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More from Better Sex Through ChemistryA Guide to the New Prosexual Drugs and
Nutrients
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| "A last point should still be mentioned: the [GHB] action on man which could be called 'aphrodisiac.' We cannot present any animal experiments on this subject. However, the oral form has now been sufficiently used so that, as generally agreed, no doubt can subsist as to its existence." |
After this provocative statement, Laborit offers no elaboration aside from brief speculation as to the nature of the underlying biological mechanism of GHB's sexual effects (a subject taken up at the end of this section).
Four central prosexual properties clearly emerge from an overview of the anecdotal data gathered from interviews and other sources. These are disinhibition, heightening of the sense of touch, enhancement of male erectile capacity, and increased power of orgasm.
Perhaps the foremost prosexual property of GHB is disinhibition. Some users suggest that GHB's other sexual benefits are secondary effects made possible by this loosening and relaxation of psychosomatic constraint. A number of people have commented that disinhibition from GHB is particularly marked among women. A man who has used GHB with a variety of female partners describes this compound as "a profound disinhibitor for women." His observation is echoed by a female researcher who has collected a great deal of technical as well as anecdotal and experiential data on GHB: "A lot of women say it helps their libido because of the disinhibition."
A woman in her early thirties had been using GHB as an aid to sleep. When she heard about its disinhibiting effects on sexuality, she thought that it might help her and her new partner overcome the "tentative and nervous quality that comes from being with somebody new." She reports:
"Inhibitions were definitely gone. It made me more aggressive, and definitely helped us break through some barriers. After the GHB started to kick in, it was just really easy to go for it."
One male who has experimented extensively with GHB in group sex contexts describes the results as "wonderfully loose."
As a male user put it, "the sense of touch becomes electric or sparkling" with GHB. One woman-who described a scene in which her and her partner spent a long stretch of time exploring the pleasures of touching a sheepskin rug-attributes GHB with "enhanced sensuality and intense eroticism. You can get lost in what something feels like-not only how things feel to the touch, but how your whole body feels when it's being touched."
Many men report that GHB helps them to achieve erection more quickly, and makes their erections firmer, more stable, and longer-lasting. As one man put it, "GHB really helps to sustain erection. Something that would normally distract you just doesn't."
In her book Love Potions, Cynthia Mervis Watson, MD relates an anecdote involving a man in his seventies who "took GHB and noticed a return of his morning erections, which had disappeared for many years following cardiac surgery" [Watson, 1993]. A male scholar in his fifties, who sometimes has spontaneous erections on GHB even in the absence of sexual stimulation, compares and contrasts the effects of this drug with those of MDMA (or "Ecstasy"): "With GHB, I get both warm and cuddly, like you do with Ecstasy, and hard and crusty, like you don't."
Women often report that GHB makes their orgasms longer and more intense-as well as more difficult or time-consuming to achieve, especially at higher doses. One forty-one year old songwriter and single mother who has sometimes "had a hard time coming on GHB" tells of one occasion when she "took a very small quantity-an eighth of a teaspoon. Although I didn't get 'high' and couldn't really feel anything from the drug, I had this incredibly long orgasm that was quite unusual."
As with its other effects, GHB's impact on female orgasm seems highly sensitive to small adjustments in dosage. A biochemist who has collected data on GHB says, "higher doses can postpone orgasm. I've heard complaints from women that if the amount isn't just right, or if they've had too much, they have trouble with orgasm. The effect is very dose-dependent."
GHB's effects on male ejaculation also seem to bear a close relationship to dosage. One man reports, "It can become very hard to come if you take a tiny bit too much." When GHB was still sold over-the-counter, one company advertised its GHB product with the claim that it "markedly delays ejaculation." Apparently, at slightly higher dosage levels, this delay can be experienced as interference.
This occasional interference with orgasm, however, does not seem to interfere to any great extent with users' enjoyment of sex under the influence of GHB. Most feel that a GHB-charged orgasm is well worth the extra wait and work that it may entail. The young woman whose experiments with GHB and sexual disinhibition were described above said, "I did find it harder to come, it took a little longer. But it seems to really enhance orgasm... everything's just going on up in your head...it's hard to explain!"
