What is 1,4-butanediol and its mechanism of action as a substance of abuse?
1,4-butanediol (BD) is an industrial chemical that individuals use as a source of gamma-hydroxybutyrate (GHB). After oral ingestion, BD is rapidly converted into GHB by alcohol dehydrogenase and aldehyde dehydrogenase. As a precursor and metabolite of GABA, GHB binds to its own receptor and GABA-B receptors that results in euphoric and sedative effects. Typical onset of action is within 5-20 minutes, and the effects last 2-3 hours. Due to its rapid on and off pharmacokinetics and rapid tolerance development, typical ingestion interval in GHB-dependent individuals is every 1-3 hours. Withdrawal symptoms can start only a few hours after ingestion, and reported relapse rates are as high as 60% within 3 months of detoxification.
Schep LJ, Knudsen K, Slaughter RJ, Vale JA, Mégarbane B. The clinical toxicology of γ-hydroxybutyrate, γ-butyrolactone and 1,4-butanediol. Clin Toxicol (Phila). 2012;50(6):458-470. doi:10.3109/15563650.2012.702218