GHB may be OK’d to treat narcolepsy

Friday, Dec. 26, 2003 | 11:38 a.m.

A version of the date-rape drug GHB may soon be approved in Nevada for treatment of the sleep disorder narcolepsy.

The state Board of Pharmacy will conduct a public hearing Jan. 14 in Las Vegas regarding a proposal to allow physicians to prescribe Xyrem, a form of gamma-hydroxybutyrate (GHB), for treatment of narcolepsy, the condition characterized by a frequent and uncontrollable need for short periods of deep sleep.

GHB is currently on the prohibited drug list along with drugs such as cocaine and heroin. But narcoleptics and their advocates have asked the board to allow physicians to use the drug to treat their problems, Louis Ling, a lawyer who works for the pharmacy board, said Tuesday.

The federal Food and Drug Administration recently approved Xyrem, whose active ingredient is GHB, for use in narcolepsy.

Ling said the GHB would have to be manufactured by a licensed drug company and would come in a pill form. Its dosage would be far smaller than that used by men in cases of date rape.

"We want to allow the pill to be prescribed," said Ling. "There is no way it will diverted into the illicit market."

However, the central pharmacy that handles all prescriptions for Xyrem, manufactured by Orphan Medical, says the drug comes only liquid and only through the federally regulated Patient Success Program.

Ling said he is aware of only two or three people in the state that suffer from narcolepsy. The drug will not be mass produced and it will be very expensive. It will only available by prescription from a doctor.

"Even if they (men) get a hold of it, it will not do them very much good," because the strength is so low that it would take several doses to equal the homemade batch of the date rape drug, Ling said.

In its street form, GHB is a nearly tasteless liquid manufactured in clandestine labs. Someone who ingests a significant amount of the liquid can become incapacitated.

Raymond Flores, 25, a former Marine, entered an Alford plea last month to charges he used GHB in drugging and raping a Las Vegas woman. An Alford plea does not include a admission of guilt but it is considered a guilty plea.

Flores is to be sentenced Feb. 25 for attempted sexual assault, coercion and perjury. He was accused of putting a drug in a woman's drink at The Beach nightclub and then raping her in August 1999. The woman said she remembered drinking a shot of tequila that Flores gave her and then woke up the next day in his motel room.

Ling said a woman who is given GHB goes into a convulsive state and then wakes up with no memory of events that occurred during that time. The drug disappears from the system in three to four hours so doctors may not detect it. He suggested women be careful when in bars to make sure they open their own beverages or watch when the drinks are being mixed. And they should be careful if they leave the table. Somebody could put GHB into an unattended drink.

During its meeting next month, the Pharmacy Board will also consider a proposed regulation to make it easier for pharmacists to administer the intranasal flu vaccine.

Ling said pharmacists already have the authority to do this but the regulation will relax some of the restrictions.

Another proposed regulation would require pharmacists to check identification cards before dispensing a controlled drug. But this regulation would not apply if the prescription drug was being paid for by an insurance plan; if the prescription for the same controlled substance was previously filled; or if the pharmacy is part of a health care facility where the patient is being treated.