Management of GHB acute intoxications

Intoxications related to γ-Hydroxybutyric acid (GHB), arising from its success as recreational drug due to its psychotropic properties, are significantly and alarmingly jeopardizing public health, posing major challenges to medical staff. In recent years, GHB's prodrug -butyrolactone (GBL) has often supplanted GHB in recreational settings, owing to its lower cost and the ease with which it can be obtained, mainly due to its various legal industrial applications. The Authors intend to stress that symptoms should be assessed and confirmed by timely toxicological analyses by highly-trained, expert professionals. Such tests aimed at analytical confirmation are instrumental in providing physicians valuable indications in terms of the proper pharmacological treatments in order to revert the adverse, or even fatal, side effects, particularly when the overall intoxication picture looks ambiguous. At the time being, little is known about the pharmacological therapies effective in GHB intoxication cases; further comprehensive research is therefore essential, if we are to tackle such a burgeoning public health emergency before it is too late.