What Is Ghb And How Dangerous Is Its Abuse?
In This Article
GHB, or gamma-hydroxybutyrate, is a central nervous system (CNS) depressant with effects similar to alcohol and other drugs. It can produce feelings of euphoria and disinhibition, where you don't feel embarrassed by things you say or do while under the influence.
Unfortunately, GHB also carries many risks. The medication can cause significant toxicity if you don’t use it responsibly.
This blog post explores the side effects and dangers of GHB abuse. It also looks at the current treatments for short-term and long-term users of this dangerous substance.
What is GHB?
GHB (gamma hydroxybutyrate), often referred to as "liquid ecstasy," is a potent central nervous system (CNS) depressant drug. It occurs naturally in tiny quantities in the human brain as a neurotransmitter, a chemical that signals between brain cells.
GHB acts by slowing the activity of the central nervous system. It has a soothing effect, creating feelings of relaxation and euphoria. GHB also has an amnesia-like effect at higher doses, causing people to forget what happened under its influence.
GBL (gamma-butyrolactone) and 1,4 BD (1,4-butanediol) are two compounds that can be converted into GHB in the body and are sometimes associated with its use.
Is GHB Legal?
GHB is not an FDA-approved prescription drug in the U.S. It’s also a well-known “date rape” drug, so the Drug Enforcement Administration classifies GHB as a Schedule I controlled substance.
Its abuse potential and hazardous side effects have limited its prescription, making it legally accessible only through a restricted-use program. Although GHB is a controlled substance, it’s a widely available street drug nationwide. Illicit vendors also easily produce GHB.
Illicit sellers distribute GHB as a clear, colorless liquid or a white powder that easily dissolves in liquids. People who take the drug can feel its effects within 15 to 30 minutes. The duration of these effects ranges from 3 to 6 hours, depending on the dose and your physical characteristics.
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Is GHB Addictive?
Yes, GHB has a high abuse and addiction potential. It activates the CNS reward system, which can cause physical and mental GHB dependence.
Because of its abuse potential and addictive properties, GHB is a Schedule I controlled substance under the Controlled Substances Act in the U.S. This means that it has a high abuse potential and no medical uses.
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What are the Side Effects of GHB?
GHB occurs naturally in the brain, where it slows down brain activity, similar to an anesthetic. The side effects of GHB are related to these depressant effects:
- Euphoria
- Drowsiness
- Dizziness
- Confusion
- Sense of calm
- Severe memory problems
Other significant potential side effects of GHB include:
- Seizures
- Depression and suicidality
- Sleepwalking
- Nausea and vomiting
- Reduced appetite
- Blurred vision
- Amnesia
- Headache
- Agitation and aggression
- Dry mouth
- Loss of bladder control
When misused, GHB can suppress breathing as a CNS depressant, leading to loss of consciousness, coma, and death.
What are the Risks of GHB Abuse?
The most severe risk of GHB abuse is death. As a CNS depressant, GHB can cause respiratory suppression to the point where you stop breathing and die. This can occur even at relatively low doses.
GHB also poses the following risks:
- Overdose: GHB can cause respiratory suppression, leading to loss of consciousness, coma, and GHB-related deaths.
- Loss of inhibition and risky behaviors: This includes acts such as sexual promiscuity or other dangerous behaviors.
- Problematic behaviors: GHB can induce visual hallucinations, agitation, and aggression, causing users to act unpredictably.
- Increases effects of other CNS depressants: GHB affects other substances, such as alcohol or opioids. This can lead to sedation, impairment, and overdose.
- Addiction and withdrawal syndrome: Regular use of GHB can lead to dependence and withdrawal symptoms.
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Why Do Users Abuse GHB?
Despite its dangerous nickname, "grievous bodily harm," users are drawn to GHB for various reasons. These include:
- Fitness: They believe that GHB boosts muscle growth and exercise performance and reduces weight.
- Recreational: To experience its soothing effects, euphoria, and hallucinogenic properties.
- Sexual: People take GHB to increase libido, sexual pleasure, and suggestability and to reduce inhibitions and shyness. GHB is clear, colorless, and easy to slip into a drink. It's also difficult to detect in the body unless tested within four hours of administration.
- Self-Medication: Some people use GHB to treat anxiety, depression, or insomnia.
What Are GHB Addiction Symptoms?
Addiction to GHB primarily involves using the drug without a prescription despite experiencing obvious negative consequences. You may also find it difficult to cease drug use despite having a strong desire to do so.
The symptoms of GHB addiction can manifest through physical, mental, behavioral, and social behavior.
