GHB, one in the family of so-called "date rape" drugs that is blamed for the overdose death of a Santa Rosa teenager last summer, is considered rare by local drug educators and law enforcement investigators still trying to determine how the 14-year-old came to ingest the fatal dose.
Investigators determined this week that Takeimi Rao died from drinking Gamma-hydroxybutyrate while hosting a July 9 sleepover for three friends in her Santa Rosa home.
"We see a lot of youth throughout the county and we are not seeing very much of (GHB) at all," said Michael Spielman, executive director of the Drug Abuse Alternative Center in Sonoma County that serves about 1,000 adolescents annually.
Alcohol and marijuana abuse account for 85 percent of the teens seeking treatment at one of the private-non profit's 25 centers in Sonoma County. Prescription drugs and methamphetamine account for the vast majority of the remaining 15 percent, Spielman said.
"It's not something we see very much of," he said. "So where the kids got it is a mystery."
"GHB has not been identified locally as a priority problem," said Kathy Elder, health programs manager for the Sonoma County Department of Health Services Healthy Communities Section. "Not to say it hasn't been out there."
Marijuana, alcohol and methamphetamine by far outpace all other drugs among those ages 12-17 in Sonoma County and statewide who sought treatment in a publicly funded treatment center, according to the California Department of Alcohol and Drug Programs.
The 2011 Monitoring the Future survey conducted by the National Institute on Drug Abuse showed that less than one percent of eighth and 10th graders, and 1.4 percent of 12th graders had abused GHB at least once in the year prior to their being surveyed.
It remains unclear whether Rao took GHB intentionally or accidentally. Initially it was believed she might have suffered alcohol poisoning or possibly choked on her own vomit after all four girls became violently ill during the night. The surviving girls later admitted drinking vodka, though they have told police they were unaware of the presence of GHB that night.
Dr. Loren Fong, medical director of the emergency room at Petaluma Valley Hospital, said he can only recall treating only two cases of GHB reaction since 1993.
"It doesn't cause death per se within itself but it can be contributory," he said, adding that a person can pass out after ingesting the drug.
"You slow down your breathing and you don't oxygenate, you can certainly die or have brain injury," he said.
When combined with alcohol, the affects of GHB are compounded, said Dr. Eric Sterling, an emergency room doctor Sutter Medical Center.
"It's virtually indistinguishable - someone who has been drugged versus someone who is drunk from alcohol," he said. "Decreasing respiration, people aspirating and vomiting - that is where people get into trouble with that drug."
Reaction to the overdose ruling has been met with muted reaction at both Rincon Valley Middle School where Rao graduated last spring and Maria Carrillo High School where she likely would have enrolled as a freshman in August.
"Everyone has gone through their grieving process already. While they are concerned about the circumstance of her death, they have already grieved for her," said Matt Marshall, principal at Rincon Valley Middle School, adding that Rao's death caused a "hole" in the lives of her friends.
In Santa Rosa City Schools, instruction on the effects of drug and alcohol use is given in seventh grade life science, 10th grade biology, a required high school life skills course and through assemblies and extracurricular programs such as "Every 15 Minutes" and "Nightmare on Puberty St."
The investigation remains open, said Sheriff's Lt. Dennis O'Leary.
"We just keep investigating to see if we can determine where it came from," he said.
Staff writer Kerry Benefield writes an education blog at extracredit.blogs.pressdemocrat.com. She can be reached at 526-8671 or kerry.benefield@pressdemocrat.com.
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