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wedrifid comments on A rationalist's guide to psychoactive drugs - Less Wrong Discussion

59 Post author: Skatche 10 February 2011 01:01AM

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Comment author: wedrifid 08 September 2013 08:46:10AM *  1 point [-]

GHB is in all ways a better version of alcohol. Therapeutic index, long term toxicity, clear headedness, shorter duration of action, no hangover, higher sleep quality, possibly even less addictive, and causes numerically fewer date rapes (:P). It's a shame that this hasn't replaced alcohol.

What? This is wrong. GHB has a excessively steep dose-response curve and a terrible theraputic index. Enough so that GHB was the example the lecturer used in my pharmacology class when explaining what the theraputic index is and the risks of a bad one. It's about 2, which means that double the dose that gets you high can kill you. He went on to give details about the later stages of the synthesis of the end product (typically done a step or two closer to the final dealer) and how varying practices can lead to a variability in the delivered dose greater in magnitude than the theraputic index. This is bad.

My past self seems to have voted up the parent. I can only hope that is because he didn't read through fully. While most of the claims are true, the one that is wrong is a belief that gets people killed.

Comment author: jimmy 08 September 2013 05:48:29PM *  0 points [-]

You have a cite for the LD50? Erowid gives 2000mg/kg for male rats and 1650mg/kg for female rats, and a strong dose of up to four grams for a human. I haven't seen any LD50 data for humans, but have read about people taking well over the normal dose, passing out, and waking up fine. It does seem to imply a therapeutic index well over two, and the comparison was made to alcohol which has a quite low one itself. Lethal BAC is around 0.4 and up to 0.2 is pretty common.

Mixing GHB with alcohol is a big no-no though, and does get people killed.

Comment author: wedrifid 09 September 2013 06:46:46AM 0 points [-]

You have a cite for the LD50?

Pardon me. Cntrl-C failure. The link in the grandparent was supposed to be to the source but I evidently copied the wrong tab. In any case the measure was likely based on rats---there doesn't seem to be good data for humans. It also seems that the more 'official' (in social authority not academic authority) a source is the worse the drug is made to appear.

Further investigation brought up a few things worth mentioning:

  • The cause of death from GHB overdose is respiratory failure from CNS depression. If respiratory support is supplied the lethal dose (from whatever critical thing fails next) is several times higher. This suggests increased expected valueof having a sober friend who knows Expired Air Resuscitation and the emergency services number relative to other drugs of abuse.
  • Many of the deaths that are attributed to "GHB overdose" can (allegedly) actually be better attributed to a different cause of death (including the GHB and alcohol cocktail mentioned).
  • More 'official' sources suggest a lower LD50 than less official sources. In this case 'official' refers to social authority and not academic authority and there is good cause to doubt the credibility of sources for which writing a high LD50 could get the author fired by some moralizer with power.
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