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Gamma Hydroxy Butyrate -
Spotlight on GHB Get Info and / or register - there's still time to sign up! Agendas updated: DAY ONE
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------------------------------------------------ The Rare Disease of SSADH—Too Much “Natural” GHB Dr. K. Michael GibsonConference Feature! Gymgoers, senior citizens and businessmen who travel are common targets of the hype that GHB is a totally safe, non-addictive, anti-aging, sleep aid or workout aid, sexual enhancer, etc. They are the ones who most often end up addicted to it, living a life of ongoing chaos, though they are often the last to know, while those around them are stupefied by the observed behavior changes. Part of the hype is that GHB is “naturally occurring” and thus safe. Bear in mind, earthquakes, tornados, poison ivy, etc., are also “naturally occurring.” And, “more” just isn’t necessarily “better.” GHB is supposed to help reduce cataplexy attacks (sudden, brief, dramatic loss of muscle control) in those suffering from the relatively rare combination of narcolepsy and cataplexy. Perhaps a little more works for some with this condition (GHB is now marketed as Xyrem and demonstrating a 70 percent reduction in cataplexy attacks, according to studies presented to the FDA). But consider the even more rare disease of Succinic Semialdehyde Dehydrogenase Deficiency (SSADH), in which people accumulate too much GHB and basically live their lives in a state of GHB overdose. Sometimes diagnosed early on as autism, the condition really seems to manifest itself in the late teens or 20s as gamma-hydroxybutyric aciduria. Clinical presentation may include behavioral disturbances and psychosis (hallucinations, disabling anxiety, aggressive behavior and sleep disorder). Researchers studied the cerebrospinal fluid from 13 patients and found GHB levels elevated from 65 to 230 times the normal “naturally occurring” levels. Levels of two chemicals indicative of dopamine and serotonin metabolism increased in linear correlation with the GHB concentrations, suggesting enhanced dopamine and serotonin turnover had occurred. Findings from this study will be presented at the National GHB Conference in Orlando, Florida, May 9-11, by Dr. Michael Gibson, Oregon Health & Science University, Portland, Oregon. Most patients with this condition present “global developmental delays, hypotonia, ataxia and poorly developed to absent speech development.” Seizures occur in approximately half of them. Ironically, many of the behavior patterns described by the researchers sound all too similar to GHB overdose cases and the stories from GHB addicts and their families. One patient, for example, was described as having “deterioration of behavior, with aggressive episodes, incomprehensible language, spatial and temporal disorientations, stereotypical motor movements and occasional catatonic posturing. She became isolated, demonstrated decreasing participation in the social environment and developed a serious sleep disorder.” This description is very similar to overdose indicators and to what many long-term and addicted users of GHB experience. GHB addicts (more than 800 have come forward to Project GHB’s Addiction Helpline for aid) increasingly withdraw from society, some shopping only at all-night grocery stores or even paying neighbors to shop for them. Dr. K. Michael Gibson’s presentation is scheduled for the afternoon of May 9. Co-authors with Dr. Gibson, PhD, FACMG, include Maneesh Gupta, MBBS; Phillip Pearl, MD; Mendel Tuchman, MD; L. Gilbert Vezina, MD; O. Carter Snead III, MD; Leo M.E. Smit, MD; and Cornelis Jakobs, PhD. [top] ------------------------------------------------ Hair Testing for GHB
Breakthrough for Drug-Facilitated Sexual Assault Cases [top] -------------------------------------------------- DFSA : Growing Concern But Training Sadly LackingBy Trinka Porrata [DFSA = Drug-Facilitated Sexual Assault] Unfortunately, it has been impossible to educate the media to stop saying “date rape drug” in reference to GHB, flunitrazepam (roofies, trade name Rohypnol) and other drugs used as weapons of sexual assault. There is “drug-facilitated sexual assault.” And, there is “acquaintance rape.” And, sometimes there is a cross over, and we have a “drug-facilitated acquaintance rape.” It isn’t about a date. It’s about using a drug to incapacitate a victim in order to sexual assault her (or him) or at least to deny her (or him) the ability to give or withhold consent. At best these can be tough cases to comprehend and solve due to the loss of time and memory and evidence due to the very nature of the crime and the effects of the drugs employed by the rapists. Unfortunately, the medical, law enforcement and judicial systems are simply not universally up to speed on the issues, leaving many to fall through the cracks that should not have to be lost. There are other myths too. It isn’t about just “knocking out” the intended victim. The original Mickey Finn drug (chloral hydrate) did pretty much accomplish that. Today’s drugs may at some point render a victim unconscious, but even worse, at least initially, and, depending on which drug is used and/or the amount given, the victim may appear to participate or may even appear to be the aggressor early on in the attack. GHB is especially known for its sexual enhancement capabilities. But not only is a victim disinhibited and likely to engage in behavior quite atypical for her personally (hanging on the arm of a total stranger, entering