Most people who use Gamma-hydroxybutyrate (GHB) take the party drug on a recreational basis. But partying with GHB can easily get out of hand.
While GHB overdose is the most common problem associated with the drug, repetitive use of the central nervous system depressant can lead to physical dependence and addiction.
A person in the throes of a GHB addiction may use the drug every day, or every few hours, and chronic use can cause physical dependence. People who are dependent on GHB won’t be able to function normally without it and will experience withdrawal symptoms if they suddenly stop taking GHB.
Kicking a GHB addiction can be as difficult as quitting heroin and often requires the help of drug treatment professionals.
GHB withdrawal symptoms can begin within an hour of ceasing use. Early symptoms of withdrawal include insomnia, anxiety, tremors and a rapid heart rate. In heavy users, delirium and severe agitation can quickly follow.
GHB withdrawal symptoms include:
GHB withdrawal can last from several days to two weeks and is sometimes life-threatening.
In 2003, competitive bodybuilder and former Mr. America Mike Scarcella died during GHB withdrawal.
According to the Dallas Observer, which reported extensively on the tragedy, Scarcella went into withdrawal after he was hospitalized with a broken jaw and other medical problems. As his withdrawal intensified, the 39-year-old plunged into a psychotic state and was transferred to a psychiatric hospital, where he became extremely agitated, collapsed and died.
Because of such dangers, GHB withdrawal is best handled under a doctor’s care. Some patients may be able to detox successfully as an outpatient, but those with severe withdrawal symptoms will need to be admitted to a hospital.
“GHB withdrawal and detoxification require close medical supervision. Most clients require hospitalization ranging from 7 to 14 days.”
While the Food and Drug Administration has not approved any medications to specifically treat GHB withdrawal, doctors often prescribe benzodiazepines to help relieve agitation and other symptoms. Barbiturates, anti-seizure drugs, anti-psychotics and other medications are sometimes used to manage GHB detox.
In the Netherlands, where GHB abuse and addiction is a significant problem, doctors sometimes detox people by giving them pharmaceutical-grade GHB, which is used to treat narcolepsy, and gradually weaning them off the drug. This process of giving a person smaller and smaller amounts of a drug until they are able to function without it is known as detoxification by titration and tapering, or DeTiTap.
A 2017 Dutch study published in the journal of Drug and Alcohol Dependence examined 229 people who were gradually weaned off pharmaceutical-grade GHB. The study concluded that DeTiTap is a safe alternative to benzodiazepines. Eighty-five percent of the patients were successfully detoxed in an average of 12.5 days, and the method significant decreased anxiety, cravings and other withdrawal symptoms.
With relapse rates as high as 60 to 70 percent in the first three months after detox, GHB addiction treatment is a vital component of care.
Addiction treatment programs can reveal the root causes of addiction and provide tools and strategies for staying sober. While there is no GHB-specific drug rehab regimen, most treatment programs offer counseling, group therapy and education about the disease of addiction and relapse prevention.
Many drug treatment programs follow the 12-step approach to addiction. The 12-step principles involve surrendering to a higher power, examining past behavior and making amends with others. Support and fellowship from others who’ve struggled with addiction is a core component of the process.
Treatment is available on both an inpatient and outpatient basis, depending on a person’s specific needs. The length of treatment programs varies. Typical stints in rehab last for one to three months, but some people require longer programs.
Treating GHB addiction is challenging, in part because of the effects of GHB. Because GHB causes amnesia and memory loss, for instance, individuals may not even be aware of the consequences of their addiction. This can lead to relapse and repeated stints in detox and rehab.
Scientists are looking at new and novel ways to treat addiction to the drug.
In a 2017 article in the Journal of EMDR Practice and Research, Dutch researchers reported that eye movement desensitization and reprocessing (EMDR) therapy reduced GHB cravings in a patient who underwent seven sessions.
The therapy technique involves using intentional eye movements to stimulate the brain to reprocess troubling thoughts. Though it’s controversial, EMDR is being widely used to treat PTSD and alleviate the memories of traumatic events.
Researchers are looking at medications that might help prevent people who have recovered from GHB addiction from relapsing. The muscle relaxant baclofen has shown promise.
A 2018 study published in CNS Drugs found that fewer GHB-dependent patients dropped out of drug treatment or relapsed when they were given daily doses of baclofen. Side effects were minor and included tiredness, sleepiness and depression.
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