A substance can be legal but may be banned in certain circumstances. For instance, an insurance company may test an insurance applicant for nicotine to verify the person's assertion that he or she is not currently using tobacco. In the case of prescription medications, the high addictive potential for certain medications makes drug testing important. In the case of some athletes, many of the prohibited substances are legal but have the potential to affect the athlete's performance. Athletes must exercise caution in their choices of medications as they are ultimately responsible for any substances detected in their bodies.
GHB's unique attributes have some legitimate uses. In Europe, it is still used as an anesthetic, for alcohol and opiate addiction therapy, and for narcolepsy therapy. Only this last indication of narcolepsy is recognized by the US Food and Drug Administration, which recently approved GHB (ie, sodium oxybate [Xyrem]) to treat a small subset of patients with narcolepsy who have episodes of weak or paralyzed muscles (ie, cataplexy). Because of sodium oxybate's history of abuse as a recreational drug, the FDA approved it as a Schedule III Controlled Substance. A limited distribution program that includes physician education, patient education, a patient and physician registry, and detailed patient surveillance has been established. Under the program, prescribers and patients will be able to obtain the product only through a single centralized pharmacy.