It has been mentioned elsewhere that the disinhibition associated with GHB can lead to an increase in undefended verbal disclosure. Couples and sex partners using GHB may find it easier to discuss tender, sensitive, and previously guarded emotional issues-an effect that has been compared to that of MDMA. This enhancement of verbal communication can lead to stronger feelings of emotional intensity, intimacy, and bondedness or "heart-connection" during sex.
It is also worth noting that GHB has sometimes been attributed with the capacity to increase clitoral and vaginal sensitivity.
What biochemical mechanism might underlie GHB's aphrodisiac effects?
The disinhibition which seems to occur as part of GHB's "hypnotic" effect is probably one of the most important factors leading to GHB's aphrodisiac action. But endocrine and other factors may be significant as well.
Drugs that increase dopamine levels often have sex-enhancing effects. However, as mentioned earlier, greater dopamine activity is not associated with GHB's augmentation of cerebral dopamine concentrations. It is therefore unlikely that this compound's effects on dopamine can be held directly responsible for its prosexual action.
However, it has been speculated that GHB's dopamine-related effects might lead to a decrease in serotonin levels. The latter neurotransmitter is often attributed with anti-sexual properties, partly due to observations that serotonin-depleting compounds such as pCPA facilitate sexual activity in animals. Such possible anti-serotonin action might account for some of GHB's prosexual properties [Laborit, 1972].
In contrast to conjectured effects on the serotonin system, GHB's potent stimulation of growth hormone release is well-documented [Takahara, 1977; Fowkes, 1993]. Strong anecdotal evidence points towards aphrodisiac effects on the part of growth hormone and growth hormone releasers. Thus GHB's growth hormone-related effects provide an additional possible explanation for its prosexual qualities.
As mentioned earlier, levels of the neurotransmitter acetylcholine rise in response to GHB. This effect may well serve as one of the mechanisms underlying GHB's ability to promote firm and long-lasting erections, as acetylcholine is thought to play a significant role in erectile physiology [PDR, 1994].
GHB is also a vasodilator, an agent which expands blood vessels and therefore increases blood supply to those areas of the body in which vasodilation occurs. As mentioned earlier, strong vasodilatory action of GHB has been observed in the regions of the liver and kidney [Laborit, 1964]. If this effect extends to the nearby genital area, it could further account for GHB's prosexual properties, particularly with regard to male erection and female genital sensitivity.
At the same time that GHB prevents the release of dopamine from brain cells, it increases the rate at which this neurotransmitter is manufactured within brain cells [Cash, 1994; Cooper 1974]. Between this increased synthesis of dopamine during the period of GHB's activity, and the large release of stored dopamine suspected to occur as GHB wears off, it seems almost certain that dopamine activity is greater after a GHB session than it was before. Thus, in spite of the short-term dopamine-dampening property of this compound, GHB probably has the net effect of a dopamine-boosting agent. Such an increase in subsequent dopamine activity might be responsible for a more long-range prosexual effect in addition to the short-term sex-enhancement discussed in most of the anecdotes in this chapter.
It is indeed peculiar that a substance known to stimulate short-term surges of prolactin (a hormone implicated in decreased libido, impotence, and other sexual problems), and which probably actually decreases dopamine activity, should demonstrate such marked aphrodisiac qualities. It seems likely that the combination of disinhibition and growth hormone release-perhaps along with vasodilation and possible anti-serotonin action-simply overwhelms those actions of GHB that would tend to predict anti-sexual results. It's also entirely possible that the primary mechanism of GHB's prosexual effects has not yet been identified.
In any case, at least one aspect of GHB's aphrodisiac properties is not in doubt: for most people it works.
Note: As we are going to press with this book, the legal status and availability of GHB is in flux. The FDA says it is banned, yet one US pharmacy (legally, they say) is making it available by prescription. By the time you read this the situation may have changed. Our suggestion is that you send us the tearout card at the front of this book and request our Directory of Mail Order Pharmacies and Directory of Physicians. These listings are kept up to date and, if there are any legal sources for GHB, you will find them there.
