Is 1,4-butanediol converted to GHB (gamma-hydroxybutyrat) in humans? Is there any information on it

Fråga: Is 1,4-butanediol converted to GHB (gamma-hydroxybutyrat) in humans? Is there any information on its pharmacokinetics? Is there any information on abuse of butanediol? Is there any information about effects and side-effects?

Abuse of butanediol is spreading among drug addicts and youngsters. According to some sources the substance is the follow up of GHB.

Sammanfattning: 1,4-butanediol is rapidly converted to GHB and gives the same effect and side-effects as the latter compound. We have not found any information on the pharmacokinetics of 1,4-butanediol. There are some reports of intoxication that has occurred in Sweden but little is known about abuse.

Svar: 1,4-butanediol is an industrial chemical and rapidly oxidised by alcohol dehydrogenase to gamma-hydroxybutyraldehyd and by aldehyde dehydrogenase to GHB in human. The enzymes are inhibited by ethanol and disulfiram respectively (1). GHB is an endogenous substance in the brain and could be used as an anaestethic and sedative (2). As 1,4-butanediol is rapidly converted to GBH the effects and side-effects are the same as for GHB. No information on the pharmacokinetics of this substance could be found. According to the Swedish poison control centre intoxications have occurred in Sweden (3).

We have found three case reports of intoxication. In the first case a 20-year-old man took four times the usual dose of "pine needle oil". Rapidly after the intake he began to vomit and lost consciousness. Coma developed and intubation was performed. 50 minutes later the patient woke up and was alert. Case 2 included a 44-year-old man who took 9 yohimbine tablets and a few sprays of "pine needle oil". He became agitated, unconscious and vomited. On arrival at the hospital he presented with unconsciousness and myoclonic jerking. Within 3 hours he was awake and alert (1). Case 3 described a 39-year-old with a history of depression and insomnia who started to ingest 10 ml aliquots every night. On the seventh night he had a tonic episode with altered mental status and incontinence of stool. He recovered soon thereafter (4). 1 Dyer JE, Galbo MJ, Andrews KM: 1.4-Butanediol, "Pine needle oil": överdose mimics toxic profile of GHB. J Toxicol Clin Toxicol 1997; 35: 554 2 Drugline no 16155 (year 1999) 3 Personal communication Giftinformationcentralen 4 Cisek J, Holstege C, Rose R: Seizure associated with butanediol ingestion. J Tox Clin Tox 1999; 37: 650