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GHB Abuse and Addiction

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15 Cited Research Articles

The notorious “date rape” drug gamma hydroxybutyrate, or GHB, is also a popular club drug that is prevalent in the rave subculture and gay nightlife scene. Bodybuilders have also been known to use the drug to promote muscle growth. GHB is highly addictive, and those who use it long-term can experience severe and even deadly symptoms during withdrawal.

Fast Facts: GHB

Addiction Liability
Scientific Name
Street Names
Liquid Ecstasy, Firewater, Cherry Meth, Gib, Scoop, Poor Man's Heroin
Side Effects
Decreased Inhibitions, Disorientation, Impaired Memory, Loss of Coordination, Decreased Heart Rate, Loss of Consciousness
How It's Used
Psychological Dependence
Physical Dependence
Legal Status
Schedule I & III

When it was first used clinically in the 1960s, the central nervous system depressant GHB seemed to hold promise as a fast-acting anesthetic agent. Unfortunately, the drug lacked any pain-killing properties and also tended to trigger seizures. The medical community quickly abandoned interest in its clinical use.

By the 1980s, however, over-the-counter GHB emerged as a popular supplement in U.S. body building circles because of the belief that it stimulates the release of growth hormones, thereby helping to burn fat and build muscle.

Many people mistakenly believe that GHB is relatively harmless and nonaddictive. However, it is a Schedule I controlled substance, meaning it has a high potential for abuse. The drug can cause people to turn violent, hallucinate or slip into a coma. Frequent use of GHB can result in physical dependence and addiction.

At the height of his GHB drug addiction in his early twenties, former World Wrestling Entertainment star Ryan Reeves, who wrestles under the ring name Ryback, would fill the cap of a water bottle with GHB after practice, consume the drug and take a nap. When he awoke, he’d eat and take another capful before heading to the gym.

Eventually I would do [GHB] every day, and it became a very regular part of my life. It was kind of the first thing I ever really, truly got addicted to.

Former WWE star Ryan Reeves

After a three-hour workout, he would head home, consume even more GHB and eventually pass out. Many nights, he’d wake up and take another capful to fall back asleep.

“Eventually I would do it every day, and it became a very regular part of my life,” Reeves said on his podcast, Conversation with the Big Guy, in 2016. “It was kind of the first thing I ever really, truly got addicted to.”

Sometimes, the drug would cause Reeves to sleepwalk and do things he couldn’t remember. One morning, he recalls waking up feeling horrible and finding that he’d vomited and defecated all over his bedroom and urinated on the walls.

“How I didn’t die, I don’t know,” said Reeves, who quit GHB for good not long after.

In 1990, following more than 30 reports of GHB-related illnesses, the Food and Drug Administration banned over-the-counter sales of GHB and declared it unsafe.

A few drops of GHB can knock a person unconscious within 30 to 40 minutes.

Despite the crackdown, GHB found its way into the club scene as a recreational drug known as “G,” “Liquid Ecstasy” and “Grievous Bodily Harm.”

While clubgoers would typically drink a tiny teaspoon of GHB for its euphoric and libido-boosting effects, sexual predators discovered a nefarious use for the powerful sedative.

In higher doses, GHB can cause loss of consciousness and blackouts — and because it’s colorless, odorless and mostly tasteless, GHB can be easily slipped into someone’s drink without his or her knowledge.

By the mid-1990s, troubling reports emerged of young women blacking out and being sexually assaulted after consuming drinks laced with GHB. The potent drug earned a reputation as the leading date rape drug.

GHB acts quickly, intoxicating someone in as little as 15 to 20 minutes, and a few drops can knock a person unconscious within 30 to 40 minutes and leave them blacked out for hours. Because GHB also causes amnesia, victims often have no memory of what happened to them, making it difficult to report a sexual assault.

Bottle of GHB

4 Grams
of GHB can cause death. That’s less than the weight of 2 US pennies.

4 grams of GHB can cause death

GHB Dependence, Addiction and Withdrawal

Long-term, frequent use of GHB causes changes to the brain’s neurochemistry much in the same way that alcohol and benzodiazepines do. While GHB slows brain activity, the brain becomes accustomed to the drug over time and compensates for its effects.

If GHB use is stopped suddenly after long-term use, individuals can experience uncomfortable withdrawal symptoms.

