GHB Death Statistics
DEATH BY WAY OF GHB
By Trinka Porrata
Are we just here for a moment and then, well, just gone? Life indeed will go on without each of us (no matter how indispensable we might feel we are!), but we each have made a mark in some way in the lives of others. And, regardless of our beliefs of what might be on the other side, death leaves sadness behind, right here on this earth. In dealing with death as a police officer for 25 years I certainly had a bit of a view into it. But working with Project GHB, started by parents who lost a son to the drug GHB, has given real insight into the process of death and grieving. I know how lonely many people feel in times of trouble, having dealt with many on the brink of suicide while fighting the grip of GHB on their bodies and souls. Some came back from that edge of life and some did not. I’ve dealt with families and friends who have lost a loved one to a direct overdose of the drug from one time use to prolonged agony because of this drug. I’ve heard from parents and brothers and sisters who themselves stood on that brink, suffering from the pain of loss of a child, brother or sister, punishing themselves with guilt that they “should have done more,” and so on. I’ve watched marriages fall apart or strengthen because of the shattering loss of a child to drugs.
Two of the many heartbreaking cases--Matt and Josh--are documented in part on the website and in our book “G’d Up 24/7: The GHB Addiction Guide,” after their mothers sought help for their addiction to GHB for many months, going to doctor/hospital after doctor/hospital begging for help to save them. Despite the valiant efforts of their families and their own desperate desires to survive, neither one made it. Their stories launched the Project GHB Addiction Helpline in December 1998. The Addiction Helpline and Message Board are still heavy with activity worldwide to this day.
One recent email really brought home the lasting impact that death makes.
“My mother was Kerri Breton and she was murdered by this awful drug in Syracuse, NY, back in 1998. The man last seen with her denies any involvement. However the investigation proves that she did not take it herself. There was not enough evidence to convict this man or even have a trial. Her killer --- that coward--- has been walking the street 10 years this past May. My grandfather left a comment here 9 years ago. So I figured why not add mine. My mother was 26 years old and a single mother. She was on a business trip in Syracuse, NY, when someone slipped GHB into her drink. Her killer was never caught and has never paid for what he did. She left behind myself and now my son, as well all of the other people who really loved her. Due to my mother’s death there has been awareness brought to many other young women and men.”
Indeed I remember Kerri Breton’s death when we were just digging into these issues and getting this website going. Efforts by her loved ones, especially her father and a good friend, did result in awareness and legislation about GHB in NY.
All drug-related deaths are tragic. Some of them, regardless of the drug involved, could have been prevented in some way, via prevention, intervention or whatever. And with all drug abuse climates, there are those deaths where a life could have been saved, if only someone had called for help.
This is your brain on drugs---I’ll just risk letting my best friend die rather than call 911 and risk getting myself in trouble for my own drug use.
But with the drugs GHB and MDMA (Ecstasy & related drugs), there is a special sadness to this climate. Beyond the usual “let’s don’t get in trouble ourselves” attitude, there is an intense “training” program out there about not calling 911.
With MDMA the idiotic belief is that you just need to cool them off, since MDMA causes the body temperature to rise to potentially fatal levels. Well, drinking water is indeed crucial as MDMA causes dehydration, but not a guaranteed fix. So instead of calling for help while help would still be of value, many let their friends’ brains cook on this drug and simply urge them to drink tons of water (which can result in water poisoning, literally, and also prove fatal by flushing crucial nutrients/chemicals from the body), put them in a cold shower or even tubs of ice, or take them out into the cold night air, etc. By the time their “friends” realize it isn’t working, the brain damage and organ damage may be too far along to reverse.
With GHB there is an equally idiotic belief that all you need to do is let them “sleep it off.” Most people DO sleep off a GHB overdose. The rest are called brain damaged, or D-E-A-D. Unbelievably, GHB pushers often label their “cleaning” products with wording like, “In case of an accidental ingestion, a sense of well-being and euphoria may be felt.” The so-called dietary supplement Blue Nitro gave this pathetic message: “Ensure that those around you are aware that you may be unarousable and that this is normal. Higher doses will result in proportionally longer periods of deep sleep. Excessive doses may result in sweating, muscle spasms, vomiting, bedwetting and diarrhea. Unless drugs or alcohol have been taken with Blue Nitrol the only treatment necessary is to SLEEP IT OFF! A call for help may result in uninformed emergency medical personnel using expensive, unnecessary and potentially dangerous methods of arousal.” Nothing normal about being close to death and nothing unnecessary about having your life saved.