Physical Signs
Physical symptoms include developing tolerance and GHB withdrawal signs, which include:
- Insomnia
- Shaking
- Rapid heart rate
- High blood pressure
- Seizures
Mental Signs
Mental symptoms of GHB addiction include:
- Obsessive or invasive thoughts about using the drug
- Using the drug to deal with stress or mental illness symptoms
- Mental illness symptoms from drug use, especially depression or anxiety
Behavioral Signs
Behavioral symptoms of GHB addiction include:
- Taking the drug when your doctor hasn’t prescribed it, or taking more than the ideal dose
- Secrecy and solitude
- Denial, lying, and concealing drug use
- Use of other addictive substances
- Neglecting responsibilities and usual life activities due to drug use
- Participating in dangerous behaviors
Social Signs
Social symptoms of GHB addiction include:
- Legal problems due to drug use
- Relationship/marital difficulties
- Financial difficulties due to reduced income from employment difficulties and the expense of obtaining the drug
What Drugs Interact with GHB?
Drugs that interact with GHB include:
- Alcohol: It has a synergistic, or additive, effect when you combine it with GHB. This means the effects are greater than the sum of their individual effects and lead to increased risks for respiratory suppression and overdose.
- Opioids: Almost all opioids have an additive CNS depressant effect when you take them simultaneously with GHB, increasing the risk of overdose, respiratory depression, and death.
- Amphetamines: Stimulants can counteract the sedative effects of GHB, leading to severe body strain, respiratory arrest, and seizure risk.
- Antidepressants: By taking GHB with antidepressants, you can increase the risk of serotonin syndrome, a life-threatening condition.
- Other CNS depressants: Combining sedatives or hypnotics like benzodiazepines and GHB can lead to body strain, respiratory suppression, coma, and death.
Avoid using GHB with other drugs, and never use it without consulting your doctor. Doing so can lead to dangerous consequences.
What are GHB Addiction Treatment Options?
Recovery from substance addiction requires more than simply not using the drug. Overcoming physical and mental dependence on the drug's powerful effects requires intensive treatment, or the relapse rate can be very high.
Treatment for GHB addiction can involve pharmacological measures to help with the physical dependence and withdrawal symptoms and behavioral therapies. They help with the mental dysfunction that can be both a cause and effect of drug abuse.
Detoxification
Detoxification is an important first step for treating GHB addiction and involves managing the physical withdrawal symptoms. It usually requires supervised care in a medical setting, as severe withdrawal symptoms can occur.
Behavioral Therapy
Behavioral therapy, which addresses the root of most addiction problems, is a significant component of treating substance abuse disorders. It helps to identify underlying causes of addiction and correct distorted beliefs and thinking patterns that lead to drug-seeking behaviors.
Common forms of behavioral therapy include:
- Cognitive Behavioral Therapy (CBT)
- Motivational Interviewing (MI)
- Contingency Management (CM)
Each uses a different approach, but they aim to identify the motivations for using GHB, teach positive coping skills, and provide social support.
Support Groups
These groups provide a safe space to share experiences with people who relate to similar situations. They also provide educational resources on the science of addiction and how to manage cravings and prevent relapse.
Support groups can also play an important role in recovering from drug addiction, especially when combined with other forms of treatment. Examples include 12-step programs like Narcotics Anonymous (NA) and Smart Recovery.
Other available support forms include family therapy, peer mentoring, faith-based programs, sober living homes, and outpatient care.
Summary
GHB is a powerful central nervous system (CNS) depressant that produces sedative-like effects. However, it poses a high potential for abuse.
Long-term GHB use can cause users to experience withdrawal symptoms, physical dependence, and addiction. It's especially dangerous when combined with other drugs like alcohol or opioids, leading to respiratory suppression, coma, and even death.
If you or someone you know has a GHB addiction, seek help from a medical professional. Treatment options are available to help you overcome physical and mental dependence on the drug.
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- Busardò, F.P., and Jones, A.W. “GHB Pharmacology and Toxicology: Acute Intoxication, Concentrations in Blood and Urine in Forensic Cases and Treatment of the Withdrawal Syndrome.” Current Neuropharmacology, 2015.
- “Drugs of Abuse.” Drug Enforcement Administration, 2017.
- “Drug Scheduling.” Drug Enforcement Administration.
- “Highlights of Prescribing Information: Xyrem.” U.S. Food and Drug Administration, 2018.
- Kamal et al. “The Neurobiological Mechanisms of Gamma-Hydroxybutyrate Dependence and Withdrawal and Their Clinical Relevance: A Review.” Neuropsychobiology, 2016.
- “Comorbidity: Substance Use and Other Mental Disorders” National Institute on Drug Abuse, 2018.

