What to Know About GHB Use

Gamma hydroxybutyrate (GHB) is a central nervous system depressant. Until 1992, it could be purchased over-the-counter in health food stores and was used primarily by bodybuilders purportedly to reduce fat and build muscle. In 2000, GHB was classified as a Schedule I drug.

Similarly to drugs like Rohypnol, GHB has earned a reputation for being used to facilitate sexual assault, as it is odorless and mostly tasteless and can cause unconsciousness and memory loss.

Learning about GHB, including what it looks like and what it does to your mind and body, is perhaps the best way you can protect yourself or someone you love from becoming a victim.

Also Known As: GHB is also known as the date rape drug, liquid ecstasy, soap, easy lay, vita-G, Georgia homeboy, scoop, grievous bodily harm, liquid X, and goop.

Drug Class: GHB is classified as a depressant.

Common Side Effects: Side effects of GHB include euphoria, hallucinations, drowsiness, dizziness, nausea, vomiting, vision changes, and blackouts.

What Does GHB Do?

GHB increases the activity of the neurotransmitter known as gamma-aminobutyric acid (GABA), which carries messages from one cell to another. By increasing the amount of GABA activity, brain activity is reduced which can lead to symptoms like drowsiness, relaxation, decreased inhibition, amnesia, sleep, coma, and even death. These side effects make it a potential choice for drug-facilitated sexual assault and rape.

GHB is also used recreationally. Recreational use of GHB is most common at nightclubs, circuit parties, sex parties, and sex clubs. Users report positive effects including euphoria, increased sex drive, and tranquility. The drug is often combined with other illicit substances, including methamphetamine, MDMA, and ketamine, as well as alcohol. The combination can heighten its effects but is also potentially lethal.

The effects of GHB typically begin in about 15 to 30 minutes and peak at 20 to 60 minutes.

What the Experts Say

GHB is an especially deceptive drug. Experts say that many people don't notice or remember the negative side effects of having taken the drug, leaving them with only the memory of the high. But GHB is considered highly addictive. In fact, the difficulty of overcoming a GHB addiction has been compared to that of heroin addiction. And dependence is associated with severe withdrawal symptoms, which some researchers say is a leading cause of the high relapse rate of those who try to quit.

Off-Label or Approved Uses

GHB was first used in France in 1960 as an anesthetic. In the 1990s, GHB was sold over-the-counter in vitamin supplement stores and marketed as a sleep aid and growth hormone enhancer (to enhance sexual performance and to build muscle and reduce fat).

During this same year, at least 100 people were reportedly poisoned using GHB, and the Food Drug Administration (FDA) banned sales, declaring the drug unsafe and illegal, except under FDA-approved, physician-supervised protocols.

Because of concern about GHB, and other similarly abused sedative-hypnotics like Rophynol, Congress passed the "Drug-Induced Rape Prevention and Punishment Act of 1996" in October 1996. This legislation increased Federal penalties for use of any controlled substance to aid in sexual assault.

The pharmaceutical drug sodium oxybate, a formulation of GHB sold under the brand name of Xyrem, is used to treat excessive daytime sleepiness and cataplexy (sudden weakness) in people with narcolepsy. It is a Schedule III drug (lower abuse potential, medical use, and moderate or low dependence risk) and only specially enrolled medical providers can prescribe it. When used illicitly for recreational purposes, Xyrem converts to Schedule I status.

In Italy, Xyrem is an approved therapy for alcohol dependence and abuse. 

Common Side Effects

Some of the common short-term side effects that GHB users experience include:

• Drowsiness
• Dizziness
• Problems with vision
• Feelings of relaxation
• Heightened sensuality
• Seizures
• Memory loss
• Sweating
• Slow heart rate
• Nausea and vomiting
• Blackouts
• Loss of consciousness

Depending on the dose, some people can experience severe side effects of GHB, including coma and seizures. Combining GHB with other drugs such as alcohol can intensify the effects and result in nausea, breathing difficulties, and even death.

In patients admitted to the hospital for using GHB, bradycardia (slowed heart rate) and hypothermia (drop in body temperature) are commonly reported.

Signs of Use

If you or someone you care about suddenly feels overheated, sick, weak, or dizzy (and hasn't knowingly taken drugs or drank excessive amounts of alcohol), it could be a sign of GHB intoxication.

Other signs of GHB use may include:

• Reduced inhibitions
• Reduced ability to make judgments
• Confused
• Sleepy
• Sedated
• Slurred speech
• Feeling weak
• Headaches
• Difficulty breathing

Myths and Common Questions

There is a common misconception that it is safe to take club drugs like GHB in small amounts. But GHB is unpredictable and the strength can vary from batch to batch; even one pill can cause an adverse reaction. What’s more, overdose on a small amount is possible. 

Tolerance, Dependence, and Withdrawal

Recreational users of GHB can build tolerance and need to take more and more of the drug to achieve the desired effect. Many users become dependent on the drug to mitigate withdrawal symptoms.

How Long Does GHB Stay in Your System?

GHB exits the urine and blood fairly quickly, which is why it's important to get to a hospital and request a urine sample if you suspect you've been drugged. For most accurate results, the Office on Women's Health recommends that you wait to urinate, bathe, shower, brush your teeth or hair, eat or drink, or change your clothes until after you've been examined and tested.

Like other drugs, how long GHB stays in your system depends on how much of the drug was taken as well as your sex, weight, metabolism, and hydration and activity levels.

Addiction

Regular use of GHB can quickly lead to physical and psychological dependence. Unfortunately, people who misuse GHB often have difficulty recognizing a problem with their GHB use, in part because the drug has the ability to wipe out memory after taken.

While people can experience addiction differently, some telltale signs and symptoms include:

• Tolerance
• Withdrawal
• Secretiveness
• Lying
• Stealing
• Financially unpredictable
• Changes in social groups
• Repeated unexplained outings, often with a sense of urgency
• Drug paraphernalia
• “Stashes” of drugs (GHB liquid can be stored in water bottles, eye and nasal sprays, and mouthwash bottles.)
• Difficulty cutting down or controlling the addictive behavior
• Loss of social, occupational or recreational activities
• Preoccupation with getting, using, and recovering from drug use
• Extreme mood changes
• Shifts in sleeping patterns
• Sleeping a lot more or less than usual, or at different times of the day or night
• Unexplained fatigue or changes in weight

Withdrawal

If you or someone you love is looking to stop using GHB, it's best to seek a medically-supervised detox, which may include a tapering process to control and reduce the risk of dangerous withdrawal symptoms. People addicted to GHB are at risk of acute withdrawal symptoms, including:

• Severe anxiety
• Delirium
• Disorientation
• Hallucinations
• Tremor
• Insomnia
• Paranoia

How to Get Help

Given its association with sexual assault and rape, if you believe you have been given GHB, don't wait to reach out for help.

If you or someone you love is misusing GHB, your healthcare provider can help recommend resources for a safe, medically-supervised detox as well as inpatient or outpatient addiction treatment including disease education, counseling, and support groups.