How sad indeed to lay dying as “friends” just party on nearby. I’ve heard of cases where they partied for eight hours or more AFTER their “friends” had already died nearby. Add to that those who do wake up from their own fun night on drugs to find a dead body beside them and those who tucked their buddies into bed and left completely, assuming they would wake in the morning……but they didn’t. Some innocently had no idea what their friends were on (assumed it was “just” alcohol, which can also be fatal in excess) but many KNEW it was GHB and left them despite the fact they had behaved very bizarrely, turned blue, vomited, lost urinary or fecal control, etc.
REAL friends don’t let friends lay dying when help could save them.
And it doesn’t end there. There have been cases of people trying to play god or doctor by administering other drugs, trying on their own to reverse the GHB overdose. Giving methamphetamine or cocaine or other stimulants to try to counteract the depressant effects of a GHB coma are NOT effective or sane.
My personal and heartfelt thanks to Dr. Deborah Zvosec of Minnesota who launched into a thorough review of many of the deaths related to GHB. She dug into and analyzed 226 of the more than 350 we have heard about. No one before had looked at more than a couple at a time. Of course, it has been difficult getting the data published as there is such a resistance to learning new things it seems. Project GHB had accumulated dozens of autopsy reports and hundreds of notes regarding known GHB deaths and suspected GHB cases, hoping that someday, someone would plow through the vault of rough data and make some sense of it. She has! Her work has blown away two key myths about GHB death. 1—You can’t die from GHB alone; you die only if mixed with alcohol or other drugs. More than one third of the deaths in her review were from GHB only. 2—You just need to let them “sleep it off” rather than seek medical attention. I’ve already referenced that sad, proven-bad myth. Hopefully as the data gets published here and there more awareness will be generated and more lives saved.
Trinka Porrata, President Project GHB
GHB FATALITY RESEARCH SUMMARY
Deborah L. Zvosec, Ph.D.
Department of Emergency Medicine
Hennepin County Medical Center
Colleagues and I set out to collect data on deaths associated with use of GHB and its analogs, gamma butyrolactone (GBL) and 1,4 butanediol (BD). After hundreds of phone calls, emails, and letters to Medical Examiners (ME’s), coroners, and toxicologists in the U.S., Canada, and the UK, we identified 226 deaths that occurred from 1995-2005.
While this is a sizeable number, it is most likely a significant under-representation of the actual number of GHB/analog-associated deaths. This is because: 1) routine toxicology tests used by hospitals and ME’s do not detect GHB/analogs; 2) many coroners and ME’s are unfamiliar with GHB/analogs and do not know to request specific tests to detect them; 3) limited funds are available for death investigations, so toxicology testing often stops when other drugs are detected; 4) there are no centralized databases to indicate when and where GHB-associated deaths are detected; 5) death records are often un-searchable, due to limited technology and/or funds; and 6) access to death records is, in some states, limited by privacy concerns. Thus, it is important to remember that our series in no way indicates the total number of deaths, it simply presents information on a series of deaths for which we were able to both locate and access information.
The 226 deaths that we identified included 155 men and 71 women, including 209 in the U.S. (36 states), 4 in Canada (Quebec), and 13 in the UK. Ages ranged from 15-53 years (average: 28 years). Of the 226, 207 deaths were classified as GHB-caused, in which toxic effects of GHB caused or contributed to death. Thirteen other deaths resulted from fatal accidents suffered while GHB-intoxicated, including 6 drownings (hot tubs, swimming pool), 6 motor vehicle collisions (3 drivers, 3 pedestrians), and 1 smoke inhalation; four of these deaths occurred with no co-intoxicant drugs or alcohol. And 6 deaths occurred with GHB detected, but its role in cause of death was undetermined.
We have reported findings from our series at numerous conferences and in medical journals, to educate clinicians in different medical specialties (see references below); more publications will follow. It is important here, however, to emphasize two key issues:
1. GHB is lethal with and without other drugs or alcohol.
Internet sites warned that GHB was lethal when used with alcohol or other depressant drugs, but users and their friends were instructed that GHB was harmless when used by itself. However, toxicology testing in our series confirmed that, of 207 GHB-caused deaths, 71 (34%) occurred with no co-intoxicant drugs or alcohol. Of the remaining deaths, 76 (37%) had depressant co-intoxicants (drugs and/or alcohol), 23 (11%) had stimulant co-intoxicants, and 34 (16%) had both depressant and stimulant co-intoxicants detected. Three deaths (2%) lacked blood toxicology results, so co-intoxicant use is unknown. This data confirms that GHB is lethal, even without other drugs or alcohol, and confirms previous reports of recreational drug users that, despite widespread warnings, use of GHB with depressant drugs and/or alcohol is quite common.
