The Toxicity of 1,4-Butanediol

1,4-Butanediol is a depressant substance and a prodrug for GHB. It occurs as a thick, colorless liquid or solid depending on storage temperature (melting point of 16℃), and has a distinct bitter-sweet taste. It is used as a recreational intoxicant with effects similar to alcohol and GHB.

1,4-Butanediol is used industrially as a solvent and in the manufacture of some types of plastics, elastic fibers and polyurethanes. In organic chemistry, it is used for the synthesis of γ-butyrolactone.

Toxicity

1,4-Butanediol is added to a wide variety of dietary supplements to enhance sleep, libido, athletic performance, obesity metabolism, and relaxation. It is also used as an industrial solvent. After ingestion, it is rapidly metabolized to gamma-hydroxybutyrate, which itself is abused for euphoric and sexual side effects.

Clinical findings included vomiting, urinary and fecal incontinence, agitation, combativeness, labile level of consciousness, coma, and death. 1,4-Butanediol was undetectable in nonfatal cases, but gamma-hydroxybutyrate concentrations in the blood and urine far exceeded normal concentrations.

As overdoses from gamma-hydroxybutyrate-related compounds occur commonly, targeted analysis is needed to detect these compounds because routine toxicologic screens do not detect them. Furthermore, given its rapid metabolism, gamma-hydroxybutyrate may be nondetectable in the blood after a few hours but may remain detectable in the urine. Fortunately, most patients recover from overdoses rapidly and uneventfully, as long as proper supportive care is instituted. Extensive use of 1,4-butanediol as an industrial solvent, along with easy access, ensures continued supply, so we will be confronting these events for the foreseeable future.