A colorless liquid or white powder often dissolved in liquid, GHB (gamma-hydroxybutyrate) is considered a Schedule I drug in the United States by the Drug Enforcement Administration, or DEA. This means that it has no accepted medicinal uses and is considered to have a very high possibility for abuse and addiction. There is one form of legal GHB, approved by the U.S. Food and Drug Administration (FDA) to treat narcolepsy, called Xyrem (generic form is sodium oxybate). Straight GHB is usually produced in illicit laboratories and sold illegally, often as a club drug.
The Federal Bureau of Investigation (FBI) lists GHB as one of six popular club drugs that may commonly be distributed at raves, which are all-night electronic music dance parties typically attended by teenagers and young adults.
On the street, GHB is often called:
- Grievous bodily harm
- Georgia home boy
- Liquid ecstasy or liquid X
- Easy lay
- Liquid G
Like benzodiazepine drugs, GHB works on the neurotransmitter gamma-aminobutyric acid, or GABA, slowing down the central nervous system and reducing heart rate, blood pressure, respiration, and body temperature, while enhancing relaxation, pleasure, libido and sexual experience, and lowering inhibitions. GHB may also be used as a “date rape” drug for its amnesiac effects, as often someone taking it may not remember the events that may have occurred while intoxicated. A person may be rendered unconscious after a drink is “spiked” with the drug, the Global Information Network About Drugs (GINAD) publishes. GHB may also be used by bodybuilders as it is reported to potentially help build muscle and enhance weight loss. The 2015 Monitoring the Future Survey published by the National Institute on Drug Abuse (NIDA) reports that just under 1 percent of all 12th graders report past-year abuse of GHB.
Due to its sedative effects, GHB abuse can lead to a potentially fatal overdose by suppressing necessary life functions, such as breathing, heart rate, blood pressure, and body temperature. When mixed with alcohol, opioids, or other central nervous system depressants, these effects may be multiplied. It may be difficult to know the purity of GHB and therefore how potent a dose may be, as it is manufactured illegally in underground laboratories. GINAD reports that a GHB overdose may lead to coma, respiratory failure, seizures, or even death. Signs of a GHB overdose include:
- Loss of balance
- Shortness of breath
- Irregular heart rate
- Blurred vision
- Extreme drowsiness or loss of consciousness
- Slurred speech
- Lack of motor coordination or muscle control
- Nausea and/or vomiting
A GHB overdose is a medical emergency requiring immediate professional care.
How to Know if Someone Is Abusing GHB
GHB may often be abused with other drugs or even dissolved in an alcoholic drink, as it is colorless, highly soluble in liquid, and may have a slight salty taste. According to the DEA, it starts working 15-30 minutes after ingestion and produces effects lasting 3-6 hours. Mixing it with other substances greatly increases all risk factors and effects of both substances (i.e., alcohol and GHB are both depressants, and using them together will heighten the level of intoxication from both).
GHB is often considered a “party” drug and may be most commonly associated with clubs, raves, and nightlife. It may be distributed in small vials or water bottles in liquid form, or as a white powder at these scenes. Someone intoxicated with GHB may appear drunk and have slurred speech, impaired coordination, poor judgment, dilated pupils, enhanced sociability, and more self-confidence. The person may make bad decisions, get involved in risky or hazardous situations, and have more energy. In some cases, an individual may display aggressive behavior. In large amounts, GHB may even cause hallucinations.
After GHB wears off, users may feel fatigued, depressed, confused, and not fully remember the events that occurred while intoxicated. Common indicators of drug, or GHB, abuse may include:
- Mood swings
- Changes in sleep habits
- Weight loss and potential changes in appetite
- Increased secrecy
- Inability to remember events or periods of time
- Drop in grades at school or production at work
- Less concern over appearance and personal hygiene
- Increased and potentially risky sexual encounters
- Other risk-taking behaviors
- Financial struggles
Using GHB regularly may lead to dependence on the drug as it disrupts the brain’s normal functioning. The severity of the dependence may depend on several factors, including age at first use, amount and method of abuse, duration of abuse, biological and genetic factors, potential concurrent mental illness, polydrug abuse, and environmental factors. Someone with a family history of addiction who uses large amounts of GHB with other mind-altering substances for a long time may be more significantly dependent on the drug than someone who uses it at a party here and there, for example. Both forms of abuse may lead to dependence in some form, however, and may continue on to addiction.
Addiction and GHB Withdrawal
Someone may be dependent on a drug physically, but not addicted to it, while someone who is addicted to a drug is almost always dependent on it as well. Addiction is a brain disease affecting the way people feel pleasure since drugs alter the way people process rewards by changing what motivates them and leading to compulsive, drug-seeking behaviors that are essentially out of their control. Addiction is both physical and psychological in nature, and social, emotional, physical, and behavioral changes may all be noted.
Those who battle GHB addiction may not be able to control how much of the drug they take or how often, for example, and may spend all of their time trying to get the drug, using it, and recovering from it. They may withdrawal from family and friends, and stop participating in events, activities, or hobbies they used to enjoy before using drugs. Responsibilities may be overlooked and a shift in personality as well as uncharacteristic behavioral changes may occur. Those struggling with addiction may continue to use the drug in full awareness of negative social, emotional, or physical consequences.
GHB may be highly addictive due to the significant withdrawal symptoms that may occur when the drug leaves the body after a person is dependent on it, encouraging a user to take more of the drug in order to feel relief.
- Racing heart rate
- Mental confusion
- Psychotic thoughts
GHB withdrawal may be similar to withdrawal from other sedative drugs such as benzodiazepines and may include life-threatening seizures without proper treatment.
Abuse and Addiction Treatment
Withdrawal from GHB may start relatively quickly after the last dose, within 1-6 hours, according to the California Poison Control System. What happens during withdrawal from GHB is that the brain, which has become accustomed to having certain functions repressed, is suddenly freed from the drug and a rebound may occur. All of the things the drug was holding back may now flood the system and may overload it with dangerous psychological and even physical side effects. For this reason, GHB should not be stopped “cold turkey,” or suddenly, and it may be important to have vital signs monitored during withdrawal to ensure a level of safety.
Medical detox is often the safest way to stop using GHB as medications like benzodiazepines may be used to manage the powerful withdrawal symptoms. With medical detox, individuals can be monitored while having access to 24-hour medical care.
After a level of physical stabilization is reached through medical detox from GHB, behavioral therapies may be helpful in determining what may have prompted the drug abuse and potential subsequent addiction, and how to manage triggers or stressors as they occur. If an underlying mental health problem also exists, this can also be properly cared for simultaneously through an integrated medical and mental health approach during substance abuse treatment and recovery.
Treatment for GHB abuse and/or addiction may be done in either an outpatient or residential basis, and both offer resources for families and individuals that may include both group and individual therapy and counseling sessions. Holistic methods, including nutritional diet plans, an exercise regime, and mindfulness techniques, may all be beneficial during addiction treatment as well. Support groups work with individuals and families alike to maintain abstinence and healthy life balance well into recovery. A strong foundation provided by substance abuse treatment through a specialized and individualized care plan can set up a person for long and prosperous recovery.