a wet T-shirt contest or pulling her bra up for the crowd, for example), she most likely truly will not even remember such conduct. Needless to say, waking up with little idea of what has taken place, a sneaky suspicion (or obvious evidence) of sexual activity, leaves one confused, dazed and hesitant to run to the police. This results in a delay as the victim attempts to piece together her plight, talks to a close confidant or someone who had been there during her last recollection of the evening. By the time she comprehends the situation, precious time has been lost in terms of collecting evidence. Thus you frequently read in the newspapers this uneducated statement: “The victim claims she was drugged and raped, but they tested her for ‘date rape drugs’ and there weren’t any. So, it wasn’t a drug rape.” That statement misstates the reality of the typical drug rape. Each drug---and there are at least 36 of them known to be used to commit rape—has its own profile of symptoms and it’s own lifespan in the victim’s body fluids. Some stay for a couple of days, but GHB, the most popular for obvious reasons, very quickly dissipates from the system. In the first place, hospitals can’t even test for GHB. There is no “screening test” for it; it requires a confirmation test that hospitals cannot do and crime labs only do upon specific request (which often means they must send it out to a contract lab or state or federal lab as many crime labs aren’t set up to do it). Thus a negative toxicology report often just means that we didn’t get the evidence taken soon enough, for a variety of reasons. In fact, hospital screening tests should never be considered the final word as to whether or not a drug was present because they are screening tests and not all drugs in even the categories they can test for are identified so simply. Even crime labs, due to lack of money and lack of training about how many and which drugs are utilized, seldom exhaust all possibilities on a sexual assault case. Unfortunately, life is NOT like the CSI TV shows where each case is handled to the maximum of all real (and some imagined) technology. The GHB rape article in the December 2002 issue of Glamour magazine and the article in the February 3, 2003, issue of Newsweek magazine brought tears to the eyes of many victims whose stories had remained untold out of fear and confusion or whose stories were told but disbelieved and ignored by the system. Worse yet are those whose stories were simply mishandled. Fortunately, the stories also brought attention to this neglected issue and beyond the flood of email/calls from victims, I also got a number of contacts from detectives and prosecutors determined to handle cases more appropriately and aggressively to bring some true justice to the system. There is much work to be done. Potential victims (who must become personal survivors, even if the system fails them)---need to be educated in advance to do everything possible to prevent this horrific crime. That means knowing who their friends are, not going out alone or with strangers, trying to avoid risky situations (that includes risky-atmosphere bars where the bartender may be part of the crime spree and is the first opportunity to dose a drink), not accepting drinks from strangers or unusual drinks they would not normally take (sweet, fruity, or unusual tasting concoctions are often offered to mask the typically salty taste of GHB, for example), guarding your drinks as carefully as possible (but realizing that you DO look away from your table now and then) throwing away any drink left unattended or that doesn’t taste right or tastes differently than when you first got it, etc.). This also means realizing that drinking and/or doing drugs “like the boys” puts you at risk of becoming a victim. It’s still rape if you get wildly drunk and pass out or do drugs and become incapacitated or otherwise unable to protect yourself (and yes, Ecstasy IS considered a rape drug too)…………..but it certainly clouds the issues and there is no question that there is a bias against women who put themselves in harm’s way. Getting drunk doesn’t equate to consent for anyone to have sex with you, but why volunteer to be a victim? Be responsible for your condition to every extent possible. The message also has to include that if a person feels that he or she has been drugged and raped or robbed, that person MUST get to the hospital and/or police station IMMEDIATELY. And, she must INSIST that a urine sample be taken (many hospitals and police departments still aren’t up to speed and may take only a blood sample) right away……not hours and hours later. It’s ideal to have the examination done before urination or cleansing, but reality is that hospital exams often involve delays and you can’t realistically be denied the opportunity to urinate if need be. So, this item of evidence should be collected at that point. Hospitals and rape treatment centers and rape crisis hotlines need to be universally educated to the critical needs of forensic evidence. Urine is the most important sample, not blood, in most cases and timing is of the essence! Victims need to be encouraged to act promptly to get to a facility to make the report. Systems need to be streamlined so that urine evidence is obtained more promptly. It’s hard enough to get the victim in time, without losing evidence due to simple delays. Police departments need to provide training for their patrol officers (first line responders) and detectives about the drugs utilized in sexual assaults. They need to know