Department of Emergency Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan; Forensic and Clinical Toxicology Center, College of Medicine and National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan; Department of Forensic Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan; Kunming Prevention and Control Center, Taipei City Hospital, Taipei, Taiwan.
J Formos Med Assoc. 2021 Oct;120(10):1914-1920. doi: 10.1016/j.jfma.2021.03.030. Epub 2021 May 1.
The recreational drug γ-hydroxybutyric acid (GHB) is a central nervous system depressant, and can produce euphoria at low doses. GHB is a controlled substance in Taiwan. However, the organic solvents γ-butyrolactone (GBL) and 1,4-butanediol (BD), which are unregulated, may be used as an alternative source of GHB. There is no clinical report of analytically confirmed GHB use in Taiwan. We retrospective reviewed the clinical characteristics from the medical charts between May 2017 and April 2020. The urine samples of patients presented to the emergency departments with drug-related complaints were sent for toxicological analysis. Patients with urine samples detected GHB >10 μg/mL by liquid chromatography/tandem mass spectrometry were included. Overall, 11 men and one woman with an average age of 35.3 ± 8.7 years were included. Most patients co-ingested amphetamine (n = 6) and initially presented with depressed consciousness levels (n = 7). One patient presented with out-of-hospital cardiac arrest and one with respiratory depression. All patients regained consciousness within 6 h of admission. All patients used GBL to evade conviction. Although patients recovered with supportive care, respiratory failure and cardiac arrest occurred after GHB/GBL use. It is important to legislate GBL and BD as controlled chemical substances in Taiwan.
娱乐性药物 γ-羟基丁酸（GHB）是一种中枢神经系统抑制剂，低剂量即可产生欣快感。GHB 在台湾被列为管制物质。然而，不受管制的有机溶剂 γ-丁内酯（GBL）和 1,4-丁二醇（BD）可能被用作 GHB 的替代来源。目前在台湾还没有关于分析确认 GHB 使用的临床报告。我们回顾性分析了 2017 年 5 月至 2020 年 4 月期间的病历，将急诊以药物相关投诉就诊的患者的尿液样本送去进行毒理学分析。尿液样本经液相色谱/串联质谱检测 GHB 浓度大于 10μg/ml 的患者被纳入研究。共有 11 名男性和 1 名女性患者，平均年龄为 35.3±8.7 岁。大多数患者同时摄入了安非他命（n=6），最初表现为意识水平降低（n=7）。1 名患者发生院外心脏骤停，1 名患者发生呼吸抑制。所有患者在入院后 6 小时内意识恢复。所有患者均使用 GBL 来逃避定罪。尽管患者在接受支持性治疗后康复，但在使用 GHB/GBL 后仍发生呼吸衰竭和心脏骤停。在台湾，将 GBL 和 BD 立法为管制化学物质非常重要。
