Gamma-hydroxybutyrate (also known as GHB or simply G) is a drug that is officially used to treat narcolepsy. This highly regulated drug is prescribed under the brand name Xyrem (sodium oxybate), but since the 1990s, it has been used illegally as a party drug.
The drug functions as a central nervous system depressant similar to, but stronger than, alcohol. Before putting users to sleep, GHB provides a strong feeling of euphoria. The drug takes effect within 20 minutes of use, and its effects can last three to six hours.
According to the U.S. Drug Enforcement Administration, the most recent statistics from 2016 showed that approximately 1,400 people (12 and older) in the United States have used the drug. While that may not seem like many, the number is likely higher when we factor in younger users. Rates of GHB-related emergency room visits are estimated to be in the thousands each year.
GHB was used by bodybuilders who believed it enhanced body mass in the 1980s and 1990s. Due to incidents of GHB being used as a date rape drug and an increasing number of overdoses, laws were passed making illegal to sell or possess GHB unless prescribed by a medical professional.
This has led to a decrease in its use. Drug addiction specialists and law enforcement agencies have started to express concern over an increase in use, particularly for young gay men who use the drug as a party drug.
GHB is most often used in a liquid form inside of as a capsule or tablet, though it can also be used as a powder. It is colorless and odorless, and therefore easily mixed with beverages.
It is often used in collaboration with alcohol, which will increase its sedative effects and the danger of overdose. It is also used in conjunction with stimulant drugs, such as methamphetamines, in order to help users with the comedown effects of the drugs.
Since GHB is a depressant, this drug slows everything down. You may experience a sense of euphoria and profound relaxation. Many also experience slurred speech, a lowering of inhibitions, lack of coordination, some degree of sedation, and nausea.
Depending on the dosage, you may become unconscious in a short amount of time and not remember the events that took place during the time you were using GHB. Less frequently, people experience hallucinations, seizures, or increased sexual arousal.
According to one study, the most common overdose symptom presented in emergency rooms is a slow heart rate. Other overdose symptoms include unconsciousness, difficulty breathing, slow breathing, low body temperature, and vomiting
Withdrawal symptoms from GHB can last up to about one week, and they can be severe, including the possibility of dangerous seizures. Average withdrawal will include sweating, anxiety, insomnia, restlessness, and confusion. Other more dangerous symptoms include hypertension, delirium, and hallucinations
The euphoric effects of the drug may enhance sexual encounters (a practice known also as “chemsex”). However, since the drug can cause varying degrees of sedation and confusion, successful safe sex practices are less likely.
One study showed that GHB and other drugs did increase incidents of sexually transmitted infections in men who have sex with men as well as the incidents of sexually transmitted infections among women.
It’s important to consider also that one’s ability to consent to sexual activity can become compromised. GHB is notoriously known as a date rape drug. According to one article from the Health Research Funding database, women between the ages of 16 and 24 were four times more likely to be unwillingly exposed to GHB
Some people find themselves using GHB more than they would like or find that they can’t stop using it even if they want to stop. Sometimes, the addiction is specific to certain situations. For example, some people may find that they are unable to enjoy a night out or a sexual encounter without the use of the drug
There are medical conditions that can be severely affected by the use of GHB. People who have heart conditions, sleep apnea, or chronic obstructive pulmonary disease (COPD) are at particular risk of serious complications from GHB use
There are many cases of people slipping into a coma or dying from use of GHB. Since GHB is a depressant, an overdose can lead someone to stop breathing or have a heart attack. Since this drug can cause unconsciousness, people may not be able to seek appropriate help during an overdose
Since 2000, it has been illegal to possess or purchase GHB without a prescription from a doctor in the United States. Many states have fines in the thousands of dollars for possession, not to mention the possibility of jail and/or probation. It is also illegal and potentially dangerous to share your own prescription drugs with other people.
Some argue that unconsciousness or a decrease in consciousness is in itself a sign of an overdose. In fact, a 2017 study of GHB overdose victims found that 60 percent had experienced losing full consciousness and another 25 percent experienced a reduction in consciousness.
However, a decrease in consciousness alone may not require medical intervention. Some people pass out during use of GHB and awaken with a headache or other uncomfortable feelings but not dangerous symptoms. What is difficult is that with GHB, unlike some other drugs, the line between expected symptoms and dangerous symptoms can be very thin.
Below is a list of things to watch for when using GHB. If you witness any of these or have any concerns about what is happening during use, seek emergency medical attention immediately.