that a variety of drugs are used. They need to know what to look for in terms of crime scene evidence (drug paraphernalia and how these drugs are transported, especially GHB) and realize there may be more than one crime scene (location of drugging, location of rape, evidence related to accessing the drug and info about it, etc.). They need to know that EVERY possible witness is crucial as even tidbits of information may be crucial to developing the necessary timeline of events to determine what happened. Police departments need to recognize that this is a serious and widespread drug of abuse, even within fire and police agencies, the military, etc. Too many police officers around the nation have lost officers to abuse of this drug, from LAPD to Panama City. It IS a problem. And, many drug-rape victims end up driving cars and being arrested for DUI. Unfortunately, when they try to report the assault once they have come out from under the drug, they are disregarded, ridiculed, etc. Handling the DUI is one thing (and, of course, that’s what the officers are initially faced with and must handle) but ignoring a rape report by making the value judgment that “she’s just making this up to get out of a DUI” is inexcusable. Taking the rape kit may help determine the truth in case it is a made-up effort to escape prosecution for DUI and clearly is the only way to go in the event it is true! Refusing to allow the rape kit to be taken is tantamount to the officer destroying evidence. Prosecutors need to be trained similar to the police regarding the drugs used and how they are employed and how to investigate these cases. They need more training on forensic evidence and how to best use expert witnesses, which are typically needed for these cases. Unfortunately, many lack the confidence to move forward on a challenging case, and let the suspect off the hook with pleading to a simple drug charge or a battery, without sexual assault consequences (being a registered sex offenders). Drug rapists are most commonly serial rapists……..They will commit this crime again. Judges need to be trained more intensely about these crimes as well and truly need to be educated about the drug GHB. Too many just don’t take the drug as seriously as they should and lack adequate training re forensic issues. For example, all too often when someone is convicted of a GHB DUI and put into ‘drug testing,’ the judge fails to specify that the testing MUST include the specific drug GHB. No drug panel (typical slate of drugs included in the standard testing procedures) includes GHB. Thus the GHB abuser won’t test dirty. And, in fact, many being tested for alcohol and other drugs will party on GHB, knowing it won’t come up in the test panel. Lack of adequate training has not only resulted in insult and lack of justice for victims, it is also a liability issue. One police department, in my opinion, totally blew the investigation of a case in which the rape victim ended up being arrested for DUI (no argument with the initial arrest, but with the resulting investigation or lack of adequate investigation). When she attempted to report the rape, despite rather significant evidence and a bartender who provided crucial information about the events leading up to her leaving the location, the police department failed to understand the crime. In fact, they interviewed the suspect, declared him a “nice guy” whom they believed and reported to the victim and her husband in a conference call that she was a liar and had had consensual sex with this man. That particular case brought to mind the possibility of a domestic violence beating or death for a victim in the event of an unstable marriage. Well, now it has happened but not quite as I feared. In a similar case in another state, officers concluded the victim was a liar and had had consensual sex with the alleged suspect (they typically claim consent as a defense, knowing it will be treated as “just a he said-she said” situation). The husband was told this (that it was consensual sex) by a police officer, and he committed suicide shortly thereafter. Everything said relating to sexual assault involving GHB also applies to GHB deaths cases. Lack of training about GHB has resulted in many cases going under-investigated and under-prosecuted. GHB has actually been used as a deliberate weapon of murder, plus its roll in manslaughter cases against those who supply it to those who die. Project GHB has taken on the huge challenge of coordinating a national conference on all aspects of GHB on May 9-11, 2003, in Orlando, Florida. Many police agencies especially are right now being short-changed on budgets and have faced loss of personnel due to military call-ups. Many have issued a “NO training” decree for this year. But we hope that they will recognize that this may well be the single most important training their narcotics, sexual assault and even homicide detectives can attend. Please help us spread the word about the conference to all law enforcement, prosecutorial and judicial agencies in your area. The conference is also designed (three tracks of training) for medical personnel (rape doctors/nurses/counselors, ER doctors, addiction treatment staff and coroners) and school/community resources (for prevention and intervention regarding GHB and other drugs of abuse). We can make a difference. [top] -------------------------------------------------- CLICK HERE FOR Research Studies INFORMATION ------------------------------------------------ [top]
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