It usually comes in a plastic water bottle and it can kill you--on those two points both sides can agree.
But the effects of GHB, widely referred to as the date rape drug, and the amount it takes to kill you will likely decide the case against Brian Lee Randone, who is accused of torturing and murdering his 31-year-old girlfriend in 2009.
Felicia Lee was found dead by paramedics in Randone's apartment in the 500 block of Duarte Road on Sept. 11, 2009 with . Prosecutors say Randone ; his lawyers insist Lee took too much GHB, , and overdosed.
Each side has used expert testimony to bolster their case. And each side has painted a drastically different portrayal of what GHB does to the human body and just how much of it is lethal.
The Defense's Argument
On Thursday, defense expert Trinka Porrata, a former LAPD narcotics detective, finished her second day of testimony in Randone's trial. Porrata helped write the legislation that made GHB illegal in California and created a non-profit organization--Project GHB--to raise awareness of the dangers of the drug. Its reputation for being used to drug women in sexual assaults is well documented, but it is also used recreationally by people who enjoy its effects.
Porrata, who said she has interviewed more than 3,300 GHB addicts and several hundred victims of GHB-related sexual assault, testified that the drug has an "unusually wide range" and "bizarre" range of effects on users, producing a euphoric feeling in most people that is similar to heavy alcohol consumption.
GHB is classified as a dissociative anaesthetic--a drug that can "disassociate your mind from your body," according to Porrata. Though it was originally developed as a surgical anaesthetic, doctors stopped using it when patients reported feeling pain while they were supposed to be sedated.
Attorneys on both sides agree that Felicia Lee was a regular user of GHB. She took it alone, took it with friends at parties, and she took a lot of it. On the day of her death, she had a level of GHB in her blood that both sides have characterized as "high."
What experts don't agree on is what happens to people who take too much.
Porrata testified that people intoxicated with GHB often stagger around, have seizure-like jittery movements and can become combative with other people. They can also exhibit "head snap" movements that can lead to serious injury, she said.
"They've hit the edge of sink, knocked out their teeth, broken their nose," Porrata said.
Porrata described one case she encountered where a man high on GHB "hatcheted" his entire house in a "GHB rage." The man would destroy parts of the house, pass out, wake up in a pool of his own blood, and then continue to tear the house apart. He didn't remember any of it when he finally came down from the drug, she said.
"The entire house looked like a mass murder scene," she said.
GHB has what Porrata describes as a "steep dosage curve." For some people, a large amount of GHB will merely intoxicate them and sedate them. For others, that same dose could be fatal.
"You can't tell who's going to live and who's going to die from this," she said.
GHB is also highly addictive, and like with many drugs, users must take more and more of it over time to get the same desired effect. Lee had been using the drug for years.
The critical question for the jury to decide is whether the level of GHB in Lee's body was a fatal amount. Both sides agree that the best place to test a deceased person for GHB is by sampling the fluid in the eyeball--the vitreous humor--which represents the amount of GHB in the blood more reliably than any place else in the body.
The level of GHB in Lee's blood was 311 micrograms per millileter of blood. Randone's attorneys insist that's enough to have killed her.
The Prosecution's Case
Dr. Cyrus Rangan, the director of the Los Angeles County Department of Public Health's Bureau of Toxicology, took the stand for the prosecution late last month and painted a different picture of GHB and its effects.
Rangan, who has treated patients who have overdosed on GHB, said that the amount of GHB found in Lee could not be used to conclude that she definitely died of an overdose.
"When you look at the levels of GHB...they can be exremely different to interpret," Rangan testified.
Because different people are capable of handling different doses, there is no such thing as a standard lethal dose of GHB. Some people who have had GHB levels below 311 have died. Many have also lived.
"When you look at cases of people who die of GHB, the levels...are all over the map," he said. "The level in and of itself cannot be used to make a determination that there is, quote unquote, a fatal level."
Like their tolerance to the effects of GHB, habitual users of the drug can also push their fatal level higher as their capacity to handle it grows. The amount of GHB it takes to kill a regular user can increase as they continue to ingest the drug over time.
There are two significant physiological side effects to the drug when taken in large amounts, Rangan said. One is sedation--a person intoxicated on GHB can get very sleepy and even pass out. In even larger doses, GHB can cause respiratory depression, or the slowing of breathing. If a person takes enough of the drug, the breathing can eventually slow down to a full stop, killing them.
In Rangan's experience, a level of 311 typically would put a GHB patient into a "moderate to deep sleep" for a first time user.
Randone's attorneys have suggested that Lee sustained the many injuries throughout her body during a GHB-induced seizure, which they argue sent her careening through a closet door made out of particle board.
But Rangan said GHB abusers do not have seizures when they're using the drug, as Lee was the morning she died. Instead, seizures have only been reported in GHB users who are going through withdrawal from the drug, Rangan said.
"I've never seen them have a seizure while they're intoxicated," Rangan said on the witness stand. "With a level of 311 you're not going to be in withdrawal."
Additionally, Rangan testified that the GHB patients he's treated rarely injure themselves seriously.
"In general, it's just a few bruises on the body and occasionally a broken bone," he said.
The homicide detective who investigated Lee's death testified that she had a total of 320 scrapes and injuries on her body, not counting all the deep bruises on her limbs. The said that the abrasions on her eyes, nose, lips and inner mouth were all signs that she was forcibly smothered to death.
Under cross-examination, one of Randone's attorneys asked Rangan if he could determine what Lee's fatal level of GHB was.
"Everyone who uses GHB has a lethal level, we just don't know what that is," he said. "I don't know what that lethal level is. I don't think it's determinable."
Since a GHB level does not provide conclusive evidence of a cause of death, Rangan said the only clue for a case like Lee's is to look at the way she died.
"We have to look at the manner of death. How did she die?," he said.
