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Forensic toxicology findings in deaths involving gamma-hydroxybutyrate

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Abstract

Concentrations of the illicit drug gamma-hydroxybutyrate (GHB) were determined in femoral venous blood and urine obtained at autopsy in a series of GHB-related deaths (N = 49). The analysis of GHB was done by gas chromatography after conversion to gamma-butyrolactone and quantitation of the latter with a flame ionization detector. The cutoff concentration of GHB in femoral blood or urine for reporting positive results was 30 mg/L. The deceased were mainly young men (86%) aged 26.5 ± 7.2 years (mean ± SD), and the women (14%) were about 5 years younger at 21.4 ± 5.0 years. The mean, median, and highest concentrations of GHB in femoral blood (N = 37) were 294, 190, and 2,200 mg/L, respectively. The mean urine-to-blood ratio of GHB was 8.8, and the median was 5.2 (N = 28). In 12 cases, the concentrations of GHB in blood were negative (<30 mg/L) when the urine contained 350 mg/L on average (range 31–1,100 mg/L). Considerable poly-drug use was evident in these GHB-related deaths: ethanol (18 cases), amphetamine (12 cases), and various prescription medications (benzodizepines, opiates, and antidepressants) in other cases. Interpreting the concentrations of GHB in postmortem blood is complicated because of concomitant use of other psychoactive substances, variable degree of tolerance to centrally acting drugs, and the lack of reliable information about survival time after use of the drug.

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Acknowledgment

There was no external funding for this project, and none of the authors consider that they have a conflict of interest.

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Authors and Affiliations

  1. Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Artillerigatan 12, 587 58, Linköping, Sweden

    Fredrik C. Kugelberg, Anita Holmgren, Arne Eklund & Alan Wayne Jones

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  1. Fredrik C. Kugelberg
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  2. Anita Holmgren
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  3. Arne Eklund
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  4. Alan Wayne Jones
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Correspondence to Alan Wayne Jones.

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Kugelberg, F.C., Holmgren, A., Eklund, A. et al. Forensic toxicology findings in deaths involving gamma-hydroxybutyrate. Int J Legal Med 124, 1–6 (2010). https://doi.org/10.1007/s00414-008-0299-2

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  • DOI: https://doi.org/10.1007/s00414-008-0299-2

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