At the time of this writing, GHB has been banned from over-the-counter sale in the US. However, it has not been legally scheduled like those controlled substances falling within the purview of the DEA. These conditions leave GHB in a legal twilight zone in the United States. While there is technically no illegality attached to the possession or sale of GHB-and it continues to be available to legitimate laboratories and scientists for research purposes-selling it specifically for human consumption, especially while making claims about its health benefits, can constitute a violation of FDA strictures. (Simple personal possession and use, on the other hand, should at least theoretically incur no legal risk.)
The status of GHB in the US is comparable to that of the amino acid tryptophan. Until a few years ago, tryptophan was widely available in health food stores, pharmacies, and even grocery stores. After its use was linked to incidents of an unusual blood disorder, over-the-counter sales of tryptophan were restricted and subsequently banned by the FDA. Although these cases were definitively traced to impurities present in only a few batches produced by a single company using an unconventional manufacturing process, the ban was never lifted. To this day, tryptophan is still unavailable-even by prescription-in the United States.
Despite the fact that GHB is not technically a controlled substance, those involved in the manufacture, distribution and sale of GHB should be forewarned. One chemist who attempted to comply with FDA guidelines while making and selling GHB has nonetheless been prosecuted and imprisoned. He cautions: "The FDA has been programmatically harassing people involved in the sale of GHB and busting them on any charge they can get away with."
The situation regarding GHB and the law is yet fluid. While possession is still legal at the time of this writing, the intense controversy surrounding GHB could easily fuel Federal scheduling in the near future. Meanwhile, individual states may independently pass their own statutes against GHB.
The peculiar legal status of GHB in the United States leaves those who wish to acquire it for personal consumption with little means to do so except by way of personal connection to the informal, semi-underground network. Presently, GHB seems to be widely available-and growing in popularity-via this "gray market." Since most of the GHB available through such channels is of the "bootleg" variety, manufactured by non-professional "kitchen" chemists, concerns about quality and purity become paramount. Caveat emptor (buyer beware!).
(Note: In various European and other nations, GHB is available by prescription. Doctors, pharmacists, or government agencies in locations where GHB has been granted a legal status different from that in U.S. should be able to provide specific information on GHB's legality and availability in their respective countries.)
A chemist who has examined various batches of bootleg GHB warns that "there is a lot of bad stuff out there." He has found everything from "dog hair to sodium hydroxide" in GHB products, and has noted that some "street" GHB is manufactured using recycled industrial ingredients, a process which can result in the presence of toxic heavy metals in the product. (The research for this book, however, has produced no clear cases of adverse effects attributable to impurities in "street" GHB), This chemist recommends purchasing GHB only in powdered-as opposed to liquid-form. "If someone is sophisticated enough to produce the granular product," he advises, "they probably know what they're doing."
Pure GHB powder can be recognized by a number of characteristics. It has a salty/licorice flavor, and is at first chalky in texture but becomes greasy when rubbed between the fingers. It is very "hygroscopic," meaning that it readily absorbs water. Thus, when a small quantity is left out in open air overnight, it will turn into a puddle (unless you live in a desert-dry area.) Pure GHB powder will completely dissolve in a sufficient quantity of water; any particles that do not dissolve represent some kind of impurity.
Keep in mind that the purity of "street" or gray market GHB is not an issue which played a role in prompting the FDA ban, but rather is a consequence of it. Such matters would be of considerably less concern if GHB were still available over-the-counter from manufacturers practicing quality control and using a brand name whose reputation they desired to uphold.
As of 1994, 100 gram bottles of GHB sold in the range of fifty to eighty dollars.
