GHB Withdrawal and Detox

GHB is highly addictive. Withdrawal from the drug can cause severe symptoms that can last up to two weeks and may be life-threatening. GHB withdrawal is a medical emergency best handled at an inpatient detox facility.
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GHB, often referred to as liquid ecstasy, is a potent and dangerous central nervous system depressant. Small amounts of the drug can render you unconscious or kill you. Recreational use of the drug can easily progress to GHB addiction, and quitting the drug can be hellish.

A person who regularly uses GHB rapidly develops a physical tolerance to the drug. Tolerance is a phenomenon whereby the brain and body adapt to a drug’s presence in the body and need it to function normally.

People who have developed a tolerance to GHB require increasingly larger amounts of the substance to achieve a high. If they take less of the drug or stop taking it, their body revolts with severe withdrawal symptoms.

Because the symptoms can be fatal, detoxing at an inpatient rehab facility is the safest way to overcome GHB withdrawal and start the path to recovery.

GHB Withdrawal Symptoms

Quitting GHB cold turkey after continued use can cause physical and psychiatric withdrawal symptoms. The symptoms are particularly severe for people who used the drug frequently or took high doses for a lengthy period of time.

Symptoms of GHB withdrawal can include:

  • Anxiety and restlessness
  • Tremors
  • Insomnia
  • Confusion and paranoia
  • Delirium (losing touch with reality)
  • Hallucinations
  • Elevated heart rate
  • High blood pressure
  • Nausea and vomiting
  • Abdominal cramps
  • Diarrhea
  • Sweating

Additional symptoms of GHB withdrawal may include lack of appetite, nightmares, trouble concentrating, memory problems, increased sensitivity to sound and touch, elevated body temperature, dehydration and seizures.

Tony Southard, a North Carolina man who became addicted to 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 overcome GHB withdrawal after spending seven days in a hospital detoxing under heavy sedation. He called the experience the hardest thing he ever did in his life.

GHB Withdrawal Timeline

Because GHB is rapidly metabolized and only stays in the body a short time, withdrawal develops rapidly.

Symptoms usually begin within one to three hours of use, and they can last for six to 12 days or longer.

The first withdrawal symptoms to appear are typically anxiety, insomnia, tremors and episodes of racing heartbeat. Sweating and blood pressure spikes are common for the first couple of days, as is vomiting.

Withdrawal from GHB is unpredictable. Within 24 hours to five days after the last dose of GHB, withdrawal symptoms often progress, and people can enter a psychotic state. Hallucinations and confusion are typical, and the person may become violent and completely lose touch with reality.

This psychotic state is similar to the most severe form of alcohol withdrawal, delirium tremens. It usually occurs in people who have been using GHB every two to three hours around the clock.

While withdrawal symptoms gradually resolve, episodes of anxiety, confusion, sleeplessness and hallucinations can continue to occur for one or two weeks. Some people continue to experience anxiety, depression and persistent insomnia. They may have trouble thinking for months after detoxing from GHB.

GHB Detox

GHB withdrawal is difficult — and potentially life-threatening — and usually requires professional help. In many cases, the process of withdrawal should be handled in a hospital setting.

Complications of GHB Withdrawal

Several complications can arise during GHB withdrawal.

These problems can include fever, fluid and electrolyte imbalances, and rhabdomyolysis, a catastrophic breakdown of muscle tissue that can overwhelm and damage the kidneys. Patients who become severely agitated and violent may have to be physically restrained for their own protection.

Inpatient detox centers can medically manage these issues as well as any other complications that may arise during GHB withdrawal.

GHB Withdrawal Treatment

According to a 2015 study in the journal Current Neuropharmacology, GHB withdrawal symptoms are best managed by administering high doses of benzodiazepine sedatives, such as Valium or Ativan, for up to seven days.

Some patients require anti-seizure medications, antipsychotics and other medications to manage their symptoms. The muscle relaxant baclofen has proven helpful in GHB withdrawal cases where benzodiazepine therapy failed.

In the Netherlands, where GHB abuse and addiction is rampant, GHB withdrawal is often treated by giving patients pharmaceutical-grade GHB and gradually tapering the dose.

A 2017 Dutch study in the journal Drug and Alcohol Dependence followed 229 detox patients who were gradually weaned off GHB in a medical setting. Eighty-five percent successfully detoxed in approximately 12.5 days. The approach was associated with fewer GHB withdrawal symptoms and cravings.

Unfortunately, most of those patients relapsed on GHB within three months.

Because of the high rate of relapse, GHB addiction treatment is crucial. Rehab treatment facilities can provide individuals with therapy and other effective tools and techniques for overcoming GHB addiction.

Medical Disclaimer: aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.

Amy Keller, RN, BSN
Content Writer,
As a former journalist and a registered nurse, Amy draws on her clinical experience, compassion and storytelling skills to provide insight into the disease of addiction and treatment options. Amy has completed the American Psychiatric Nurses Association’s course on Effective Treatments for Opioid Use Disorder and continuing education on Screening, Brief Intervention and Referral to Treatment (SBIRT). Amy is an advocate for patient- and family-centered care. She previously participated in Moffitt Cancer Center’s patient and family advisory program and was a speaker at the Institute of Patient-and Family-Centered Care’s 2015 national conference.

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