Gamma-hydroxybutyric acid (GHB) is a central nervous system depressant commonly used recreationally and known as a date rape drug. It produces sedation, euphoria, and relaxation, leading to a loss of inhibitions and decreased motor coordination. At higher doses, GHB can cause confusion, memory loss, and respiratory depression and may even lead to long-term cognitive impairments.1 Its effects can vary depending on the individual and the dosage, making it crucial to be aware of its potential dangers.
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What Is GHB?
Gamma-hydroxybutyric acid (GHB), also known by various street names such as “liquid ecstasy,” “G,” “Georgia Home Boy,” or “fantasy,” is a synthetic drug that acts as a central nervous system depressant. Notably, despite being commonly referred to as “liquid ecstasy” – or “liquid x,” GHB bears no chemical or pharmacological resemblance to MDMA or MDA ecstasy compounds. It is classified as a Schedule I substance (the same class as heroin), indicating a high potential for abuse and a lack of known or accepted medical use.2
GHB can be produced in a liquid or powder form and is typically ingested orally. When consumed, GHB affects multiple body regions, including the brain, central nervous system, and various neurotransmitter systems. Its primary action involves binding to GABA-B receptors, and enhancing the inhibitory actions of gamma-aminobutyric acid (GABA), a neurotransmitter that helps regulate brain activity.2 The effects of GHB ingestion include sedation, euphoria, relaxation, and a loss of inhibitions.
One pharmaceutical form of GHB, known as Xyrem, has been approved by the U.S. Food and Drug Administration (FDA) for specific medical uses, including narcolepsy, a sleep disorder characterized by excessive daytime sleepiness. However, Xyrem is classified as a Schedule III controlled substance, indicating a lower potential for abuse than illicit forms of GHB.2 It is tightly regulated and strictly controlled due to its abuse potential and the risks associated with its misuse.
How Does GHB Work?
GHB works by affecting certain chemicals in the brain that help regulate our body’s activities. It specifically interacts with a chemical called GABA, which is responsible for calming the brain and slowing things down.2 When GHB enters the body, it enhances the effects of GABA, making us feel more relaxed and sleepy. It’s like pressing a “slow down” button in our brains. This can lead to sedation, a sense of relaxation, and even loss of consciousness if taken in higher doses.
GHB falls into the category of central nervous system (CNS) depressants. These are a class of drugs that slow down brain activity, producing calming and sedative effects. Apart from GHB, other CNS depressants include benzodiazepines (e.g., diazepam, alprazolam), barbiturates (e.g., phenobarbital, secobarbital), and certain sleep medications (e.g., zolpidem, eszopiclone).3 These substances act on GABA receptors in the brain, promoting relaxation and sedation, and in higher doses, they can lead to respiratory depression and coma.
How Is GHB Abused?
GHB is commonly used as a “club drug” due to its euphoric and sedative effects. It is known to enhance sociability and promote a sense of relaxation, making it appealing in social party settings. However, using GHB as a club drug can be dangerous. One of the risks is its unpredictable potency, as the concentration and purity of illicitly produced GHB can vary significantly. This makes it difficult to determine a safe and appropriate dosage, increasing the likelihood of overdose and adverse effects. Additionally, combining GHB with other substances, such as alcohol or stimulants, can amplify the risks and lead to severe health consequences.4
GHB’s use among bodybuilders has gained attention due to its potential to enhance muscle growth and aid recovery. However, using GHB for these purposes is highly risky and strongly discouraged. Misusing GHB as a bodybuilding supplement can lead to significant health risks, including respiratory depression, loss of consciousness, and even coma.5 Moreover, the purity and dosage of GHB obtained from illicit sources can be highly uncertain, further increasing the dangers associated with its use.
In both scenarios, it is crucial to recognize that the misuse of GHB can have severe consequences on physical and mental health. It is essential to prioritize legal and safe methods for recreation and bodybuilding, seeking guidance from healthcare professionals and following appropriate protocols and regulations.
GHB as a “Date Rape” Drug
It is essential to address the problematic nature of the term “date rape,” which is colloquially used in relation to GHB. GHB has gained a reputation as a drug associated with sexual assault due to its sedative effects and potential misuse. It is crucial to emphasize that the responsibility lies with the perpetrators of sexual assault, not the substance itself. Using the term “date rape” can perpetuate victim-blaming and undermine the importance of consent and personal boundaries.
When GHB is consumed along with alcohol, the combination can have dangerous consequences. Both GHB and alcohol are central nervous system depressants, meaning they slow down brain activity and can impair judgment and coordination. Taking GHB and alcohol together can intensify these effects, leading to severe sedation, nausea, problems with breathing, loss of consciousness, and memory loss.4 The combination can also increase the risk of overdose and respiratory depression, which can be life-threatening. It is crucial to be aware of these risks and avoid mixing GHB with alcohol or other substances to ensure personal safety.