As has been emphasized, the overall safety of GHB is well-established, and no deaths attributable to GHB have been reported over the thirty year period that this compound has been in use [Vickers, 1969; Chin, 1992]. In fact, as of 1990, only forty-six adverse reactions had been reported in the United States-surely constituting only an infinitesimal fraction of actual usage-all followed by rapid and complete recovery [Chin, 1992]. Unlike a large proportion of other drugs-including alcohol and even Tylenol-GHB has no toxic effects on the liver, kidney, or other organs [Vickers, 1969; Chin, 1992].
A number of long-term human studies not yet discussed seem to leave the basic safety of this compound beyond doubt. One program of sleep therapy using six to eight grams daily for a period of eight to ten days produced no side effects. One researcher even reports that doses as high as twenty to thirty grams per twenty-four hour period have been used for several days without negative consequences [Vickers, 1969] (although such a level for self-experimentation is certainly not recommended). In the Canadian studies of narcolepsy mentioned earlier, the nightly use of two to six teaspoons (one teaspoon equalling roughly 2.5 grams) for several years resulted in neither in reports of long-term adverse effects nor problems with issues of addiction or dependence when use of the substance was discontinued. (See "Addictive potential" at the end of this section.) In one of these studies, a patient inadvertently ingested fifteen teaspoons without adverse consequence "other than deep sedation and headache the next day" [Chin, 1992]. And in France, sub-anesthetic oral doses were used by "a large number of patients for about six years" without untoward effect [Laborit, 1972].
The "LD 50" ("lethal dose 50%," or the dosage level fatal to half of those to whom it is administered) for GHB in rats has been calculated at 1.70 grams per kilogram of body weight [Laborit, 1964], which is in the range of five to fifteen times the anesthetic dose [Vickers, 1969]. Some have even questioned whether the animal deaths that occur at these dosage levels are due to the active drug itself or to sodium poisoning from the salt form in which it is administered [Vickers, 1969]. As one researcher has pointed out, if sodium toxicity is indeed the cause of rat fatality, it becomes safe to say that GHB is "less toxic than table salt." Rats injected daily for seventy days with one-tenth of the LD 50 have shown no significant differences from a control group [Laborit, 1964].
Extrapolating from the data on rats, the human LD 50 would be around 115 grams for a 150 lb person-a quantity about fifty times that usually required to induce sleep in most people. Although such extrapolations are frequently unreliable due to differences in absorption between rats and human beings, this information nonetheless points towards a remarkable safety profile for GHB.
GHB is classified as a sedative-hypnotic. Its effects will therefore bear some similarity to those of other hypnotics like tranquilizers and alcohol. GHB not only "may cause drowsiness" like these other drugs-it will almost inevitably do so. Ataxia, or discoordination, can also be a side effect of GHB. Therefore, the following warning is in order:
Do not drive or operate dangerous machinery while under the influence of GHB.
One researcher has characterized the action of GHB as "without serious side effects," and some research programs have reported no side effects at all. Nonetheless, it's clear that side effects can occur. Those most commonly experienced are drowsiness, dizziness, nausea, and sometimes vomiting. Headache is sometimes reported. As mentioned, clonic movements (muscle spasms or "seizures") have been observed during the onset of GHB-induced sleep. Some ataxia (or discoordination) is not uncommon. As discussed in the section on "The Action of GHB in the Body," a moderate slowing of the heart-rate is a common, and small changes in blood pressure can take place. At very high doses, cardiac and respiratory depression can occur. Orthostatic hypotension (a sudden drop in blood pressure upon standing up quickly, recognizable by a brief dizziness) has also been reported.
More unusual and extreme reactions have included diarrhea, lack of bladder control, temporary amnesia, and sleepwalking. More side effects can occur when GHB is combined with central nervous system depressants [Chin, 1992, Gallimberti, 1989; Takahara, 1977; Vickers, 1969].
Anecdotal evidence suggests that most "recreational" users of GHB do not usually experience unpleasant side effects. Furthermore, it should be emphasized that such effects can generally be avoided by careful and informed self-administration (see below).
