"1,4-Butanediol is added to a wide variety of dietary supplements to enhance sleep, libido, athletic performance, fat 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. This report describes 9 episodes of severe toxic effects from 1,4-butanediol in 8 patients, 2 of whom died.
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. The amount ingested ranged from 5 g to 20 g (88 mg/kg-300 mg/kg) in the patients who died and 1 g to 14 g in those who survived.
Although only 9 toxic episodes related to 1,4-butanediol are reported here, 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 good supportive care is instituted
(emphsis mine)."
*See? It's a precursor to GHB, as OP (
@311) stated.
https://www.jwatch.org/em200102280000009/2001/02/28/toxic-effects-1-4-butanediol
"From June 1999 through December 1999, cases of toxic effects of 1,4-butanediol involving patients who presented to emergency departments with a clinical syndrome suggesting toxic effects of gamma-hydroxybutyrate and a history of ingesting 1,4-butanediol and patients discovered through public health officials and family members /were identified/. Gas chromatography-mass spectrometry /was used/ to measure 1,4-butanediol or its metabolite, gamma-hydroxybutyrate, in urine, serum, or blood. Nine episodes of toxic effects in eight patients who had ingested 1,4-butanediol recreationally, to enhance bodybuilding, or to treat depression or insomnia /were identified/. One patient presented twice with toxic effects and had withdrawal symptoms after her second presentation. Clinical findings and adverse events included vomiting, urinary and fecal incontinence, agitation, combativeness, a labile level of consciousness, respiratory depression, and death. No additional intoxicants were identified in six patients, including the two who died. The doses of 1,4-butanediol ingested ranged from 5.4 to 20 g in the patients who died and ranged from 1 to 14 g in the nonfatal cases. The health risks of 1,4-butanediol are similar to those of its counterparts, gamma-hydroxybutyrate and gamma-butyrolactone. These include acute toxic effects, which may be fatal, and addiction and withdrawal."
https://toxnet.nlm.nih.gov/cgi-bin/sis/search/a?dbs+hsdb:@term+@DOCNO+1112
"1,4-Butanediol is also used as a
recreational drug known by some users as "One Comma Four", "Liquid Fantasy", "One Four Bee" or "One Four B-D-O". It exerts effects similar to
γ-hydroxybutyrate (GHB), which is a metabolic product of 1,4-butanediol.
[11][12] When mixed with other drugs, misuse of 1,4-butanediol has resulted in addiction and death.
While co-administration of
ethanol and GHB already poses serious risks,
co-administration of ethanol with 1,4-butanediol will interact considerably and has many other potential risks. This is because the same enzymes that are responsible for metabolizing alcohol also metabolize 1,4-butanediol so there is a strong chance of a dangerous drug interaction (emphasis mine). Emergency room patients who overdose on both
ethanoland 1,4-butanediol often present with symptoms of
alcohol intoxication initially and as the ethanol is metabolized the 1,4-butanediol is then able to better compete for the enzyme and a second period of intoxication ensues as the 1,4-butanediol is converted into GHB.
[14]
Like
GHB, 1,4-butanediol is only safe in small amounts. Adverse effects in higher doses include, nausea, vomiting, dizziness, sedation, vertigo, and potentially death if ingested in large amounts. Anxiolytic effects are diminished and side effects increased when used in combination with alcohol.
https://en.m.wikipedia.org/wiki/1,4-Butanediol
"At least two people have died from a chemical cousin of GHB and six others have overdosed in the decade since the government banned the sale of the "date-rape drug," a study found.
More such overdoses have almost certainly occurred but have gone unreported, in part because many coroners and emergency rooms do not test for GHB, said medical anthropologist Deborah L. Zvosec, a Ph.D. who led the study published in Thursday's New England Journal of Medicine."
http://www.mapinc.org/drugnews/v01/n061/a09.html?397
"I decided to start small;
T=0; 1.2ml mixed in a shot of Orange juice.
T+60min; The effects seem to be winding down ever so slightly, so now I feel comfortable going to bed. I am sooooo grateful that I did not take any more when I considered doing so at ten minutes. I feel that, had I taken any more at that time, unrousable sleep would've surely ensued. I had originally considered taking 3ml. Good thing I started with just 1.2ml."
https://erowid.org/experiences/exp.php?ID=9125
"This was the second time my wife and I tried 1,4-Butanediol. The first time we each did 5ml with very little effect. So we tried it again but this time we mixed it in our alcohol in our drinks.
1hour 45min went by and I mixed more 1,4-Butanediol in our drinks, then it started to really hit me but my wife was still sober. at this point I ended up putting a total of 40ml of the stuff between both of our drinks.
...[my wife] was cold, her face was blue, she had no signs of life except she was starting to go into uncontrolable convulsions from time to time. she did not respond to any external stimuli. someone ask me what did we take. I was so out of it I didn't even remember going to the party, let alone what we took.
... [hospital staff] confirmed that her coma would have been induced with the mixing of alcohol and 1,4-Butanediol. she finally came out of her coma after 6 hours, she did not remember anything. not the party or how we got there or any thing. it took another 5 hours till she was recovered enough that they released her. this stuff might be fun, but take it from my own stupidity DO NOT MIX WITH ALCOHOL!!!!"
https://erowid.org/experiences/exp.php?ID=16276
"... 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."
https://abcnews.go.com/Health/story?id=117703&page=1
"The lowest reported LD50 (Lethal Dose, 50%; i.e. the dose that is lethal for half of the animals tested) value is 1200 mg/kg bw (body weight) in guinea pigs.
In rats and mice, reported values are in the range of 1525-1830 mg/kg bw and 2060 mg/kg bw respectively."
https://www.nicnas.gov.au/chemical-information/factsheets/chemical-name/butanediol-1,4-butanediol
