GHB (gammahydroxybutyrate or gammahydroxybutyric acid) is a fast-acting central nervous system depressant abused for its euphoric, sedative, and anabolic (body building) effects.

It is a colorless and odorless liquid with a salty taste, but it is also found in powder and capsule forms. GHB is an illegal substance, but it is increasingly used as a recreational drug and hallucinogen. In the dance club/party scene, GHB is often mixed with water and passed around. As with Rohypnol and clonazepam, GHB has been associated with sexual assault.

GHB has been marketed in the past as a health food product for its hypnotic effects and also to promote weight loss and muscle development. Health food stores and pharmacies also have sold GHB over the counter as a dietary supplement. (GHB promotes slow-wave sleep, which is when muscle growth hormone release takes place, although it has not been directly linked to increased body mass.)

GHB has surfaced in 27 states. Most GHB cases have appeared in California, Florida, Georgia, New York, and Texas. GHB is also common in the club scene in Phoenix, Honolulu, and Texas. Detroit reports liquid GHB used in nightclubs for effects similar to Rohypnol. Miami poison control center calls show increased GHB use, reporting rise in effects including loss of consciousness. In New York City, GHB use in the fashion industry has been reported. In Atlanta fitness centers and gyms, GHB is commonly used as a synthetic steroid.

Other Names for GHB.
Some street names for GHB include liquid ecstasy, grievous bodily harm, Georgia home boy, liquid X, liquid E, GBH, soap, scoop, easy lay, salty water, G-riffick, cherry meth, nature's quaalude, zonked, organic quaalude, and somatomax.

GHB Effects
A GHB dose of 5-15 ml or 1-2 grams is considered low to moderate. But the same dose of GHB can have different effects on different people, with serious, negative outcomes.

At first, a GHB user may experience euphoria and relaxation/calmness. But adverse GHB effects can set in 15 minutes to an hour after ingestion:

Poisonings and deaths resulting from ingestion of GHB have been well documented since 1990. Withdrawal syndrome, including sweating, insomnia, muscular cramping, tremors and anxiety, can develop.

GHB intensifies feelings of intoxication and may result in enhanced sexual feelings. It produces a similar feeling to alcohol, and GHB’s effects are exacerbated by combining it with alcohol, including nausea and difficulty breathing.

The risk of seizure appears to be higher when combined with methamphetamine.

GHB as a Date Rape Drug.
GHB is sometimes characterized as a date rape drug. Because it is odorless and colorless, it can be slipped into someone's drink to facilitate rape. Since GHB may make a person less inhibited and may increase sexual feelings, establishing whether or not a rape occurred becomes more difficult. GHB may produce amnesia so the victim cannot recall what happened.

What the Law Says about GHB
Due to concern about Rohypnol, GHB, and other similarly abused sedative-hypnotics,
Congress increased federal penalties for use of any controlled substance to aid in sexual assault in the "Drug-Induced Rape Prevention and Punishment Act of 1996".

Although possession of GHB is not illegal under federal law, it is illegal for any person to produce or sell GHB in the United States. The Food and Drug Administration has re-issued a warning against the use of GHB, as it is not approved for any use. (In Europe, GHB is an approved drug available by prescription only.)

In Georgia and Rhode Island, GHB has been classified as a Schedule I drug - a drug that does not have a currently accepted medical use, has a high abuse potential, and is not proven to be safe under medical supervision. The Drug Enforcement Administration is considering a scheduling review for possible control of GHB under the Federal Controlled Substances Act.

Potential Medical Uses of GHB
GHB has been used in clinical testing but has never been approved for sale as a medical product in the United States. GHB has been studied for its ability to induce short-term coma and possible surgical anesthesia. It has also been used successfully as a sleep-inducing aid to treat people who suffer from narcolepsy, a rare sleeping sickness, though its effects are short-term. Other potential clinical roles are treatment of alcohol and opiate dependence, protection against hemorrhagic shock, and improving liver function.

ROHYPNOL
Rohypnol is the trade name for flunitrazepam, which is a benzodiazepine prescribed as a sleeping pill.

Rohypnol has become known as a date rape drug. It can be mixed in a drink to incapacitate a victim and prevent them from resisting sexual assault. Rohypnol produces sedative-hypnotic effects including muscle relaxation and amnesia.

Although Rohypnol is the most widely prescribed sedative-hypnotic drug in Europe and also marketed in Asia and Central and South America, it is not licensed for sale in the US and importation is banned.

Illicit Rohypnol Use
Rohypnol is usually sold in bubble packs of 1 or 2 mg doses. Generic and illegally manufactured versions of Rohypnol exist as well, although the brand Rohypnol seems to be preferred among abusers.

Rohypnol abuse often accompanies abuse of other drugs. For example, heroine abusers find Rohypnol enhances the high from low-quality heroin. Rohypnol can help mellow a user on cocaine or bring down a user on a crack binge.

Most frequently, American Rohypnol users seem to combine Rohypnol with alcohol to produce disinhibition and amnesia. It allows drunk drivers to avoid detection, as the blood alcohol level remains low and the Rohypnol is not detected. However, to counter this, the Florida law allows screening for flunitrazepam (Rohypnol) if a driver seems impaired but has a low blood alcohol level.

