Study: Solvent BD Addictive, Lethal
N E W Y O R K, Jan. 10, 2001 -- Sipping industrial solvents may not be everyone's idea of a good time, but apparently the practice is on the rise, as a calorie-and-hangover-free-alcohol substitute gains favor at parties around the country.
When ingested, 1,4 Butanediol — the solvent in question — converts in the central nervous system into its chemical cousin, y-hydroxybutyrate, more commonly known as the date-rape drug, GHB.
But while substances such as GHB and its other precursor GBL are considered illegal substances by the federal Drug Enforcement Administration, 1,4-butanediol is marketed not only as a solvent but also as a nutritional and body-building supplement, to enhance everything from sleep to sexual performance to muscle building and fat loss.
Available in products at gyms and health food and sports nutrition stores across the country, 1,4-butanediol, or BD, can also be concocted from recipes found online. The chemical is often listed on ingredient labels as tetramethylene glycol, butylene glycol or sucol-B, in products with brand names like Thunder Nectar, InnerG, Amino Flex, Rejuv+Nite, Liquid Gold, Thunder, Serenity, X-12 and N-Force.
Alarmed by the increase in emergency room visits related to BD, researchers in Minnesota, Texas and Florida set out to discover the solvent's health risks. Led by Dr. Deborah Zvosec of the Hennepin County Medical Center in Minneapolis, researchers studied nine cases of toxic effects from 1,4-butanediol in eight patients reporting to their emergency departments from June through December of 1999.
"1,4-Butanediol is toxic, addictive and potentially lethal," they concluded in a study published in the current issue of the New England Journal of Medicine. "Although the long-term effects are poorly understood, frequent use of 1,4-butanediol can result in physical and psychological addiction and potentially severe withdrawal syndromes."
Patients took the drug either recreationally to get a buzz similar to alcohol, to enhance bodybuilding or to treat depression or insomnia and ingested doses ranging from one to 20 grams. The symptoms of BD overdoses included vomiting, incontinence, combativeness, decreased consciousness, respiratory depression and death in two of the study patients.
A Deadly High
In fact, according to the Drug Enforcement Administration, there were 49 deaths associated with the use of BD from 1995 through October 1999. "Patients use [1,4-butanediol] to get high, but … the dose needed to get high is close to the toxic dose," explains Dr.Brent Morgan, a medical director at the Georgia Poison Control Center, who is not associated with the study. "Toxicity usually causes coma that can be associated with vomiting and aspiration." In other words, people pass out and choke and their own vomit.
Morgan says he has heard of several cases of adverse effects related to BD, but that it's a difficult substance to monitor because there are no lab tests for it, and many physicians are not aware of it.
While the number of fatalities is relatively low, compared to, say the estimated 4,000 people who die annually from cocaine overdoses, the concern is that BD use is flying below the radar.
Dr. Katherine Delaney, medical director of the Parkland Hospital emergency department in Dallas, Texas says she has seen a lot of BD use. "Currently we see most intoxications in young people who work out at gyms or are otherwise 'body conscious.' When you talk to them, they say they use it not because they expect muscles to develop but as a calorie-free alcohol substitute."
The problem with doing shots of BD, though, is that it's very difficult to determine the amount needed to get high. "Unlike alcohol, the 'high' that they experience is difficult to titrate [determine the concentration of the solution], so they end up unexpectedly passed out on the disco floor, or at the pool side, or worse, in the pool," Delaney says.
She says that BD-related emergencies at her hospital currently occur at a rate of approximately 20 per month, down from about 40 a month prior to a Food and Drug Administration warning about 1,4-butanediol issued in May of 1999. The agency now considers BD to be an unapproved new drug and says it has conducted seizures to prevent sales of the substance to consumers.
Nonetheless, "extensive marking continues on the Internet, and the use has increased," the researchers wrote in their study, one of the few formal efforts to examine this substance. "If you talk to 100 doctors, maybe 10 have heard about this," says study co-author Stephen W. Smith of the Hennepin County Medical Center.
BD is reportedly a tasteless substance and, like alcohol, is often mixed with juice and soda.
Reuters and ABCNEWS.com's Robin Eisner contributed to this report.