose, Annals of Emergency Medicine, 31, 716-722.

Scharf, M., Brown, D., Woods, M., Brown, L. & Hirschowitz, J. (1985) The effects and effectiveness of gamma-hydroxybutyrate in patients with narcolepsy, Journal of Clinical Psychiatry, 46, 222-225.

Vickers, M. (1968) Gammahydroxybutyric acid, Proceedings of the Royal Society of Medicine, 61, 821-823.

Laborit, H. (1964) Sodium 4 hydroxybutyrate, International Journal of Neuropharmacology, 43, 433-452.

Hunter, A., Long, W. & Ryrie, C. (1971) An evaluation of gamma hydroxybutyric acid in paediatric practice, British Journal of Anaesthesia, 43, 620-627.

Takahara, J., Yunoki, S., Yakushiji, W., Yamauchi, J., Yamane, Y. & Ofuji, T. (1977) Stimulatory effects of gamma-hydroxybutyric acid on growth hormone and prolactin release in humans, Journal of Clinical Endocrinology and Metabolism, 44, 1014-1017.

Friedman, J., Westlake, R. & Furman, M. (1996) "Grievous bodily harm": Gamma hydroxybutyrate abuse leading to the Wernicke-Korsakoff syndrome, Neurology, 46, 469-471.

Gallimberti, L., Cibin, M. & Pagnin, P. (1993) Gamma hydroxybutyric acid for the treatment of opiate withdrawal syndrome, Neuropsychopharmacology, 9, 77-81.

Gallimberti, L., Cibin, M. & Pagnin, P. (Gamma hydroxybutyric acid for the treatment of opiate withdrawal syndrome) Neuropsychopharmacology, 9.

Maremmani, I., Lamanna, F. & Tagliamonte, A. (2001) Long-term therapy using GHB (sodium gamma hydroxybutyrate) for treatment-resistant chronic alcoholics, Journal of Psychoactive Drugs, 33, 135-142.

Caputo, F., Addolorato, G., Lorenzini, F., Domenicali, M., Greco, G., Del Re, A., Gasbarrini, G., Stefanini, G. & Bernardi, M. (2003) Gammahydroxybutyric acid versus naltrexone in maintaining

alcohol abstinence: An open randomi-sed comparative study, Drug & Alcohol Dependence, 70, 85-91.

United States Department of Health and Human Services (1990) Epidemiologic notes and reports: Multistate outbreak of poisonings

associated with illicit use of gamma hydroxybutyrate, Morbidity and Mortality Weekly Report, 39, 861-863.

Australian Bureau of Criminal Intelligence (2000) Australian Illicit Drug Report 1998-1999 (Canberra, Australian Bureau of Criminal Intelligence).

Breen, C., Topp, L. & Longo, M. (2002) Adapting the IDRS methodology to monitor trends in party drug markets: Findings of a two year feasibility trial. NDARC Technical Report No. 142 (Sydney, National Drug and Alcohol Research Centre, UNSW).

White, B., Degenhardt, L., Breen, C. & Roxburgh, A. (2003) NSW Party Drug Trends 2002: Findings from the Party Drug Initiative. NDARC Technical Report No. 153 (Sydney, National Drug and Alcohol Research Centre, UNSW).

United States Department of Health and Human Services (1997) Gamma hydroxybutyrate use - New York and Texas, 1995-1996, Morbidity and Mortality Weekly Report, 46, 281-283.

Whitten, L. (2001) Conference highlights increasing GHB abuse, NIDA Notes, 16, 10-11.

Thomas, G., Bonner, S. & Gascoigne, A. (1997) Coma induced by abuse of gamma-hydroxybutyrate (GBH or liquid ecstasy): A case report, British Medical Journal, 314, 35.

Weir, E. (2000) Raves: A review of the culture, the drugs and the prevention of harm, Canadian Medical Association Journal, 162, 1843-1848.

Miro, O., Nogue, S., Espinosa, G., To-Figueras, J. & Sanchez, M. (2002) Trends in illicit drug emergencies: the emerging role of gammahydroxybutyrate, Journal of Toxicology - Clinical Toxicology, 40, 129-35.

Ingels, M., Rangan, C., Bellezo, J. & Clark, R. (2000) Coma and respiratory depression following the ingestion of GHB and its precursors: Three cases, Journal of Emergency Medicine, 19, 47-50.

Miotto, K., Darakjian, J., Basch, J., Murray, S., Zogg, J. & Rawson, R. (2001) Gammahydroxybutyric acid: Patterns of use, effects and withdrawal, American Journal on Addictions, 10, 232-241.

