Detection of γ-hydroxybutyric acid-related acids in blood plasma and urine: Extending the detection window of an exogenous γ-hydroxybutyric acid intake?

Abstract

In crimes facilitated by γ-hydroxybutyric acid (GHB) administration, the frequent occurrence of anterograde amnesia of the victims as well as the short detection window and variations of endogenous GHB concentrations complicate obtaining analytical proof of GHB administration. Because elevated endogenous organic acid concentrations have been found in the urine of patients with succinic semialdehyde deficiency (leading to accumulation of GHB in human specimens) and after GHB ingestion, we searched for an alternative way to prove GHB administration via detection of elevated organic acid concentrations in blood plasma and urine. We collected blood and urine samples from narcolepsy patients (n = 5) treated with pharmaceuticals containing GHB sodium salt (1.86-3.72 g GHB as free acid per dose). Although GHB was detectable only up to 4 h in concentrations greater than the commonly used cutoff levels in blood plasma, 3,4-dihydroxybutyric acid (3,4-DHB) could be detected up to 12 h in blood plasma in concentrations exceeding initial concentrations of the same patient before GHB ingestion. Furthermore, four of the five patients showed an increase above endogenous levels described in the scientific literature. In urine, GHB concentrations above commonly used cutoff levels could be observed 4.5-9.5 h after GHB intake. Creatinine standardized initial concentrations were reached again for glycolic acid (GA), 3,4-DHB, and 2,4-dihydroxybutyric (2,4-DHB) acid at 6.5-22, 11.5-22, and 8.5-70 h after GHB intake, respectively. Therefore, 2,4-DHB, 3,4-DHB, and GA are promising and should be further investigated as potential biomarkers to prolong the detection window of GHB intake.

• Authors: Theresa Küting, Bianca Schneider, Anna Heidbreder, Michael Krämer, Pouria Jarsiah, Burkhard Madea, Cornelius Hess
• Journal: Drug testing and analysis (Drug Test Anal) Vol. 13 Issue 9 Pg. 1635-1649 (Sep 2021) ISSN: 1942-7611 [Electronic] England
• PMID: 33991073 (Publication Type: Journal Article, Validation Study)
• Copyright: © 2021 The Authors. Drug Testing and Analysis published by John Wiley & Sons Ltd.

Chemical References

• Hydroxybutyrates
• 4-hydroxybutyric acid

Topics

• Adolescent
• Adult
• Aged
• Female
• Gas Chromatography-Mass Spectrometry (methods)
• Humans
• Hydroxybutyrates (analysis, blood, urine)
• Male
• Middle Aged
• Narcolepsy (drug therapy)
• Substance Abuse Detection (methods)