What to Know About GHB Use

Drink on a bar

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GHB (gamma hydroxybutyrate) is a central nervous system depressant. Until 1992, it was often purchased over-the-counter in health food stores and used primarily by bodybuilders to reduce fat and build muscle.

It is one of the top drugs used to facilitate sexual assault and date rape, as it is odorless and 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: "date rape" drug, liquid ecstasy, soap, easy lay, vita-G, Georgia homeboy, scoop, grievous bodily harm, liquid X, goop

Drug Class: depressants

Common Side Effects: euphoria, hallucinations, drowsiness, dizziness, nausea, vomiting, vision changes, blackouts

How to Recognize GHB

GHB can be a tablet, capsule, white powder or clear liquid. It is usually mixed with a flavored drink or alcohol, which can mask its slightly salty taste. GHB is commonly hidden in water bottles, eye and nasal sprays, and mouthwash containers.

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—and this can lead to symptoms such as drowsiness, relaxation, decreased inhibition, anesthesia, sleep, coma, and even death.

The effects typically begin in about 15 to 30 minutes, and with only a tiny amount of the drug, and peak at 20 to 60 minutes.

When used as a club drug, GHB has the potential to be addictive. 

What the Experts Say

The recreational use of GHB is most common among gay and bisexual men at nightclubs, circuit parties, sex parties, and sex clubs. Users report positive effects including euphoria, increased sex drive, and tranquility.

GHB is often combined with other illicit substances, including methamphetamine, MDMA, and ketamine, as well as alcohol. This can heighten the effects of the drug and can potentially be lethal.

One study linked regular GHB use, especially when users were left unconscious, with negative effects on long-term memory, working memory, IQ, and higher levels of stress and anxiety.

Off-Label or Recently 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 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.

In 2000, GHB became a schedule I drug, meaning it has high abuse potential, no medical use, and is unsafe.

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, moderate or low dependence risk) and only specially enrolled medical providers can prescribe the drug. When used for recreational purposes, Xyrem converts to schedule I status.

In Italy, GHB is an approved therapy to block alcohol cravings, similar to the use of methadone for heroin addiction treatment. 

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

Severe Side Effects
Depending on the dose, some users 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 roughly a third of patients admitted to the hospital for using GHM, bradycardia (slowed heart rate) and hypothermia (drop in body temperature) are 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.

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 in a small amount. Yet 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. 

Recognizing Overdose

Since there’s a fine line between a safe and potentially harmful dose of GHB, the risk for overdose is high. If you or someone you care about experiences any of the following signs of overdose call 911 or poison control at 800-222-1222.

  • Vomiting
  • Loss of a gag reflex
  • Loss of control over bodily movements
  • Shaking, tremors, or seizures
  • Loss of consciousness and unresponsiveness
  • Lack of pain response
  • Rapid side-to-side eye movement
  • Profuse sweating
  • Reduced body temperature
  • Respiratory breathing (slowed below 15-20 breaths per minute)

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 you took (or was given) as well as your gender, weight, metabolism, and hydration and activity levels.

Addiction

Regular use of GHB can quickly lead to physical and psychological dependency. Unfortunately, convincing someone that he or she has a problem with GHB use may be challenging, especially since the drug has the ability to wipe out your memory after you've taken it.

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. People addicted to GHB are at risk of acute withdrawal symptoms, including:

  • Severe anxiety
  • Delirium
  • Disorientation
  • Hallucinations
  • Tremor
  • Insomnia
  • Paranoia
  • Treatment-resistant psychosis

How to Get Help

Date rape can happen to anyone, so don't wait to reach out for help. If you're not sure where to turn, the anti-sexual violence network RAINN (Rape, Abuse & Incest National Network) has a national hotline (800-656-HOPE) that will route you to the nearest sexual assault service provider.

If you or someone you love is abusing 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.

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