GHB or Gamma Hydroxybutyrate (C4H8O3) is a central nervous system (CNS) depressant that is referred to as club drug or date rape drug. It is an abused substance mainly used by teenagers or young adults when they go out. It increases one’s sex drive and it increases one’s happiness/exhilaration. GHB has severe impacts on the physical health, such as muscle tremors, loss of coordination and can also have a result of death. If an individual were to die due to prolonged use of GHB or an overdose, close family and friends will be affected mentally. The wider community will also be affected as you could become a public nuisance by taking more risks than usual, having a heightened sense of touch and an increased want for sex. The report starts by explaining the chemical properties of GHB and showing GHB in its different solid forms. It then goes on to explain how GHB is taken and how it enters the bloodstream, then talks about the brain and the effects GHB has on the brain. Physical effects in the next section of this report.

Background

The production of GHB consists simply of mixing "lactone" (short for gamma butyrolactone) and sodium hydroxide in the proper amounts. This combination is exothermic, releasing heat and energy. A small amount of water (H2O) is added to the gamma butyrolactone and the sodium hydroxide is mixed into the solution. This step is undertaken  over a hot bath to make it easier for the  sodium hydroxide to dissolve into a solution. The final chemical formula of GHB is C4H8O3.


Figure 1.The reaction pathway of GHB. Retrieved from https://erowid.org/archive/rhodium/chemistry/gaba2ghb.html
Figure 2: Showing GHB in its final form. Chemical structures of GHB. Retrieved from http://www.brainprotips.com/how-long-does-ghb-stay-in-your-system/ 
The chemical structure of GHB has an alcohol functional group at one end of the molecule and a Carboxylic acid at the other end. It is a clear liquid that looks like water or powder and it has a bitter/salty taste when it is mixed into a drink making it hard to detect. The molecular weight is 104.1 g/mol and it is soluble in water, alcohol and ether. GHB’s melting point is -43.53 degrees celsius.

GHB is usually taken through the mouth, however it has also been injected and inserted up the anus. Suppositories (inserting up the anus) are dissolved into the bowel lining and then enter the bloodstream. Oral doses are rapidly absorbed through the gastrointestinal tract, while injections are put straight into the bloodstream. When taken on an empty stomach GHB is absorbed quicker. GHB  crosses the blood-brain barrier and placental barrier, and is distributed in the brain, cerebrospinal fluid, liver, and kidney. It is metabolized rapidly within 6-8 hours into CO2 and eliminated through the lungs.

GHB is naturally produced in the brain as a neurotransmitter, in small amounts therefore it is detected by the receptors that are specifically for the drug. However, when GHB is put into the system for recreational use, it has severe impacts such as affecting the brain by manipulating dopamine levels. GHB has a profound effect as an inhibitory neurotransmitter in the dopaminergic system. Initially, it slows down the release of dopamine however after a while it causes an overproduction and release of it into the blood. GHB is powerful due to it being able to break through the blood brain barrier when most other drugs can not. It is used because of it affecting the nerve pathways, including activating the body pain-killer system and raising levels of growth hormones. It also affects the serotonin system and raises the serotonin levels increasing feelings of wellbeing and euphoria and it slows down the brain's activity during sleep stages 3 and 4. It has significant cardiovascular pharmacology, causing the bradycardia and dysregulation of blood pressure and it affects the central nervous system. Its highest concentration is in the Basil Ganglia and the binding sites are the cortex, midbrain,substantia nigra and mostly in the hippocampus.  It also binds with the GABA-B,GABA and GHB receptors in the brain.
People that use GHB frequently develop a high tolerance to it therefore making it hard to do research about how the brain is effcted on long term abuse.

Discussion

GHB has some immediate impacts on the body, for example muscle tremors and loss of coordination are a physical effect of having a low to moderate dose of GHB. A high dose of GHB causes vomiting, sweating a lot, and seizures. After a light or high dose, the effects can occur within 15-20 minutes of using it and can last for 3-4 hours, however these are only short term effects. Long-term effects can be as bad as death. GHB affects the central nervous system- which is made up of your brain and spinal cord - by interfering with the nerve signal transmissions between the brain and body. Using GHB can make one feel happy and confident, excited or upset, take more risks than usual, have a heightened sense of touch, have an increased sexual drive and tired or drowsy. 
When on a come down the body might shake, experience muscle cramps, sweats and delusions, having these symptoms will affect how one interacts in social and physical aspects of their life. If they were having muscle cramps,sweats and body shakes work will be impacted, such as if one was a builder/carpenter they would not be able to complete the tasks needed in a safe manner and if one was in a relationship and having these symptoms it would affect the way the relationship operates. 

Conclusion

In conclusion GHB has many different effects on the brain and the body.  GHB has its own receptors in the brain therefore taking it at a recreational use has a much larger affect  and impact when used as explained prior in the report. It causes severe short term impacts on the body such as anxiety reduction, droziness, vomiting, decreased of blood pressure. Severe comedown effects include muscle jerks,delusions and body shakes which have an impact on aspects of one's social and physical life.

Public Education Piece

For my public education piece I made a brochure to advise the general public of the information showed in this report.

References

Alcohol and Drug Foundation (2017) GHB. retrieved from http://adf.org.au/drug-facts/ghb/

Cedia (2013) GHB.  retrieved from http://www.ceida.net.au/depressants/GHB.asp

Drug and Human Performance sheet, (n.d) Gamma- Hydroxybutyrate. Retrieved from  
https://one.nhtsa.gov/people/injury/research/job185drugs/gamma-hydroxybutyrate.htm
Government of Canada(2015)GHB. Retrieved from  https://www.canada.ca/en/health-canada/services/substance-abuse/controlled-illegal-drugs/ghb.html

NSW Ministry of Health (2014) GHB:The Facts. Retrieved from http://yourroom.com.au/wp-content/uploads/2013/05/GHB-facts.pdf

PubMed Health (2017) Using medication: Injection, supporesties and other dosage form. Retrieved from https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0087078/

Steven Looi (2012) GHB brain effects. Retrieved from http://www.brainhealthandpuzzles.com/GHB_brain_effects.html

The Drug Classroom (2016) GHB: what you need to know [video]. Retrieved from https://www.youtube.com/watch?v=j5FW7gZfhPU&t=1s

Theodore Benzer (2015) Gamma Hydroxybutyrate Toxicity. Retrieved from http://emedicine.medscape.com/article/820531-overview#a6

The Vaults of Erowid (2015) Basic Synthesis Producer. Retrieved from https://erowid.org/chemicals/ghb/ghb_synthesis.shtml

Trip Canada (n.d) GHB: Gamma Hydroxy Butyrate. Retrieved from http://www.tripproject.ca/trip/?q=node/10/