Ministry repeats Warning on GHB and 1,4 butanediol

30 April 2001

Ministry repeats Warning on GHB and 1,4 butanediol

THE Ministry of Health is repeating its warning to the public not to consume any products containing 1,4 butanediol (One4b) or gamma hydroxy butyrate (GHB, GBH or Fantasy).

It is also warning against use of associated chemicals such as sodium oxybate and gamma butyrolactone (GBL).

There is a potential risk of severe adverse reactions, including death from the use of these chemicals.

The Ministry published a warning in January, following reports of three people becoming unconscious as a result of taking a product that contained 1,4 butanediol. A year earlier, the Ministry classified sodium oxybate, commonly known as Fantasy, as a prescription medicine.

National Drug Policy Team Leader, Matthew Allen said the Ministry has seized a substantial amount of One4b (a product containing 1,4 butanediol) in both Auckland and Timaru, and an investigation is currently underway following concerns of possible breaches of the Food Act 1981 and Medicines Act 1981.

"The investigation is intensive and has involved interviewing people who had taken products containing 1,4 butanediol, reviewing information from suppliers, distributors, and websites as well as seeking legal and technical advice and international expertise. Analysis of the product One4b and of blood samples has also been necessary.

"Work is progressing, but has been delayed due to the reluctance of some people who have taken products containing the substance to allow the Ministry access to medical blood samples taken at the time. This information is a crucial factor in the investigation."

Mr Allen said the investigation is now nearly complete and a recommendation on whether prosecution action is appropriate is expected to be made to the Director General of Health by the end of next week.

Meanwhile, the membership of a new Expert Advisory Committee on Drugs was announced on 18 April. This committee, charged with providing advice to the Minister of Health on drug classifications, will meet for the first time on 29 May.

1,4 butanediol, GHB, GBL and similar substances will be some of the first substances considered by this new committee that has been set up to streamline the process of legislating for substances that may be subject to abuse. Officials are currently developing comprehensive advice for that committee on the substances to be reviewed.

"In addition, the Ministry is looking at enhancing its health education resources to help get information out on the harms posed by the various synthetic drugs - including GHB and 1,4 butanediol."

"We already have the Dance Party Guidelines which were released in 1999 and provided help to organisers and promoters of dance parties to help them meet their health and safety responsibilities." We also issued a health education resource in association with those guidelines for people attending events."

"International evidence shows that providing health education resources does help minimise the harm caused by drugs. We recognise that the availability and use of substances at dance parties does change rapidly, and we will be updating our education resources to meet this need."

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For more information contact: Selina Gentry Media Advisor 04 496 2483 025 277 5411 Internet address: www.moh.govt.nz/media.html

Further Information about the FDA warnings go to: http://www.fda.gov/bbs/topics/ANSWERS/ANS00953.html

Background Information:

The substances

1,4 butanediol (One4b), GBL, GHB and sodium oxybate all have similar effects when consumed, with 1,4B, GBL and sodium oxybate breaking down to GHB in the body.

Ingesting these substances is potentially dangerous as they can produce unconsciousness and respiratory depression which can be fatal.

The risk of severe respiratory depression and collapse are accentuated when the substances are taken in combination with alcohol or any central nervous system depressant drugs.

People have reported the following effects after taking the substances: euphoria, drowsiness, nausea, increased confidence and dizziness. With increased doses the initial euphoria is replaced by powerful sedative effects, which can include: confusion, agitation, hallucinations, seizures, vomiting/nausea, stiffening of muscles, disorientation, convulsions, unconsciousness/coma; and respiratory collapse.

Effects are noticeable between 10 minutes and one hour after taking the drug and can last for a day or longer.

There appears to be a fine line between the amount that is required to achieve the desired affect and that which leads to coma. Because there is often no way of knowing the strength of these substances, there is the added danger of overdosing.

Misuse of Drugs Legislation

In mid November 2000 the Misuse of Drugs Amendment Act was passed.

This new law enables New Zealand to respond far more quickly to emerging drug threats than was previously the case. Previously, scheduling of substances under the Act could only be done by way of introducing draft legislation to Parliament. The passage of amendments to legislation can take some time.

In future, scheduling of substances will be able to be undertaken by the Governor-General issuing Orders-in-Council on the advice of the Minister of Health.

Expert Advisory Committee on Drugs

The Act establishes a simple and expeditious process to classify drugs. A vital part of this process will be the Expert Advisory Committee on Drugs (EACD), which has recently been established to advise the Minister of Health. The EACD will:

carry out medical and scientific reviews of controlled drugs and other narcotic or psychotropic substances

make recommendations to the Minister about whether and how such substances should be classified, and the level at which the presumption for supply

should be set for any substances;

increase public awareness of its work by (for instance) releasing papers, reports and recommendations

Membership of the Expert Advisory Committee on Drugs

Dr Bob Boyd Ministry of Health Chief Advisor,

Public Health Directorate (chair)

Dr Stewart Jessamine Medsafe Senior Medical Advisor Det Insp Harry Quinn NZ Police Mr Andrew Coleman NZ Customs Dr Keith Bedford expertise in toxicology Assoc Prof Tim Maling expertise in pharmacologogy Dr Helen Moriarty expertise in community medicine Dr Geoffrey Robinson expertise in drug and alcohol treatment Dr Douglas Sellman expertise in psychology Mr Keremete Warbrick consumer representative

Criteria for Classification Decisions

The Act now requires classification of illicit drugs to be based on the risk of harm to individuals or society. Drugs posing a:

very high risk of harm should be scheduled as 'Class A'.

high risk of harm should be scheduled as 'Class B.

moderate risk of harm should be scheduled as 'Class C'.

When considering a particular drug, the EACD will be required to consider the following matters:

the likelihood or evidence of drug abuse

the specific effects of the drug

the risks to public health

the therapeutic value

the potential to case death

the ability to create physical or psychological dependence

the international classification and experience

any other relevant matters.

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Selina Gentry Media Liaison Communications Corporate & Information Directorate Ministry of Health DDI: 04 496 2483

mailto:selina_gentry@moh.govt.nz

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