2. GHB/analogs are not “sleep-it-off” drugs
Internet sites and product labels also instructed that the only treatment necessary in cases of GHB overdose, particularly those in which GHB was with no other drugs or alcohol, was to “sleep it off.” Tragically, of 102 cases in our series for which we had adequate information about events prior to death, 30 deaths occurred in victims left “sleeping” or “snoring” by their friends; seventy-two other deaths involved witnesses who observed toxic effects of GHB/analogs, such as loss of consciousness, vomiting, seizures, and agitation, of which 66 (92%) documented delayed 911 activation until the victim was found in respiratory arrest or dead. Among 72 deaths in which GHB use by the decedent was known to witnesses, 100% were unaided, including 51 who were seen to suffer adverse effects and 21 others who were left “sleeping.” While all of the deaths in our series occurred in victims who died or stopped breathing prior to arriving at the hospital, many other cases have been reported in which 911 was called and victims of GHB overdose survived with no long-term consequences. Thus, many of the deaths in our series were likely completely preventable, had friends or other witnesses called 911 immediately, at the signs of overdose.
1. Zvosec D, Dyer J, Porrata T, Smith S, Strobl A. Preventable deaths associated with Gamma
hydroxybutyrate (GHB) ingestion: 226 fatalities (Abstract 49). European Journal of Emergency
2. Zvosec D, Smith S, Porrata T, Strobl A, Dyer J. Fatal motor vehicle collisions while Gamma hydroxybutyrate (GHB)-intoxicated. Proceedings of the Joint Annual Meeting of the International Council on Alcohol, Drugs, and Traffic Safety (ICADTS) and the International Association of Forensic Toxicologists (TIAFT), Seattle, WA, August 29, 2007.
3. Zvosec DL, Smith SW, Porrata T, Strobl AQ, Dyer J. Preventable deaths from Gamma hydroxybutyrate ingestion. Abstract 247. Annals of Emergency Medicine 2006;48(4):S75.
4. Zvosec DL, Smith SW, Porrata T, Quinn AQ, Dyer JE. 226 Gamma hydroxybutyrate (GHB)-associated fatalities: Overlap of postmortem GHB levels with endogenous, therapeutic, and non-fatal GHB toxicity cases and factors supporting exogenous origin. Oral presentation at the Annual Meeting of the National Association of Medical Examiners, Savannah GA, October 13, 2007.
By Trinka Porrata
We initiated the death report form because no official government agency has made an ongoing effort to track GHB-related deaths. The Drug Enforcement Administration reviewed and evaluated 71 cases that they determined to be GHB related while we were working on the federal legislation to control GHB and its analogs (making the analogs legal as chemicals but illegal for human use). DEA stopped reviewing cases once the federal scheduling of GHB took effect (March 2000). No other federal agency has tracked these deaths. The Drug Abuse Warning Network (DAWN) had no place to include these deaths in the past. The state of Florida did initiate tracking of deaths related to GHB, MDMA and some of the other more unusual drugs of current abuse, especially re clubs and raves. We know this is just the tip of the iceberg due to testing difficulties regarding GHB, especially in death cases, and the to-this-day lack of awareness about this drug to law enforcement and medical/coroner personnel. GHB isn’t included in any standard testing protocol and thus without specific knowledge that they person may have ingested GHB, testing isn’t likely to occur.
Therefore, this list here includes those picked up from newspaper accounts, coroners, law enforcement and as reported by family and friends who complete the report forms. We have done this so that basic information is not lost completely. Unfortunately, references to deaths are sometimes vague and hard to track further. Even those who submit our death report form don’t always include full information. This list documents everything we have been told. Some of them may never be found because of the vague information given. Therefore we ask that anyone completing the death report forms please provide as much information as possible. Families who have copies of the autopsy reports and wish that their loved ones deaths be included in the research documentation being done are encouraged to contact me at Equus555@att.net or Trinka@projectghb.org to make arrangements for our researcher to obtain a copy of the report.
For those curious about the two deaths listed as 1948, they are included for documentation since they were recorded as related to the GHB analog 1,4 butanediol. Though GHB wasn’t synthesized until a little later, some of the chemicals related to GHB were identified and/or studied prior to that. BD was used in that research study.
This list includes a few traffic deaths related to GHB, but only of those under the influence. It does not include those killed by people driving under the influence of GHB. It includes a couple of the GHB-related suicides, but not all of them.
Again, this list is maintained in an effort to preserve information as it comes in with the hope that further research and documentation may be done as feasible.
Those wishing to have their loved one featured on the “Tragedies” page may submit the photo and story to Trinka@projectghb.org.