Adverse Events, Including Death, Associated with the Use of 1,4-Butanediol

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Abstract
1,4-Butanediol is an industrial solvent that, when ingested, is converted to γ-hydroxybutyrate, a drug of abuse with depressant effects, primarily on the central nervous system. After reports of toxic effects of γ-hydroxybutyrate and its resultant regulation by the federal government, 1,4-butanediol and γ-butyrolactone, another precursor of γ-hydroxybutyrate and an industrial solvent, began to be marketed as dietary supplements. We investigated reports of toxic effects due to the ingestion of 1,4-butanediol and reviewed the related health risks.