The only sure way to prevent a GHB overdose is to simply not use GHB. However, if you are using GHB, take the following precautions to make sure you reduce as much risk as possible:
Renowned addiction specialist and author Gabor Maté defines addiction loosely as any behavior a person craves doing despite its negative consequences. There are more defined definitions of abuse and addiction for many drugs but since GHB is not a widely used drug, no such definitions have been developed.
If you feel you may be abusing GHB, it is important to reach out to someone. Try and connect with loved ones or community resources. Tell someone, even if it is just one trusted friend, about your struggle.
This is part of why 12-step programs like Narcotics Anonymous have been so successful for some people. These programs take people out of isolation and bring them into the community. If you are struggling with GHB abuse, talk with a counselor, a friend, or recovery program in your area.
If someone you know is struggling with GHB abuse, talk to them about it with care and as little judgment as possible. There has been a lot of research in recent decades showing that confrontational approaches to helping people with addiction issues are outdated and unhelpful. In fact, it can have the opposite effect. It can push people away or invoke denial if they are not ready to deal with their addiction.
Being frank but kind is the best approach. If the person is already wanting your help, you can assist them in getting connected to a recovery program by doing research with them, going with them to check out meetings or programs, or simply being available to listen.
Drug treatment programs come in a variety of forms, some with more structure than others.
Some programs, like Narcotics Anonymous, require no signup and simply hold drop-in meetings on a daily or weekly basis.
Other programs are highly structured. In outpatient programs, you may attend treatment a certain number of days of the week. In inpatient or residential programs, you may actually live at the facility for the duration of the treatment. Both inpatient and outpatient programs often include routine drug testing, frequent therapy, and medical interventions.
A 2014 study showed that inpatient programs were just as effective as outpatient programs for most people in recovery. The study stressed that the outpatient programs that were as effective as inpatient programs had at least nine hours of treatment per week.
Ultimately, it is up to you and your loved ones to decide what is best (unless you are court-ordered to go to a particular kind of program). Sometimes, the kind of treatment available to you will depend on what kind of program your insurance will cover.
In general, drug treatment includes individual and group counseling sessions, education about how drugs affect our bodies and brains, education about the recovery process, and relapse prevention planning.
Sometimes, case managers help people with other life stressors that may affect their use, such as housing, jobs, or financial issues. Most programs provide ongoing support from staff, mentors, or other community connections after the initial treatment period.
It is also important to seek help for any underlying issues that may contribute to addiction. This could be unresolved past trauma (even from childhood) or life stressors, such as financial trouble or family issues.
While there are no specific treatments for GHB, there are some specific considerations for deciding what kind of treatment to get for someone addicted to the drug. Since the withdrawal symptoms for GHB can be so serious, it may be useful to be in a residential facility that can monitor your withdrawal and provide appropriate interventions.
Since GHB is so often used in a social setting, people who are abusing or addicted to GHB will want to think about creating other social networks and alternative ways to have fun. A study published in the International Journal of Drug Policy emphasized that recovery efforts are more successful if treatment addresses the context in which people use. This includes social settings and social relationships.
Finding a whole new group of people to socialize with can feel very daunting at first, but many people find lifelong friends in the recovery process.
(October 2018) Gamma Hydroxybutyric Acid (Street Names: GHB, G, Liquid Ecstasy, Liquid X, Liquid G, Goop, Georgia Home Boy, Grievous Bodily Harm, Easy Lay). U.S. Drug Enforcement Administration. Retrieved January 2019 from https://www.deadiversion.usdoj.gov/drug_chem_info/ghb.pdf
(February 2015) 17 Remarkable GHB Death Statistics. Health Research Funding. Retrieved January 2019 from https://healthresearchfunding.org/17-remarkable-ghb-death-statistics/
(January 2015) GHB Pharmacology and Toxicology: Acute Intoxication, Concentrations in Blood and Urine in Forensic Cases and Treatment of the Withdrawal. Current Neuropharmacology. Retrieved January 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4462042/#R9
(July 2012) Recreational drug use during sex and sexually transmitted infections among clients of a city sexually transmitted infections clinic in Amsterdam, the Netherlands. Sexually Transmitted Disease. Retrieved January 2019 from https://www.ncbi.nlm.nih.gov/pubmed/22706213
(June 2014) Substance Abuse Intensive Outpatient Programs: Assessing the Evidence. Psychiatric Services. Retrieved January 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4152944/
(May 2009) Risk environments and drug harms: A social science approach for harm reduction approach. International Journal Of Drug Policy. Retrieved January 2019 from https://www.sciencedirect.com/science/article/abs/pii/S095539590800203X
(September 2017) Intoxication with GHB/GBL: characteristics and trends from ambulance-attended overdoses. Scandinavian journal of trauma, resuscitation and emergency medicine. Retrieved January 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5610436/