Common GHB withdrawal symptoms can include:

  • Sweating
  • Anxiety
  • Tremors
  • Insomnia
  • Increased heart rate
  • Increased blood pressure

Some people going through GHB withdrawal experience psychotic thinking characterized by profound disorientation, paranoia, hallucinations and delirium. GHB withdrawal can also cause a breakdown of muscle called rhabdomyolysis, which can be catastrophic to the kidneys. In some cases, GHB withdrawal has proved deadly.

To avoid these excruciating symptoms, individuals who are addicted to GHB will consume it around-the-clock, putting them at an increased risk for an overdose.

According to a 2016 study published in Neuropsychobiology, repeatedly taking GHB three to six times per day can lead to tolerance and dependency.

Tony Southard, a North Carolina man who became hooked on GHB after a bodybuilder friend introduced him to the drug, told the San Francisco Chronicle that he used it almost 24/7 for two years to avoid experiencing violent withdrawal symptoms.

“I’d start freaking out — anxiety attacks, shaking uncontrollably,” said Southard, who also experienced unrelenting insomnia that lasted for six months.

Southard was only able to kick his habit after spending seven days in a hospital detoxing under heavy sedation. He called the experience the hardest thing he ever did in his life.

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How Long Does GHB Stay in Your System?

GHB can be detected in urine, blood, saliva and hair. The drug can be found in the urine for up to 12 hours after last use, and the largest concentration of the drug is excreted two to four hours after someone takes it.

A 2015 study published in the journal Current Neuropharmacology stated that only 1 to 5 percent of a GHB dose remains in the urine after ingestion, and the detection time ranges from three to 10 hours. The study also found that GHB can be detected in the blood for up to four to six hours after ingestion.

Unlike blood tests, saliva tests use noninvasive methods to collect samples. GHB can typically be detected in oral fluid up to 5 hours after administration.

Another study, published in the Journal of Forensic Sciences, examined the detection window of GHB in hair after a case of sexual assault. Researchers concluded that the drug can be found in hair about one month after ingestion.

GHB Overdose

A GHB overdose, whether it’s the result of illicit use or drug-facilitated sexual assault, frequently requires medical treatment. Patients may exhibit various degrees of consciousness depending on the dose taken and the time that has passed since GHB was last consumed.

Symptoms indicating that someone may have been slipped the date rape drug GHB include:

  • Dizziness and lightheadedness
  • Blurred vision
  • Confusion
  • Overwhelming sleepiness
  • Stumbling
  • Disorientation
  • Nausea
  • Vomiting
  • Muscle spasms
  • Breathing difficulties
  • Sweating
  • Uncontrolled muscle movements
  • Seizure
  • Coma

Many victims who are drugged with GHB feel a level of intoxication that is exceedingly high for the amount of alcohol they drank.

Because GHB is a central nervous system depressant, it suppresses the body’s gag reflex. Therefore, if a person is rendered unconscious by GHB and vomits, he or she is at risk for choking to death.

Unlike opioid toxicity, which can often be successfully reversed by administering the agent naloxone, there is no antidote for a GHB overdose.

Treatment & Recovery

Overcoming a GHB addiction can be as difficult as kicking heroin addiction, according to a recent study by researchers in the Netherlands.

One of the reasons for this, study coordinator Harmen Beurmanjer told a Dutch newspaper, is that GHB users “only see the positive effects of the drugs,” and “living without GHB they find unbearable.” Beurmanjer says more than half of those addicted to GHB relapse within three months of treatment.

Because GHB withdrawal can trigger life-threatening seizures and a multitude of unpleasant symptoms, those who are addicted to GHB are advised to seek inpatient treatment when quitting the drug.

The most recent medical literature suggests that GHB withdrawal is best treated by slowly tapering the dosage and using a combination of sedative and antipsychotic medications to treat withdrawal symptoms, which typically last for five to 15 days.

To successfully conquer a GHB addiction, an individual should engage in a long-term treatment plan after detox is complete. Effective programs will help people examine the underlying factors that led them to abuse the drug and teach them tools and strategies to avoid relapse.

While individuals who enter treatment for abuse of club drugs such as GHB tend to have more severe addictions than people who use alcohol and other drugs, research shows that they often respond well to treatment and are more likely than other drug users to complete treatment.

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