A second danger of GHB involves addiction. Contrary to what some proponents have said (Dean et al), GHB can cause physical dependence, albeit in extreme circumstances, and to a lesser degree than alcohol, caffeine, nicotine, methadone and many other substances. Much like other sedatives, chronic and heavy use can lead to a set of withdrawal symptoms: anxiety, tremor, hallucinations, delirium, hypertension, etc. Still, even in these cases, the symptoms disappear in a matter of days or weeks. (Cameron; Dyer et al).

But by far the most dangerous misuse of GHB involves its drug interactions, with the vast majority of GHB-related fatalities involving alcohol or other drugs. According to the Congressional testimony of Stephen Zukin, M.D., for the GHB "Date-Rape Drug" prohibition law, "The DAWN Medical Examiners have reported one GHB-related death in combination with alcohol between 1992-1995, occurring in 1995 in the Midwest. However, the Drug Enforcement Agency (DEA) has documented 32 deaths associated with GHB (4 - attributed to GHB alone)" (Statement). Another study noted that the majority of GHB-related emergency room visits involve alcohol and other drugs (Cameron). Nevertheless, according to Elizabeth Todd, PhD, chief of Drug and Environmental Toxicology of Dallas County Institute of Forensic Sciences, overdose cases often take care of themselves, even when alcohol is involved: "One to 6 teaspoons of GHB taken with alcohol will result-within 15 to 30 minutes-in a pronounced coma and substantial respiratory depression possibly necessitating intubation . . . But within 1 to 2 hours, spontaneous recovery often occurs. People have been in deep coma in the emergency room and in the process of intubation will just sit up, spontaneously 'come right back to life,' and wonder why they're there" (quote in Kaarlela).

In contrast to the approach that the government has actually taken, Dr. Todd suggests that the best method to deal with GHB misuse is education: "When it was sold in health food stores, the package included a warning that it should not be taken with alcohol and cautions about the dosing interval. To increase exposure, the advice was to take doses more frequently rather than increasing the individual dose . . . Since GHB has a very short half-life, from 20 minutes to 1 hour, this may have minimized some of the negative impact that we are now seeing" (quote in Kaarlela).

Because GHB occurs naturally in food, as well as in the human body, the FDA initially classified it as a food supplement, leaving researchers free to pursue medical applications of the molecule and consumers free to purchase it at health food stores. The turning point came in 1990, when the FDA became wary of consumers taking it in order to become intoxicated, not just for sleep and body-building (the most commonly marketed uses of GHB at the time). On the basis of several dozen unconfirmed reports of side effects (which included coma and nausea, but not fatality), the FDA released a press report stating that GHB was a threat to public safety with potential for abuse. The media, taking the FDA's word on it, disseminated reports of GHB's danger, thus beginning a decade-long trend of anti-GHB press (Dean et al, pp. 19-23).

The fact that the FDA reacted to GHB in this manner is somewhat confusing. GHB was, at this time, distributed nationwide for over-the-counter sale; even so, there were merely "more than 30" alleged incidents of illness related to GHB. "The FDA provided no scientific evidence that GHB was dangerous, nor did it establish the legal basis for GHB's 'illegality.' They also failed to mention anything about GHB's 30 - 40 year record of safety." (Dean et al, p. 20). The claim that it had a high potential for abuse apparently stemmed solely from its ability to inebriate - a quality that, of course, alcohol already possessed legally.

There certainly were some dangers associated with GHB like driving a vehicle while under the influence, overdosing or mixing drugs (as alluded to above). However, it seems highly doubtful that GHB comprised a threat to pubic safety that would have warranted its regulation; Europe, after all, has not had such difficulties despite its legal status there. Furthermore, there are far more than 30 poisonings related to vitamins and legal drugs every year: "To put these figures in context, we should note that all drugs can cause adverse reactions, including perfectly legal medications properly prescribed by qualified medical personnel. The scale of such diverse reactions is amazingly high: according to a recent survey, perhaps a hundred thousand Americans die each year from the effects of legal synthetic drugs administered in hospitals, and over two million more suffer non-lethal adverse reactions. Moreover, this survey only tracked adverse reactions in hospital settings and did not include lethal effects that might have occurred at home. The unintentional consequences of legally supplied synthetics amount to perhaps the fourth leading cause of death for Americans" (Jenkins, p. 153).

Notwithstanding the glaring gaps in its argument, the FDA proceeded to reclassify GHB as a drug.

Shortly thereafter, the media reported on a series of deaths that were allegedly related to GHB. The first such major story concerned the death of young actor River Phoenix: "The media suspected a drug connection with the death, and during the first week of coverage, the culprit was identified as GHB. . . The drug's rumored association with Phoenix's death survived for years afterwards, although subsequent autopsies showed that GHB had not contributed to the event. The young star had in fact been consuming dangerous quantities of heroin, morphine, and cocaine in hazardous combination with alcohol" (Jenkins, p. 170). Though there was no relationship between GHB and the death, this story served, nonetheless, to put GHB on the national stage in a deadly context.