What Everyone Needs To Know About GHB
Gamma hydroxybutyrate is a U.S. Drug Enforcement Administration Schedule I drug, which means that it has a high risk of addiction and no currently accepted medical benefits. Though one of the lesser-used recreational drugs, its popularity is increasing, with an estimated 184,000 Americans aged 12 and up using GHB in 2020.
While currently illegal, this drug was once sold as an over-the-counter supplement. It was a favorite among bodybuilders for its purported positive effects on muscle development and fat reduction. Everyone should know about this drug and its potential dangers.
What Is GHB?
Gamma hydroxybutyrate or gamma hydroxybutyric acid are both referred to as GHB. It is a depressant that affects the central nervous system. When it enters your body, it interacts and binds with receptors involved in producing the neurotransmitter gamma aminobutyric acid, increasing the amount of GABA released into your system.
GHB occurs naturally in the central nervous system. In this form, it plays a role in your sleep cycle, body temperature regulation and learning. The chemical also occurs naturally in some organs and soft tissues. It is also present in tiny amounts in some of the foods and drinks people consume.
The U.S. Food and Drug Administration approved a drug known as Xyrem® or sodium oxybate, which is only available with a prescription. This medication is used to treat narcolepsy or daytime sleepiness. It is the only drug containing gamma hydroxybutyrate approved for medical use in the U.S. In this form, the government lists it as a Schedule III drug.
Where Does GHB Come From?
Illicit forms of gamma hydroxybutyric acid are produced in labs operating illegally. These labs exist globally, generally supplying “customers” locally. The GHB that comes from the labs is a synthetic version of the natural chemical compound.
What Is the History of the Drug?
GHB has been around since the 1960s when it arrived on the scene as an anesthetic. By the 1980s, it was touted as a weight-loss remedy and muscle-building substance. Bodybuilders, in particular, used the drug to increase muscle mass and decrease body fat. At this time, GHB was legal and sold as an over-the-counter supplement.
In 1990, the USFDA made it illegal to sell GHB. However, illicit production began immediately. In the 90s, the neuro-depressant made headlines as a “date-rape” drug. Gamma hydroxybutyrate use occurs in a reported 4.9% of drug-facilitated sexual assaults.
In recognition of the dangers associated with GHB and similar drugs, Congress passed an amendment to the Controlled Substances Act in 1996. The Drug-Induced Rape Prevention and Punishment Act levied higher penalties on criminals convicted of violent crimes who gave their victims a drug without their knowledge or consent.
In 2000, the federal government passed another law — Public Law 106-172 — that established GHB as a public safety hazard. In March of the same year, the DEA placed the drug on its list of Schedule I drugs.
How Is It Used Now?
Gamma hydroxybutyric acid is still in use as a “date-rape” drug. It’s important to note that the context for these types of crimes is most often not associated with the dating scene. Instead, those who slip the drug to an intended victim are usually strangers or acquaintances.
GHB is also gaining popularity as a recreational drug. In 2019, more GHB was seized from the U.S., Canada, New Zealand, Australia, Sweden and China than in any other country. The drug is often combined with other drugs, including (most often) alcohol, cannabis, methamphetamines, cocaine, benzodiazepines and mephedrone. Combining these drugs can increase GHB effects but can also be much more dangerous and potentially lethal.
While this illicit drug often made appearances at the “rave” parties of the 1990s, now it turns up in more public venues, such as nightclubs. Additionally, those who frequent sex clubs or participate in sex parties or circuit parties often use the drug to enhance their experiences.
What Are the Street Names for GHB?
Like many illicit drugs, this one has several different street names. Some of the more common ones include:
- Easy Lay
- Georgia Home Boy
- Grievous Bodily Harm
- Liquid X
- Liquid Ecstasy
You may also hear it referred to simply as the date-rape drug.
What Does It Look Like?
GHB comes in capsules, white tablets and white powders. However, it is more commonly produced as a clear liquid. Its solid forms closely resemble many other drugs and medications, making it challenging to identify.
In its liquid form, it is easily mixed into drinks, including alcohol. The lack of color makes it nearly impossible to detect, especially in flavored drinks. Liquid ecstasy is often served as a “swig” without mixing it into another substance. The clear liquid is easy to hide in water bottles or smaller containers designed for other purposes.
How Does GHB Smell and Taste?