Contraindications for GHB have been described as "remarkably few" [Vickers, 1969]. Those who suffer from any of the following conditions should not use GHB: severe illness of any kind; epilepsy; eclampsia (convulsions); bradycardia (slowed heart-beat) due to conduction problems (left-bundle-branch-block is an example of conduction difficulty); Cushing's syndrome; severe cardiovascular disease; and severe hypertension [Dean, 1993; Gallimberti, 1989; Vickers, 1969].
Severe alcoholism is sometimes mentioned as a contraindication for GHB [Dean, 1993], even though GHB has been used quite successfully in the treatment of withdrawal among alcoholics. The explanation for this seeming contradiction probably lies in the assumption that severe alcoholics are likely to ignore precautions against combining GHB with alcohol. Because GHB stimulates a short-term surge of prolactin, those suffering from hyperprolactinemia may have reason to avoid GHB. (Please see the chapter on bromocriptine.)
Most of the extreme cases of adverse reaction recounted in the section entitled "Setting the Record Straight" involved the use of central nervous system depressants in addition to GHB. The effects of GHB are strongly potentiated by such compounds (and vice versa). CNS depressants include benzodiazepines ("minor tranquilizers" such as Valium and Xanax), phenothiazines ("major tranquilizers" like Thorazine and Stellazine), various painkillers (opiates like codeine and barbiturates like phenobarbital), alcohol, and even many over-the-counter allergy and sleep remedies. Mixing GHB with such medications seems to increase the likelihood of adverse reactions [Chin, 1992; Laborit, 1964.] A simple, straightforward caution is in order:
Don't mix GHB with depressants.
As one experienced user of GHB warns, "it can make you fall asleep at inappropriate times and places." This is the most potentially problematic aspect of GHB use. The amount that will leave a given individual suddenly and totally unconscious within fifteen minutes or less is usually less than twice the amount required to give the same person a pleasant, manageable prosexual "high." This rather steep "dose-response curve" results in a narrow threshold that can be inadvertently crossed rather easily, particularly for the inexperienced user.
A number of anecdotes illustrate the potential consequences-from humorous to alarming-that mismanagement of GHB's "unconsciousness threshold" can create.
One man lay down on his bed while brushing his teeth after taking GHB-and awoke some hours later, the toothbrush still in his mouth. Another man tells of an incident during a GHB-enhanced group-sex episode: "We were all gathered around one woman who was lying on the rug, touching her, the entire group giving her all our attention. She kept saying, 'Oh, this feels so good, I can't believe how good it feels.' Another woman in the group fell asleep right on top of her. So we carefully lifted her up and put her in the bed." Complications can arise when a person who has accidentally fallen into the deepest stage of GHB sleep is encountered by others who become unduly alarmed because they don't know the reason why he or she can't be aroused. In one instance, a man who had taken a few swigs of liquid GHB couldn't make it to his bedroom, and crumpled to unconsciousness at the bottom of the stairs. When his housemates-who had no idea he'd taken GHB-discovered him in this condition, they were understandably concerned, called 911, and had him taken to the emergency room. Predictably enough, he awoke suddenly in fine condition shortly after arrival at the hospital, wondering what all the fuss was about.
In talking to users of GHB, the authors have encountered a number of tales of this kind. One experienced experimenter, a woman in her early thirties who uses GHB for enhancement of both sleep and sex, offers the following succinct statement of a constructive attitude towards this drug: "It's not a toy. It's not going to kill you, but it can knock you out for a while. You have to be safe and conscientious."
Although studies have strongly suggested that addictive properties are absent with GHB, a warning is nevertheless in order. If enough people use almost any substance, there will be those who develop an addictive, unhealthy, or otherwise counterproductive relationship with it. GHB is no exception.
We have heard several stories of people using GHB in a very regular-perhaps habitual-way. But, until very recently, all these people reported their habits to be quite benign: never did their GHB use visibly interfere in their lives and, when they ran out of GHB, they experienced no withdrawal symptoms.
Recently, however, we heard of one woman who clearly developed an abusive relationship with this compound. She used GHB on a continuous basis throughout the day, every day. She began to lie, when necessary, to get it. And she found herself unable to quit when she decided to do so. Over the next few years we will probably hear more such stories.
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