Rohypnol Abuse is Spreading in the U.S.
Abuse of flunitrazepam is a worldwide problem and has been reported on every inhabited continent. In the U.S., abuse of flunitrazepam (Rohypnol) was first reported in 1993 in south Florida. As well, Rohypnol abuse has spread from the Texas-Mexico border and into other states. The Drug Enforcement Administration reports significant numbers of cases involving Rohypnol primarily from the South and West. However, cases are pending in other states, including New York and California, as well. Because Rohypnol is not legal in the US, use may not be recognized until actively investigated.

Rohypnol abuse appears to be gaining popularity with high school and college youth in the U.S. Rohypnol is associated with gangs in some areas, also becoming known as a club drug. Street names for Rohypnol include rophies, roofies, ruffies, R2, roofenol, Roche, roachies, la rocha, rope, and rib.

A very similar drug is also now being sold as "roofies" in Miami, Minnesota, and Texas. Clonazepam, which is marketed in the U.S. as Klonopin and in Mexico as Rivotril, is sometimes abused to enhance the effects of heroin and other opiates. It appears that Boston, San Francisco, Phoenix, and Seattle currently have the highest use rates of clonazepam.

Rohypnol Dependence and Withdrawal
Lethal overdose from Rohypnol is unlikely; however, Rohypnol may be lethal when mixed with alcohol and/or other depressants. Continued use can produce physical and psychological dependence.

Withdrawal symptoms range from headache, muscle pain, and confusion to hallucinations and convulsions. Seizures may occur a week or more after stopping use. Miami poison control centers report an increase in withdrawal seizures among people addicted to Rohypnol.

Medically supervised detoxification of Rohypnol using diminishing doses of other benzodiazepines is essential.

KETAMINE

Ketamine, or ketamine hydrochloride, is a non-barbiturate, rapid-acting disassociative anesthetic used in the medical community mainly by veterinarians or for minor surgery for pediatric or geriatric patients. It has also been used in dentistry and in experimental psychotherapy.

Effects of Ketamine Abuse
Ketamine produces physical and mental effects. A low dose, of around 25 - 100 mg, produces psychedelic effects quickly. Large doses can produce vomiting and convulsions and can starve the brain and muscles of oxygen. One gram can cause death.

Because the effects are so quickly felt, a user may lose motor control before injection is even complete.

Ketamine may produce feelings from euphoria to paranoia to boredom. There are hallucinogenic effects and perception is impaired, intensifying colors and sounds. Ketamine may also relieve tension and anxiety, and is alleged to be a sexual stimulant. Ketamine is an anesthetic and prevents the user from feeling pain. Therefore, a ketamine user is often not aware when something is wrong, and the numbness may lead to increased use, sometimes to the point of death.

Ketamine creates effects similar to phencyclidine, commonly known as PCP or Angel Dust, as the two drugs have a similar molecular structure. Some of the effects produced by ketamine include:

Use of ketamine commonly provides an out-of-body or near-death experience for the user. This is the effect that a ketamine user is seeking, as it allows them to disassociate themselves from their own consciousness, called k-hole.

If a ketamine user reaches the point of a k-hole, they are in danger of mental damage beyond repair. Ketamine can leave the user comatose. Or the ketamine user may develop a permanent neurosis with periodic episodes of complete consciousness perforation, leading to insanity beyond psychological assistance.

A ketamine high usually lasts an hour, but effects can persist 4 - 6 hours. It is usually 24 - 48 hours before the ketamine user feels completely back to normal. It can take from several months to two years for the effects of chronic use of ketamine to wear off. Flashbacks may even be experienced a year after the last ketamine use.

Ketamine use can lead to a vicious obsession. The Ketamine user can become dependent physically and psychologically without even realizing it. Ketamine becomes central to every thought, turning into an obsession that rules the ketamine user. This cycle of obsession is the factor that leads to ketamine use to the point of death.

Forms of Ketamine
Ketamine is most potent when injected intramuscularly or intravenously. It usually comes in liquid form but can be made into tablets. Ketamine may also be converted to a powder for smoking or snorting, by evaporating the liquid and reducing it to a fine white powder.

Ketamine’s appearance is often mistaken for cocaine or crystal methamphetamine. It is sometimes sold as ecstasy and mixed with other drugs such as ephedrine and caffeine.

Street Names for Ketamine
Ketamine is also known on the street as K, ket, special K, vitamin K, vit K, kit kat, keller, kelly's day, green, blind squid, cat valium, purple, special la coke, super acid, and super C. Slang descriptors for experiences or effects of ketamine include k-hole, K-land, baby food, and God.

Ketamine Abuse
It is marketed as Ketalar or Ketaset to veterinarians and medical personnel and classified as a Schedule II drug, having a high abuse potential with severe psychic or physical dependence liability. (Cocaine and methamphetamine are also Schedule II drugs.) Ketamine is considered a controlled substance only in California, Connecticut, New Mexico, and Oklahoma.

The Drug Enforcement Administration reports that ketamine abuse appears mostly in San Diego, New York, Miami, and Newark, DE, although use is also reported in New Jersey, D.C., Florida, and Georgia. Increasingly, young people are using it as a club drug at raves and parties. However, cafeteria use, which refers to the use of a number of hallucinogenic and sedative/hypnotic club drugs (such as MDMA, GHB, LSD, and prescription drugs) is reported almost everywhere in the U.S.

ECSTASY

Ecstasy is a street name for the chemical MDMA (methylenedioxymethamphetamine). It is a stimulant that combines the properties of methamphetamine (speed) with mind-altering or hallucinogenic properties. Ecstasy has a structure similar to stimulants like cocaine, and hallucinogenics such as LSD. The highly addictive nature of ecstasy is similar to that of cocaine and amphetamines.

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