The drug is odorless, but it isn’t tasteless. If you consume it on its own, you will notice a mild, salty flavor. The flavor is mild enough that it is hard to detect when mixed with a flavored drink.
What Are the Effects of GHB?
Gamma hydroxybutyrate produces a wide range of effects, from mild to acute toxicity and death. Though the affects you may experience are dose-dependent, it doesn’t take a large dose to have a severe reaction. The difference between a dose that produces a mild and pleasant response to one that puts you in the hospital can be slight.
Many people take GHB for the euphoria it produces. The drug can also make users feel more relaxed and less anxious. Users also experience a loss of inhibitions, which reduces the ability to make good decisions or detect threats to personal safety.
The primary physical effect users seek is a heightened libido. The increased feeling of sensuality and the reduced inhibitions are the reasons the drug is popular at sex clubs and parties. They also aid in sexual assault crimes as it is easier for the perpetrator to take advantage of the victim, especially when other mental faculties are also impaired.
Short-Term Side Effects
GHB often produces unwelcome but temporary side effects. Memory loss is one of the most significant and dangerous. Sexual assault victims may not recall anything of the incident or the individual who committed the crime. It also perpetuates continued recreational use, as many people don’t remember the adverse effects of the drug when they occur.
The drug frequently makes users feel drowsy. Gamma hydroxybutyric acid can also create confusion and induce hallucinations. Though G is a depressant, some users turn more excitable and aggressive when on the drug. Physical short-term side effects include:
- Nausea and vomiting
- Speech impairment
- Reduced pain reactions
- Rapid side-to-side eye movements
- Profuse sweating
GHB inhibits muscle coordination, making driving dangerous. Getting behind the wheel when using this drug dramatically increases the risk of serious car accidents. When the drug is combined with alcohol, impairments are more severe.
Severe Side Effects
Ingesting too much of this drug can have serious consequences. Even a single, small dose can land you in the hospital and is potentially fatal. Symptoms of toxicity and GHB poisoning include:
- Slowed heartbeat (bradycardia)
- Slowed respiration, which may decrease to fewer than 15-20 breaths/minute
- Lowered body temperature
- Loss of consciousness
Fatalities are generally associated with respiratory depression and asphyxiation. Users who lose their gag reflexes may also aspirate if they vomit. If you notice any of the above behaviors in someone, it is essential that you contact 911.
How Do You Know If Someone Is Using GHB?
It isn’t always easy to spot the signs of GHB use. Milder reactions can mimic alcohol or marijuana use. This drug is often slipped into someone’s drink in environments where alcohol and other drugs are in use.
Gamma hydroxybutyrate absorbs into the system quickly. One way to identify use is a relatively rapid behavior change. If you notice a friend or loved one exhibiting any side effects, or if the individual complains of suddenly feeling sick, overheated or dizzy, they may have ingested GHB.
Signs of Addiction
Gamma hydroxybutyric acid is not recognized as a drug with an associated use disorder in the DSM-5, but the drug has a high potential for addiction. Those who begin as recreational users can quickly become physically and psychologically dependent on the drug. People dependent on the drug develop a tolerance for it, requiring higher and higher doses to produce effects.
People who are addicted to GHB usually find that they need to use the drug multiple times a day, with heavy users ingesting it as often as once every few hours. Recreational use can become addicted within a year of taking the drug for the first time. Though not everyone experiences addiction in the same way, common signs include:
- Increasing tolerance
- Withdrawal symptoms
- Increased financial instability
- Lying, cheating, stealing
- Changes in social, work and family activities and relationships
- Justifying use or defensive about habits
- Changes in sleeping patterns
- Extreme mood swings
A person with an addiction disorder usually keeps a stash of the preferred substance on hand and grows distressed when it’s gone. If you suspect that you or someone you love is addicted to GHB, ask questions about lifestyle, mood, consumption habits and circumstances surrounding use.
Other Associated Issues
As with other addiction disorders, GHB dependence is associated with myriad issues. Addictions often result in difficulty performing and maintaining a job or declining educational performance. Addiction also puts a great deal of strain on relationships and many people become increasingly isolated.
Gamma hydroxybutyrate dependence frequently results in severe sleep disturbances, which can impair physical health and harm emotional well-being. People who have a GHB addiction are also more inclined to engage in sexually risky behavior and are at an increased risk of sexually transmitted diseases, including HIV.
Signs of Withdrawal
Heavy GHB users are more likely to experience severe withdrawal symptoms. Though some symptoms are similar to alcohol addiction withdrawal, onset is much more rapid, often occurring within hours of the last dose.
