Blood, brain, and hair GHB concentrations following fatal ingestion

Despite the increasing incidence of illicit use of gamma-hydroxybutyrate (G HB), little information is available documenting levels of the drug in GHB fatalities. We measured GHB levels in postmortem blood, brain and hair spec imens from a suspected overdose case by gas chromatography/mass spectrometr y (GC/MS) following solid phase extraction (SPE) and derivatization with bi s(trimethyl-silyl) trifluoroacetamide (BSTFA). Examination found 330 mug/mL GHB in femoral blood and 221 ng/mg GHB in frontal cortex brain tissue, val ues higher than those typically reported in the literature. The hair shaft was negative for GHB whereas the plucked root bulbs with outer root sheath attached (2221 ng/mg) and root bulbs after washing and removal of the outer root sheath (47 ng/mg) contained the drug. Our results are consistent with an acute single dose of GHB and, as the toxicology screen was negative for other drugs of abuse, emphasize the significant danger of this drug.