Degenhardt, L., Darke, S. & Dillon, P. (2002) GHB use among Australians: Characteristics, use patterns, and associated harm, Drug and Alcohol Dependence, 67, 89-94.

Topp, L., Hando, J., Dillon, P., Roche, A. & Solowij, N. (1999) Ecstasy use in Australia: patterns of use and associated harm, Drug and Alcohol Dependence, 55, 105-115.

Dyer, J. (1991) Gamma-Hydroxybutyrate: A health food product producing coma and seizure-like activity, American Journal of Emergency Medicine, 9, 321-324.

Muller, A. (2003) GHB poisoning: Three recent cases reflect the continuing danger, Journal of Emergency Nursing, 29, 72-74.

Sanguineti, V., Angelo, A. & Frank, M. (1997) GHB: A home brew, American Journal of Drug & Alcohol Abuse, 23, 637-642.

Karch, S., Stephens, B. & Nazareno, G. (2001) GHB: Club drug or confusing artifact?, American Journal of Forensic Medicine and Pathology, 22, 268-269.

Li, J., Stokes, S. & Woeckener, A. (1998) A tale of novel intoxication: Seven cases of gammahydroxybutyrate acid overdose, Annals of Emergency Medicine, 31, 723-728.

Eckstein, M., Henderson, S., Delacruz, P. & Newton, E. (1999) Gamma Hydroxybutyrate (GHB): Report of a mass intoxication and

review of the literature, Preshospital Emergency Care, 3, 357-361.

Chin, M., Sporer, K., Cullison, B., Dyer, J. & Wu, T. (1998) Clinical course of gammahydroxybutyrate overdose, Annals of Emergency

Medicine, 31, 716-722.

Us Drug Enforcement Agency (2001) Drug Intelligence Brief - Club Drugs: An Update (DEA Intelligence Division, Office of Domestic Intelligence, Domestic Strategy Unit).

Ferrara, S., Tedeschi, L. & Frison, G. (1995) Fatality due to gamma-hydroxybutyric acid (GHB) and heroin intoxication, Journal of

Forensic Science, 40, 501-504.

Marwick, C. (1997) Coma-inducing drug GHB may be reclassified, Journal of the American Medical Association, 277, 1505-1506.

Centers for Disease Control (1997) Gamma hydroxybutyrate use - New York and Texas, 1995-1996, Morbidity and Mortality Weekly Report, 46, 281-283.

Degenhardt, L., Darke, S. & Dillon, P. (2003) The prevalence and correlates of GHB overdose among Australian users, Addiction, 98,

-204.

Mansergh, G., Colfax, G. N., Marks, G., Rader, M., Guzman, R. & Buchbinder, S. (2001) The Circuit Party Men's Health Survey:findings and implications for gay and bisexual men, American Journal of Public Health., 91, 953-8.

Caldicott, D. & Kuhn, M. (2001) Gammahydroxybutyrate overdose and physostigmine: Teaching new tricks to an old dog?, Annals of Emergency Medicine, 37, 99-102.

Li, J., Stokes, S. & Woeckener, A. (1998) A tale of novel intoxication: A review of the effects of gamma-hydroxybutyric acid with reocmmendations for management, Annals of Emergency

Medicine, 31, 729-736.

Mcdaniel, C. & Miotto, K. (2001) Gamma hydroxybutyrate (GHB) and gamma butyrolactone (GBL) withdrawal: Five case studies,

Journal of Psychoactive Drugs, 33, 143-149.

Craig, K., Gomez, H., Mcmanus, J. & Bania, T. (2000) Severe gamma-hydroxybutyrate withdrawal: a case report and literature review, Journal of Emergency Medicine, 18, 65-70.

Schneir, A., Ly, B. & Clark, R. (2001) A case of withdrawal from the GHB precursors gammabutyrolactone and 1,4-butanediol, Journal of Emergency Medicine, 21, 31-33.

Catalano, M., Glass, J., Catalano, G., Burrows, S., Lynn, W. & Weitzner, B. (2001) Gamma butyrolactone (GBL) withdrawal syndromes, Psychosomatics, 42, 83-88.

Dyer, J., Roth, B. & Hyme, B. (2001) Gamma-Hydroxybutyrate withdrawal syndrome, Annals of Emergency Medicine, 37, 147-153.

Bowles, T., Sommi, R. & Amiri, M. (2001) Successful management of prolonged gammahydroxybutyrate and alcohol withdrawal, Pharmacotherapy, 21, 254-257.

Slaughter, L. (2000) Involvement of drugs involved in sexual assault, Journal of Reproductive Medicine, 45, 425-430.




DOI: https://doi.org/10.20882/adicciones.459

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