Getting help with recovery is imperative, as symptoms appear suddenly and can quickly become life-threatening. Symptoms of withdrawal include:
- Severe anxiety
- Sleep disturbances and insomnia
- Auditory and visual hallucinations
More severe withdrawal symptoms may require hospitalization or intensive care to prevent a fatality. Serious, physical symptoms usually diminish within the first two weeks, but the emotional, mental and sleep issues may last much longer.
Potential for Relapse
As with any addiction disorder, the potential for relapse with GHB dependence is high, with a 70% chance after moving through the withdrawal stage. The elevated risk increases the importance of receiving professional, holistic, personalized addiction treatment.
How Much Is Too Much?
Though the misconception persists that taking small amounts of GHB is safe, it’s impossible to know how much is too much. With drugs produced illegally, there are no established guidelines for potency, concentration or quality. You never really know how pure the product is, and every batch can vary in strength. Doses of 1-5 grams are typical, generally equating to one or two teaspoons. However, even this amount may produce adverse and acute side effects.
Body weight is a significant factor in determining how much of the drug a person can take before they experience serious side effects. Consuming 20 mg/kg generally produces milder effects, while bumping the dose up to 50 mg/kg results in more pronounced effects and side effects. At doses higher than 60 mg/kg, users are at an increased risk of convulsions, coma and respiratory depression.
Treatment for Overdose
Gamma hydroxybutyrate poisoning is potentially life-threatening. No known antidote is effective in reversing toxicity. However, treatment is still necessary. Often, those who overdose on GHB combined with another substance — especially alcohol — frequently require prolonged hospital stays and intensive care treatment.
Treatment usually consists of supportive care for symptoms and close observation. When overdose results in severely impaired breathing, the patient may be intubated to assist with breathing. With proper care, most people who overdose recover within hours of ingestion after the drug exits the body.
Risk for Overdose
Overdose is strongly associated with recreational GHB use. It is also more likely when the drug is paired with alcohol or other illicit drugs. Males have higher overdose rates than females. A survey of regular users in Australia found that 35% of them overdosed within the previous year.
Though fatalities from GHB toxicity are relatively rare, they do occur. Furthermore, rates are likely higher than reported, as detecting the drug’s presence after death is difficult. Fatalities may result from pulmonary edema — fluid accumulation in the lungs — aspiration on vomit, asphyxia and cardiorespiratory depression.
How Long Does GHB Last in Your System?
It generally takes around 15 minutes to a half an hour to notice the effects of GHB, and the drug peaks within approximately 40 minutes to an hour. The effects can last between three and six hours, but the drug stays in your system for up to 12 hours.
Your body metabolizes GHB relatively quickly. How fast it exits your body depends on factors such as metabolism, weight and body composition, and how much you have to eat and drink. It also depends on how much of the drug you ingest.
Testing for the Drug
If you ever suspect someone has given you this drug without your knowledge, it is best to get tested immediately. You may feel the effects for as much as six hours, during which time you will likely not know you’ve been drugged.
After the effects wear off, you have a small window of time to determine whether you were given GHB. To get tested, go to the nearest hospital and tell them you suspect you were given the date rape drug and that you would like a urine test to check for it.
If you suspect someone you know has been given GHB without that person’s knowledge, it’s also essential to get the victim to the hospital quickly for testing. If you believe a friend or loved one has overdosed, getting help right away is crucial, even if you have also consumed the drug. Though there is no antidote, an overdose requires medical supervision and care.
Are There Any Legal Substances Similar to GHB?
Legal substances analogous to gamma hydroxybutyrate exist and are often used in place of the illicit drug. Gamma butyrolactone is closely related to GHB and converts to the compound after ingestion. Another legal compound is 1,4-butanediol.
Both substances are sold as solvents to create pesticides, polyurethane, elastic fibers, pharmaceuticals and other legal products. They are also sold illicitly as weight-loss and bodybuilding aids and supplements to support hair growth, treat depression and drug addiction, and combat aging.
Where Can You Get Help for GHB?
If you or someone you love needs help recovering from GHB addiction, Clean Recovery Centers’ focus on holistic, person-centered treatment provides the necessary support to overcome addiction. We provide a path to recovery that helps people get clean and stay clean by recognizing what is right about each individual, not what’s wrong. Get in touch with us today to find out how we can help.