GHB, also known as gamma hydroxybutyrate, is a central nervous system depressant known for its sedative properties and its involvement in drug-facilitated sexual assault. Mixing the drug with alcohol amplifies the effects and may lead to death. If taken regularly, GHB can lead to severe dependency and addiction.
Prescription drugs containing GHB derivatives are sometimes used to treat narcolepsy and alcohol withdrawal symptoms, but GHB is not approved for any therapeutic purpose.
Medications containing GHB salts, such as Xyrem, are Schedule III controlled substances, but GHB is a Schedule I controlled substance, according to the Drug Enforcement Administration. Schedule I drugs have no medical purpose, and they have a high potential for abuse and dependency.
GHB is popular among bodybuilders, sexual predators and clubgoers. Bodybuilders use GHB as a stimulus to release growth hormones. Sexual predators sneak the drug into drinks to sedate people before an assault. Partygoers use GHB for its psychoactive and euphoric effects.
An estimated 136,000 people used GHB in 2015, and the vast majority of them were above the age of 26, according to the National Survey on Drug Use and Health. Almost twice as many men as women used the drug.
In the United States, it’s very difficult for most people to determine the strength of GHB they buy on the street or online. The difference between a recreational dose and a high dose is minimal. A high dose almost always leads to unconsciousness, and an overdose can be life-threatening if a person vomits while they’re asleep.
The drug is sometimes made from home products, such as nail polish. Gamma butyrolactone, also known as GBL, is found in many products and can be converted to GHB. The body naturally converts GBL to GHB, but people who use drugs prefer GHB because GBL has an unpleasant taste. GBL that’s bought on the street may also contain contaminants.
An estimated 136,000 people used GHB in 2015, and the vast majority of them were above the age of 26, according to the National Survey on Drug Use and Health.
In the early 1990s, GHB became notorious for its role in drug-facilitated sexual assaults. Media outlets often referred to it as a “date rape” drug. Perpetrators typically mix the drug with food or drinks to sedate and incapacitate their victims. GHB ingestion may cause amnesia and impair movement and speech.
In low doses, the drug causes a boost of self-confidence and mild feelings of euphoria. Many people also experience increased sexual arousal and decreased inhibitions.
In high doses, GHB can cause vomiting, abdominal pain and excessive production of saliva. Patients treated for GHB intoxication often exhibit slow heart rate, low blood pressure, hypothermia and acute respiratory acidosis, a condition where the lungs struggle to remove carbon dioxide.
GHB can cause life-threatening side effects when mixed with other depressants, such as alcohol. Alcohol is a common component of date rape because it causes memory loss and sedation when it’s mixed with GHB.
4 Grams of GHB can cause death. That’s less than the weight of 2 US pennies.
People who use GHB seek feelings similar to those caused by alcohol, such as confidence and relaxation. They avoid drinking alcohol alone because they believe GHB has fewer side effects and doesn’t produce the same type of hangover.
GHB’s effects kick in 15 to 20 minutes after consumption and typically last for up to four hours. The effects are similar to alcohol, but people who regularly use GHB say they can tell the difference between how the two substances make them feel.
|Low Dose Effects of GHB||High Dose Effects of GHB|
|Loss of coordination||Seizures|
Some people who use drugs mix a low dose of GHB with an alcoholic drink to amplify the drug’s effects, but most people know that drinking multiple alcohol beverages with GHB is too dangerous to try. GHB is associated with high death rates because of the thin margin between a recreational dose and a fatal dose, according to a 2015 review of studies on the drug.
In 2012, the Food and Drug Administration warned that GHB can interact dangerously with other drugs. The agency said that Xyrem should not be mixed with alcohol or other central nervous system depressants, such as benzodiazepines and opioids.
The FDA also recommended avoiding antidepressants, antipsychotics and muscle relaxants that cause sedation. Combining GHB with other drugs can cause dangerous interactions, including loss of consciousness, coma, slowed breathing and death.
The effects of GHB are usually temporary, even in high doses. People may recover from low doses within hours of consumption, and people who overdose on GHB tend to wake up within five hours of entering the hospital, according to one analysis.
GHB is quickly absorbed in the body. The drug reaches peak concentrations in blood plasma 20 to 40 minutes after consumption, and the half-life of GHB ranges from 30 to 50 minutes. Hydration and food intake can influence GHB’s rate of absorption in the body. Approximately 2.5 percent of ingested GHB passes through the urine unchanged, according to a 2015 review.
In a 2006 study, researchers drug tested 16 adults who were given GHB. Two participants tested negative for GHB within six hours of consumption, and 13 tested negative within 12 hours. The drug was undetectable in the urine tests of all participants within 24 hours. Other studies have shown that detection tests can pick up GHB in hair months after intake.
For years, most people believed GHB wasn’t addictive. Many people who use drugs recreationally thought it was safer than other illicit drugs. Today, GHB is recognized as an addictive substance based on studies and the experiences of people who use the drug recreationally.
GHB isn’t a substance that can cause addiction after one use, but a positive initial experience can motivate people to try the drug again. Regular use of GHB is usually defined as using the drug at least once a day for multiple weeks. This pattern of use causes severe dependence and withdrawal upon cessation.
Withdrawal from irregular or low-dose use can cause symptoms of a typical crash, such as confusion, memory loss and disorientation. The symptoms usually develop a few hours after a person stops taking the drug. For infrequent GHB users, withdrawal can last between hours and days. It can last weeks for people who use the drug frequently.
Withdrawal from regular GHB use can cause:
Withdrawal can be uncomfortable enough to motivate people to use GHB multiple times per day to avoid the discomfort. Dependence turns into drug addiction when people continue using drugs despite negative consequences. Using to avoid withdrawal is a classic sign of addiction.
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GHB overdoses can be life-threatening, especially if the drug was combined with alcohol. Medical professionals can provide treatment for a GHB overdose, and most patients regain consciousness within six hours of overdose.
First responders are crucial to saving an intoxicated person’s life during an overdose. They can prevent serious brain damage or death by:
When providing naloxone to patients suffering from a GHB overdose involving opioids, emergency personnel account for opioid withdrawal effects, such as vomiting. Unconscious patients can choke on their own vomit, so it’s important to seek professional help if someone overdoses on GHB.
While patients are recovering from a GHB overdose, medical professionals keep an eye on their respiration and heart rates. If the patient has trouble breathing, health providers can use machines to help them breathe. In cases of a prolonged coma or high-dose consumption, doctors may use reversal agents. Medications such as neostigmine, flumazenil, naloxone and anticonvulsants may be used to block the effects of GHB.
Recovering from GHB addiction is challenging, and continuing care is usually necessary because relapse rates are high. But with proper treatment and aftercare, people do recover.
People who misuse GHB often struggle with other substance use or mental health problems. Treatment for GHB addiction may include residential services, where health professionals provide supervised detox, counseling and therapy.
Treatment for GHB use includes therapies that help individuals develop healthy coping mechanisms and important life skills. Some people doubt the risks of GHB, so counseling about the consequences of GHB use may be beneficial.