Yes, I’m talking about the original ‘date rape’ drug. Well, technically, that would be alcohol. But Gamma-Hydroxybutyric acid (GHB) was strongly associated with the phenomenon in both the US and UK, assuming the lead role in a raft of stories about predatory bars and frat parties where young women or men were victimized.

That was mostly GHB made by outlaw chemists, however. This time around it’s as a prescription drug, newly approved by the FDA for use with patients who suffer from narcolepsy – an uncommon but sometimes extremely disabling form of sleep disorder. GHB has actually been used with narcoleptics for many years, but the new product, brand name XYWAV, is expected to reach thousands of new customers, and dramatically expand the market for the drug.

Reminds me of Oxycontin. That was another new product based on improvements to an old one. A ‘safer’ opioid, remember?

As a CNS (central nervous system) depressant, GHB is accompanied by the usual warnings to avoid use if also taking opioids, benzos, antipsychotics, antihistamines, antiepileptics, anesthetics, alcohol and street drugs, among others. Gives us some idea of the potential risks involved. There are quite a few.

There’ve already been a number of articles on GHB in the popular media. This recent one, from The New York  Times, I found particularly helpful.

F.D.A. Approves GHB, a ‘Date Rape’ Drug, for Rare Sleeping Disorder

It’s always tricky when a company releases a drug with such strong potential for abuse, especially while we’re in the grip of a drug abuse epidemic– one that actually began because of the overeager promotion of prescription medications. After all, GHB has from time to time been prominent as a drug of abuse, albeit under ten or twenty different street names. Shouldn’t be long before it shows up in its prescribed form, too, possibly in the original packaging. Users seem to prefer that. because they feel it means it’s ‘safer’.

The CEO of the Irish drugmaker behind XYWAV insists he’s “…really excited about bringing the benefit of this effective medication to more patients.”

Not least because of the big payoff involved. Right now, the company supplies 15,000-plus sleep disorder patients with their GHB products. If used nightly, it runs around $100K per patient per year. Last year’s revenue from GHB medications: $1.7 billion.

That could increase substantially as XYWAV is intensively marketed. “There’s an educational effort that we’ll be part of,” admits the CEO, “which is really making sure there’s a better understanding among treaters and among patients of the condition and its treatment.”

Boy, does that sound like what we heard from Purdue Pharma reps in the early days of the Oxycontin release. The benefits got all the attention, while the risks… well, those would make themselves known later on.

I’m afraid the youth of America are waiting. The thing that attracted them to GHB in the first place was its rapid onset. As the article notes, it’s so quick some sleep patients are advised to take it only after they’re in bed.

And you know kids: they don’t like to wait for anything.

Anyway, if there is another outbreak, maybe we’ll be better prepared, thanks to our painful recent experience with prescription opioids.

Your state agency will be tracking it, I hope. So when it does show up, you might get the news before the patients arrive in the waiting room.