Correspondence

γ-Hydroxybutyric Acid in Hair

N Engl J Med 2006; 354:96-97January 5, 2006

Article

To the Editor:

The review (June 30 issue)1 on γ-hydroxybutyric acid (GHB) generated correspondence (Oct. 13 issue),2 which revealed that biochemical genetics laboratories can detect GHB.2 There is an additional detection method worth noting.

When a medicolegal issue is present (e.g., a drug-facilitated crime), finding a hard-to-detect drug can be important.3 GHB has amnesic properties3 and is fully and rapidly metabolized to carbon dioxide and water. Even succinic acid, a product of GHB metabolism, becomes undetectable in urine within hours of ingestion.

However, the GHB in the body of a crime victim is still present, even after it has been totally removed from the circulation: GHB, like other substances, accumulates in hair, after a single exposure.4 If the hair shaft is negative for GHB, the drug may still be detected in the root bulb, at hair concentrations measured in nanograms per milligram.5

Georges Mion, M.D.
Jean-Pierre Tourtier, M.D.
Yves Diraison, M.D.
Val de Grâce Military Hospital, 75230 Paris, France
georges.mion@club-internet.fr

5 References

1. 1

   Snead OC III, Gibson KM. γ-Hydroxybutyric acid. N Engl J Med 2005;352:2721-2732
   Full Text | Web of Science | Medline

2. 2

   Sass JO, Superti-Furga A. γ-Hydroxybutyric acid. N Engl J Med 2005;353:1632-1633
   Full Text | Web of Science | Medline

3. 3

   McGinn CG. Close calls with club drugs. N Engl J Med 2005;352:2671-2672
   Full Text | Web of Science | Medline

4. 4

   Kintz P, Villain M, Ludes B. Testing for the undetectable in drug-facilitated sexual assault using hair analyzed by tandem mass spectrometry as evidence. Ther Drug Monit 2004;26:211-214
   CrossRef | Web of Science | Medline

5. 5

   Kalasinsky KS, Dixon MM, Schmunk GA, Kish SJ. Blood, brain, and hair GHB concentrations following fatal ingestion. J Forensic Sci 2001;46:728-730
   Web of Science | Medline