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GHB, or gamma-hydroxybutyric acid, is a central nervous system depressant drug that is synthesized illegally in laboratories and illicitly distributed in clear liquid or white powder form as a “club drug,” a “date rape drug,” and strength and muscle enhancer for bodybuilders. The Drug Enforcement Administration (DEA) classifies GHB as a Schedule I controlled substance, meaning that there are currently no accepted medical uses for it. The GHB-containing brand name Xyrem (which contains the generic form of GHB: sodium oxybate) is controlled as a Schedule III drug and can be prescribed to treat daytime sleepiness in people struggling with narcolepsy.
On the streets, GHB goes by a variety of names, such as:
GHB is usually swallowed and often sold by the capful, or as a “swig,” at nightclubs and parties. People may commonly mix it with alcohol or other drugs.
Young adults likely make up the largest demographic of people who abuse club drugs like GHB. The Monitoring the Future (MTF) survey published by the National Institute on Drug Abuse (NIDA) reports that just under 1 percent of high school seniors reported abusing GHB in 2016.
GHB may be abused both for its ability to make a person feel euphoric, or “high,” and for its sedative effects. It may then be used as a “party drug.” It can also increase sexual libido, make a person more passive and open to suggestion, and induce amnesia-like properties that make it a candidate for use as a date rape drug. The journal American Family Physician publishes that bodybuilders may abuse GHB for its supposed ability to break down fat, increase muscle formation, and enhance strength.
GHB may be abused for a variety of reasons; however, it is an illegal and potentially dangerous substance with many possible side effects.
GHB is actually a chemical that is found in the body naturally in small amounts, and it acts as a depressant substance. Illicit GHB, when ingested in small amounts, can cause drowsiness, nausea, and psychoactive effects like visual distortions or hallucinations and euphoria. GHB slows heart rate and respiration; lower blood pressure and body temperature; increases suggestibility and passivity; and can cause memory loss and confusion. It can also make a person become excited and potentially more aggressive.
Large amounts of GHB can result in a possible overdose, which can cause slowed heart rate, difficulties breathing, low body temperature, loss of consciousness, nausea and vomiting, seizures, psychotic thoughts, coma, or even death. There is no known reversal for a GHB overdose.
The DEA warns that there were over 500 mentions of GHB in the 2010 American Association of Poison Control Centers report and close to 2,000 visits to emergency departments (EDs) for the abuse of GHB in 2010, according to the Drug Abuse Warning Network (DAWN) report. When GHB is combined with alcohol or other central nervous system depressant substances, the risk for a potentially fatal overdose increases.
Aside from overdose, GHB abuse can have many short-term and long-term consequences. It impairs a person’s ability to think clearly and make good judgment calls and decisions, which can lead to increased risk-taking behaviors. Accidents, injuries, and unsafe sexual encounters may be the result of GHB abuse. Unsafe sex raises the risk for an unwanted pregnancy or contracting a sexually transmitted or infectious disease. GHB may be unknowingly slipped into a person’s drink, which can lead to a possible sexual assault or rape.
GHB typically starts working within a half-hour to an hour of taking it, and its effects can last as long as 3-6 hours. It may be addictive, and people taking it regularly for a period of time may then suffer from GHB-related withdrawal symptoms when the drug wears off.
Addiction is a brain disease that interferes with a person’s emotional and physical health, impacts behaviors, and has many potential social consequences. Someone battling addiction may perform poorly at work or school, and miss days due to drug-related health concerns. A decline in work production and grades is common.
GHB is a sedative drug so someone abusing it likely has irregular sleeping and waking patterns. They will also experience significant mood swings and potentially even a shift in personality altogether. Someone under the influence of a drug like GHB may be irrational, engage in behaviors that they normally wouldn’t, including those that may be physically hazardous, and they may become aggressive, hostile, and overly excited. Unpredictable and erratic behaviors may be signs of problematic GHB abuse.
Financial strain and possibly criminal actions may be the result of attempting to obtain GHB. A person may become more secretive and spend a lot of time figuring out how to get GHB, using it, and then recovering from the drug. They may stop enjoying or participating in activities or events that they previously liked and were important to them. Relationship and social problems will likely crop up, and isolation is common.
Someone who battles addiction may try to stop taking GHB and be unable to do so even after trying several times. They may continue to take the drug even though they know it will have many negative social, emotional, and physical health consequences.
A person struggling with addiction often ends up taking more of the drug at a time than they meant to and will also keep using it longer than they intended to. When someone takes GHB on a regular basis, the brain may begin to adapt to its presence and tolerate certain amounts of the drug. This means that a person will then need to take a higher dose in order to get high next time. Escalating dosage can lead a person to become physically dependent on GHB, and the brain may not be able to balance itself as easily without the drug. When this happens, the “crash” experienced after GHB wears off can be significant and withdrawal symptoms set in.
NIDA reports that addiction is a brain disease since it actually makes changes to the brain itself – to its chemical makeup and circuitry. Brain function is altered with chronic GHB exposure, and the consequences can be far-reaching. Fortunately, addiction is also a treatable disease. GHB addiction and withdrawal are optimally managed through a comprehensive addiction treatment program that often begins with medical detox.
Withdrawal is the set of side effects that occur when a person is dependent on a drug and it processes out of the body. Detox is the process of allowing the toxins to be purged from the body.
NIDA warns that GHB withdrawal can include the following symptoms:
GHB withdrawal typically sets in when the drug is no longer active in the bloodstream, so in about 6-12 hours after the last dose. Withdrawal symptoms start off slow with mood disturbances, sleep difficulties, and some physical discomfort. Within the first day or two, symptoms peak, and individuals may be significantly uncomfortable, both physically and mentally. Drug cravings may be intense as well.
After about two or three days, withdrawal side effects will begin to lessen in severity. Emotional disturbances and sleep difficulties can continue for a week or more.
While there is no specific medication to help with GHB addiction and withdrawal, a medical detox program can still be beneficial. Medical detox programs typically last 3-5 days, and during this time, a person remains in a secure and safe environment where vital signs can be closely monitored and managed. Medications can help with certain withdrawal symptoms, such as mood stabilizers to treat depression and anxiety. Benzodiazepines, central nervous system depressant drugs, are often helpful with GHB withdrawal, as they can interact on similar regions and chemicals in the brain to keep withdrawal symptoms and cravings to a minimum. These medications can then be slowly tapered off.
Treatment for GHB abuse and addiction often begins with a detox program that is then followed with either an outpatient or residential addiction treatment program. Since GHB is often combined with other drugs when abused, treatment options may need to be more comprehensive to minimize the potential for complications.
Addiction and mental health concerns often are complexly intertwined. The Substance Abuse and Mental Health Services Administration(SAMHSA) reports that almost 8 million American adults struggled with both addiction and mental illness in 2014. When co-occurring disorders are present, comprehensive integrated treatment models are imperative. Many factors can contribute to addiction, including both biological and environmental issues, and oftentimes, a residential treatment program can provide the safest and most structured environment to allow a person the time and space to heal and move forward in recovery.
Outpatient programs can be flexible with a person’s existing schedule and obligations. When drug dependence is not as significant, and home life is supportive and stable, this may be an option for GHB addiction treatment.
Both residential and outpatient drug abuse and addiction programs may use a combination of pharmaceutical and therapeutic techniques. Behavioral therapies and counseling sessions can delve into self-destructive thoughts and actions and help a person to create new and healthy habits and life skills. Potential triggers are identified during group and individual sessions, and people are given the tools to minimize relapse and manage stress safely. Family therapy and counseling can educate everyone involved, improve communication skills, and ensure that all members are on the same page with treatment and recovery.