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GHB
Australian Drug Foundation © 2005
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This information has been adapted from the pamphlet How Drugs Affect You: GHB, produced by the Australian Drug Foundation. For single copies of this pamphlet phone 1300 85 85 84 or email mailto:druginfo@adf.org.au(Victoria only). Multiple copies are available from the ADF Bookshop.
What is GHB?
Gamma hydroxybutyrate (GHB) is a depressant drug. Depressants slow down the activity of the brain and other parts of the central nervous system. Alcohol, heroin and benzodiazepines are drugs that also have depressant effects.
GHB occurs naturally in the brain. It was first manufactured and studied in the 1960s, and has been used in several countries as a general anaesthetic. GHB was withdrawn from use in most countries—including Australia—because of unwanted side effects.
Street names
Fantasy, grievous bodily harm (GBH), liquid ecstasy, liquid E, liquid X, salty water, Georgia Home Boy, soap, scoop, organic Quaalude, cherry meth, blue nitro.
What does it look like?
GHB commonly comes as a bitter or salty-tasting liquid, usually sold in small bottles or vials, such as soy sauce containers. At one time it was most commonly available as a bright blue liquid (sometimes called "blue nitro"), but it now comes in a variety of colours, as manufacturers and dealers often add food colourings to distinguish it from other liquids. It is occasionally sold as a crystal powder.
How is it used?
GHB is generally swallowed, although a small number of people have been reported as injecting or "shelving" it (inserting into anus). GHB has been trialled as a treatment for alcohol and opiate (for example, heroin) withdrawal, and sleep disorders such as narcolepsy.
GHB has been marketed as a dietary supplement for body builders. It is claimed that GHB can increase the release of human growth hormone by prolonging slow-wave sleep, the stage of sleep when the highest amount of growth hormone is released. There is no evidence to support this theory. GHB has been known to be used to facilitate sexual assault. Due to its appearance, GHB is easy to slip into a drink and it can cause drowsiness, sleep and short-term memory loss. This means that victims may not be able to resist or recall a sexual assault.
Some people take GHB for its ability to increase relaxation, sociability and disinhibition. Others may take it to help with the symptoms of the "comedown" after using stimulants, such as amphetamines and ecstasy.
Effects of GHB
The effects of GHB appear to vary greatly according to the amount used—a small increase in amount can result in a dramatic increase in effect. One of the most dangerous aspects of using GHB is the small difference between an amount that produces the desired effect and the amount that results in overdose. A further risk is that there is often no way to be sure that the drug is manufactured correctly. Improperly made GHB may result in an extremely toxic mixture of GHB and the chemical sodium hydroxide.
Immediate effects
Generally, the effects of GHB are experienced within 15 minutes of use, and last for approximately 3 hours. Effects of a low to moderate dose may include:
- feelings of euphoria
- increased libido
- lowered inhibitions
- memory lapses
- drowsiness
- sleep
- dizziness and headache
- tremor
- decreased body temperature, blood pressure and heart rate
- nausea
- diarrhoea
- urinary incontinence.
Overdose
Using GHB carries a high risk of overdose, due to the small difference between the amount required to produce a "high" and that which causes overdose. Not knowing the strength of GHB increases the risk of overdose.
High doses of GHB can result in:
- dizziness
- vomiting
- tremors
- tunnel vision
- loss of coordination (ataxia)
- confusion, irritation and agitation
- hallucinations
- blackouts and memory lapses
- seizures
- coma
- respiratory arrest (stop breathing) and death.
Signs of overdose
- Person appears to be asleep but cannot be woken.
- Person is incoherent, sweating profusely, vomiting and has irregular or shallow breathing.
- Person is not able to stand and/or has involuntary muscle contractions.
Long-term effects
The long-term effects of GHB are difficult to identify due to a lack of research in this area but it is possible to become physically and psychologically dependent on it.
Tolerance and dependence
There is evidence that GHB is highly addictive. People who use GHB regularly can develop a tolerance and dependence very quickly. Dependence on GHB can be psychological, physical or both.
People who are psychologically dependent on GHB find that using the drug becomes far more important than other activities in their life. They crave the drug and will find it very difficult to stop using it. Physical dependence occurs when a person's body adapts to GHB and gets used to functioning with the GHB present. People who are physically dependent on GHB usually develop tolerance to the drug, making it necessary to take more and more GHB to get the same effect.
Withdrawal
If a physically dependent person stops taking GHB, they may experience withdrawal symptoms because their body has to readjust to functioning without GHB.
Withdrawal symptoms usually start about 12 hours after the last dose and can continue for about 15 days.
Some of the withdrawal symptoms that may be experienced include:
- confusion, agitation, anxiety, panic, feelings of doom
- paranoia
- insomnia
- tremor
- muscle cramps
- perspiration
- delirium
- hallucinations
- tachycardia (rapid heartbeat).
Sudden withdrawal from high doses may also result in bowel and bladder incontinence and blackouts, and may require medical assistance.
Treatment options
In Australia, there are a number of drug treatment options. Some aim solely for a person to achieve a drug-free lifestyle, while others recognise abstinence as one option in an overall aim of reducing harm and risks related to a person's drug use. Treatment is more effective if tailored to suit a person's circumstances, and usually involves a combination of methods. Some of the different options include counselling, group therapy, medication (pharmacotherapy) and supervised/home withdrawal.
More on treatment.
Pregnancy and breastfeeding
Little is known about the effects of GHB on the unborn child. As is the case with many other drugs and medication, it is not recommended that people use GHB while pregnant or breastfeeding.
Many drugs can cross the placenta and therefore have some effects on the unborn child. In general, drug use during pregnancy can increase the incidence of premature labour, resulting in low birth-weight babies.
If a mother continues to use GHB while breastfeeding, it is possible that the drug will be present in her milk and may have adverse effects on the baby.
Check with your doctor or other health professional if you are taking or planning to take any substances during pregnancy, including prescribed and over-the-counter medications.
More on alcohol, other drugs and pregnancy
Reducing the risks
Australian drug policy is based on harm minimisation. The aim is to reduce drug-related harm to both the community and individuals who use drugs. Harm-minimisation strategies range from encouraging "non-use" through to providing the means for people who use drugs to use them with reduced risk.
If someone overdoses or has an adverse reaction while using GHB, it is very important that they receive professional help as soon as possible. A quick response can save their life.
More information