Common Effects of GHB
After taking GHB, the effects usually start to be felt within 15 to 30 minutes, although this can vary depending on the individual and the dosage.6 The duration of the effects typically lasts for a few hours, typically around 3 to 6 hours.2 However, it’s important to note that the effects can be unpredictable and may vary from person to person.
Several factors can amplify or dilute the effects of GHB. These include:
- Dosage: Higher doses of GHB can intensify its effects.
- Body weight and metabolism: Individuals with lower body weight or faster metabolism may experience stronger and faster-acting effects.
- Tolerance: Regular use of GHB can lead to tolerance, requiring higher doses to achieve the desired effects.
- Co-administration with other substances: Taking GHB in combination with other drugs, such as alcohol or sedatives, can enhance its effects and increase the risk of adverse reactions.
- Individual sensitivity: Some individuals may be more sensitive to GHB, while others may have a higher tolerance.
GHB can cause the following effects:
- Feelings of euphoria
- Lack of inhibition
- Hallucinations
- Relaxation and sedation
- Increased sociability
- Altered perception of time
- Impaired memory and cognitive function
- Dizziness or vertigo
- Nausea and vomiting
- Difficulty with coordination and motor control
- Headaches
- Muscle relaxation or weakness
- Confusion or disorientation
- Slowed heart rate and breathing (at higher doses)
Effects of High Doses of GHB
Even a small increase in the dose of GHB can significantly impact a person’s experience with the drug. GHB has a narrow therapeutic index, meaning that the difference between a desired effect and an overdose can be small. Taking even slightly higher doses of GHB can lead to an intensified sedative effect, potentially resulting in loss of consciousness, respiratory depression, and coma. It is crucial to emphasize that the misuse or overdose of GHB can be life-threatening and should be avoided.
High doses of GHB can cause the following effects:
- Nausea
- Confusion and disorientation
- Seizures or convulsions
- Slurred speech
- Dizziness and impaired coordination
- Profound sedation and loss of consciousness
- Respiratory depression
- Unconsciousness and coma
- Irregular or slowed heart rate
- Hypotension (low blood pressure)
- Profound memory loss and amnesia
- Impaired motor control and muscle weakness
- Agitation and aggressive behavior
- Hallucinations or delusions
- Difficulty breathing or gasping for air
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Is GHB Addictive?
GHB has the potential for both addiction and dependence, both physically and psychologically. Physical dependence occurs when the body adapts to the presence of GHB, leading to withdrawal symptoms upon discontinuation. Psychological dependence is a strong craving or emotional reliance on a drug to cope with situations or emotions. With regular use, individuals may experience both forms of dependence,
Tolerance can also develop with GHB use, requiring higher doses to produce the same effects. This can lead to escalating use, increasing the risk of overdose and other adverse consequences. If concerns arise regarding GHB dependence or addiction, seeking professional help is crucial. Healthcare professionals can provide guidance, support, and treatment options to manage withdrawal symptoms, develop a comprehensive plan, and address the underlying factors contributing to substance use.
Symptoms of GHB Addiction
Substance use disorder, including addiction, is a diagnosable condition characterized by compulsive drug-seeking behavior, loss of control over drug use, and continued use despite negative consequences. It is typically identified based on criteria outlined in diagnostic manuals such as the DSM-5. These criteria include the frequency and amount of drug use, unsuccessful attempts to cut down or quit, cravings, neglect of important obligations, and withdrawal symptoms when drug use is reduced or stopped.
Symptoms of a GHB addiction may include:
- Using GHB in greater quantities or more often than intended
- Feeling unable to cut down on GHB use
- Experiencing intense urges or cravings to use GHB
- Spending a significant amount of time obtaining, using, or recovering from GHB
- Neglecting important obligations, such as work, school, or personal relationships, due to GHB use
- Continuing to use GHB despite experiencing negative physical or psychological effects
- Giving up or reducing participation in previously enjoyed activities in favor of GHB use
- Using GHB in risky situations, such as while driving or operating machinery
- Developing tolerance to GHB, requiring higher doses to achieve the desired effects
- Experiencing withdrawal symptoms when attempting to reduce or stop GHB use, such as anxiety, tremors, or seizures
- Persistently using GHB despite being aware of its negative impact on physical health, mental well-being, or relationships
GHB Drug Overdose
It is crucial to reiterate that an overdose on GHB is a serious and potentially life-threatening situation. Factors such as taking excessive doses, mixing GHB with other substances like alcohol or sedatives, or using GHB of uncertain potency can increase the likelihood of an overdose. Since GHB has a narrow therapeutic index, even a slight miscalculation in dosage can result in an overdose, leading to severe health complications.
