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γ-Hydroxybutyrate

Bridging the Clinical-Analytical Gap

  • GHB Symposium
  • Published:
Toxicological Reviews

Abstract

Laboratory detection of γ-hydroxybutyrate (GHB) has been published as early as the 1960s. However, wide-scale use of GHB during the 1990s has led to the development of current analytic methods to test for GHB and related compounds. Detection of GHB and related compounds can be clinically useful in confirming the cause of coma in an overdose patient, determining its potential role in a postmortem victim, as well as evaluating its use in a drug-facilitated sexual assault victim. Analytical method sensitivity must be known in order to determine the usefulness and clinical application. Most laboratory cut-off levels are based on instrument sensitivity and will not establish endogenous versus exogenous GHB levels. Interpretation of GHB levels must include a knowledge base of endogenous GHB, metabolism of GHB and related compounds, as well as postmortem generation. Due to potential analytical limitations in various GHB methods, it is clinically relevant to specifically request for GHB as well as related GHB compounds if they are also in question. Various storage conditions (collection time, types of containers, use of preservatives, storage temperature) can also affect the analysis and interpretation of GHB and related compounds.

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Notes

  1. The use of trade names is for product identification purposes only and does not imply endorsement.

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Acknowledgements

The opinions contained in this review are not to be construed as official or as reflecting the views of the Department of Defense or the Department of the Navy. No sources of funding were used to assist in the preparation of this review. The author has no conflicts of interest that are directly relevant to the content of this review. The author would like to thank Dr Carl Hornfeldt, PhD, Orphan Medical, for providing editorial assistance and obtaining articles on the author’s behalf.

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  1. Navy Drug Screening Laboratory, Great Lakes, 320B B Street, Great Lakes, Illinois, 60088, USA

    Cynthia L. Morris-Kukoski

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Morris-Kukoski, C.L. γ-Hydroxybutyrate. Toxicol Rev 23, 33–43 (2004). https://doi.org/10.2165/00139709-200423010-00004

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