Signs of a GHB drug overdose include:
- Loss of consciousness
- Slowed heart rate
- Respiratory depression (shallow or slowed breathing)
- Extreme drowsiness or difficulty waking up
- Cold and clammy skin
- Blue lips or fingertips (cyanosis)
- Vomiting or nausea
- Seizures or convulsions
- Confusion or disorientation
- Unresponsiveness or inability to wake up
- Irregular or stopped breathing
GHB Drug Withdrawal
When someone is physically or psychologically dependent on GHB and wants to quit, they may experience withdrawal symptoms. Withdrawal from GHB is not typically life-threatening but can be uncomfortable. Symptoms may include anxiety, insomnia, restlessness, tremors, sweating, and in severe cases, seizures.2 The intensity and duration of withdrawal symptoms can vary, typically peaking within a few days and subsiding over one to two weeks. Seeking professional medical guidance and support is crucial for a safe and manageable withdrawal process.
Symptoms of GHB Drug Withdrawal
GHB drug withdrawal can bring about various symptoms as the body adjusts to the absence of the drug. These symptoms can vary in intensity and duration, and seeking professional support is crucial for a safe and manageable withdrawal process. Symptoms of GHB withdrawal may include insomnia, seizures, anxiety, tremors, sweating, restlessness, nausea, vomiting, hallucinations, confusion, rapid heart rate, and elevated blood pressure.
GHB drug withdrawal may cause the following symptoms:
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Treating GHB Addiction
Attempting to manage an addiction to GHB alone is not recommended due to the potential risks and challenges involved. GHB addiction can have serious physical and psychological implications, and professional support is crucial for successful recovery. GHB withdrawal can be uncomfortable and may involve potentially dangerous symptoms such as seizures. Therefore, a medical detox under the supervision of healthcare professionals is often necessary to ensure safety and provide appropriate care during the withdrawal process.
Treatment options for GHB addiction include:
- Medical detoxification: A supervised process where healthcare professionals monitor and manage withdrawal symptoms to ensure safety and comfort.
- Inpatient or outpatient rehabilitation programs: Comprehensive treatment programs that provide a structured environment, counseling, support groups, and education to address the physical and psychological aspects of addiction.
- Behavioral therapy: Therapy sessions aimed at identifying and modifying unhealthy patterns of thought and behavior associated with GHB addiction.
- Support groups: Participating in support groups, such as 12-step programs, can offer peer support, guidance, and a sense of community during the recovery journey.
- Aftercare planning: Developing a personalized plan for ongoing support and relapse prevention, which may involve continued therapy, support groups, or other forms of ongoing care.
Support Groups
Support groups and group therapy are valuable resources for individuals with GHB addiction. These settings provide support, connection, and guidance from peers who understand the challenges of GHB use. While similar to support groups for other drug addictions, groups for GHB addiction address specific concerns related to GHB use. To find the right group therapy or support group, individuals can contact local addiction treatment centers, and community health clinics or utilize online resources and recommendations from healthcare professionals.
Behavioral Therapies
Working with a licensed therapist adept at helping those with GHB addiction can be highly beneficial. Cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT) are commonly used. To find the right therapist, individuals can contact addiction treatment centers, mental health clinics or seek referrals from healthcare professionals. Online directories and resources specific to addiction treatment can also assist in identifying experienced therapists. Factors to consider include the therapist’s expertise, credentials, therapeutic approach, and scheduling an initial consultation to ensure a good fit.
Inpatient or Outpatient Rehab
Rehab options for GHB addiction include inpatient or outpatient rehab programs. Inpatient rehab involves residing at a treatment facility, offering 24/7 support and comprehensive therapies. Outpatient rehab allows individuals to live at home while attending regular therapy sessions. Rehab for GHB addiction is similar to other drug addictions but may have unique considerations. Costs and timelines vary based on program type and duration.
In My Experience
In my experience, GHB is a lesser known and less frequented drug; however, it is not to be underestimated because of this. GHB is becoming increasingly more common in the chemsex scene, where some gay and bisexual men engage in “PnP” (party and play) and utilize GHB and other drugs for sexual-enhancement purposes. These drugs are often combined with other substances, and there have been reports of fatal incidents while users are under the influence of them. It is also still consumed by bodybuilders and is used as a date rape drug and as a club drug by teens and college-age students at parties and raves. It’s crucial that we do not take this lesser-known drug for granted.
Remember, education is a powerful tool in combating the risks associated with GHB. Whether it is understanding the potential risks of misuse, recognizing the signs of addiction, or knowing how to seek help for oneself or others, knowledge about GHB can be lifesaving. Staying informed is key to promoting safety and allowing individuals to make personalized, informed decisions.
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