GHB: Gamma Hydroxy Butyrate
Gamma Hydroxy Butyrate (GHB) is a naturally occurring component of human cells. It was first synthesized in the lab in the 1960s by a French chemist looking for a sleep aid. It has been used in the treatment of sleep disorders, anxiety, fibromyalgia, narcolepsy, lack of libido, and as an aid to childbirth. GHB is commonly used as recreational intoxicant like alcohol, as a sleep aid, or as a nutritional supplement. It generally comes as a salt or powder, which is then mixed with water for recreational use. This mixture is colorless and odorless, though it has a distinct salty taste.
Most users find that GHB induces a pleasant state of relaxation and tranquillity. Frequent effects are placidity, sensuality, mild euphoria, and sociability. Anxieties and inhibitions tend to dissolve into a feeling of emotional warmth, well-being, and pleasant drowsiness. The “morning after” effects of GHB generally lack the unpleasant or debilitating characteristics associated with alcohol and other relaxation-oriented drugs. In fact, many users report feeling particularly refreshed even energized, the next day. However, there are some users who’ve reported feeling:
- Mentally fuzzy
The effects of GHB can generally be felt within five to twenty minutes after ingestion. They usually last no
more than one and a half to three hours.
The effects of GHB are very dose-dependent. Small increases in the amount ingested lead to significant intensification of the effect. Higher levels feature greater giddiness, silliness, and interference with mobility and verbal coherence. Even higher doses usually induce sleep.
Some people choose to sip it slowly over an evening, rather than drinking a full dose all at once. The duration is longer when the period of ingestion is stretched out over time.
DOSAGE: It’s Tricky Business
GHB has a narrow dose range; meaning that there is a fine line that is hard to recognize and easy to cross when dosing G, so while you may take enough G to give you a euphoric buzz, only slightly more could make you nauseous or induce sleep. GHB is most frequently found in liquid form of widely variable concentration. This makes it hard to measure out an accurate dose for your body size, which means it is easier to accidentally overdose. Be cautious when measuring! It is unwise to gage your dose by eyesight, or think “I’ll just pour a little of this, a little of that”. GHB isn’t like most other drugs and “the more you take the better you feel” idea does not apply. If you dose too much, you’ll fall into an unrousable sleep, and possibly depress your breathing and heart rate to dangerous levels. To minimize your risk of inaccurately dosing, MEASURE IT OUT!
Eating before dosing (or not)
The potency of GHB and how soon it takes effect is strongly influenced by the amount of food in your stomach at the time you ingest it. If you’re used to taking a certain dose of GHB on an empty stomach and then you take that same dose with food in your stomach, the effects may be less than what you’re expecting, or it may have a more gradual onset. If you’re used to taking a dose with food in your stomach and then you take that same dose on an empty stomach, the effect can be stronger and the onset more rapid.
How it Works
GHB works on the Dopamine System, preventing the release of dopamine at the synapse while simultaneously causing the neurons to produce more dopamine. When the GHB wears off, a Dopamine Rebound occurs. This is essentially the flush of accumulated levels of dopamine being released in the nervous system. This effect could account for the middle-of-the-night awakenings common with use of higher GHB doses, and the general feelings of increased well-being, alertness and arousal the next day.
GHB affects the Serotonin system as well, and by increasing the body’s level of serotonin, it creates feelings of wellbeing and euphoria. These effects are not as significant in the body as the Dopaminergic effects.
GHB is not known to be toxic to the body or the brain. Within a few hours, GHB is metabolized into Oxygen (O2) and Carbon Dioxide (CO2), and can then be excreted through respiration, urine and sweat. Unlike most other drugs, GHB is not a foreign substance – your body recognizes it and uses it–and it does not need to be detoxified through the body systems. As such, it does not harm the liver or kidneys, and is not known to be neurotoxic.
Some people enjoy the effects of GHB enough that they find themselves using it more frequently than they intended to or are comfortable with. Using GHB every weekend can turn into a few times a week or every night and can, for some people, turn into several times a day. If you’re using GHB daily or multiple times a day for periods of weeks of months you may have some difficulty stopping.
GHB can occupy a similar place to other addictive/habituating drugs in that it is used to reduce anxiety, manage stress, decrease social anxiety, etc. For some people, it is difficult to let go of using in this way. Physical withdrawal symptoms appear in some people who stop using GHB after more than a few consecutive days of repeated use. Rather than stopping cold turkey, some users find it more comfortable to gradually taper off dosages over the course of 2-3 weeks.
Withdrawal symptoms can include:
- Difficulty sleeping
- Chest pains and tightness
- Muscle and bone aches
- Sensitivity to external stimuli (sound, light, touch)
These symptoms seem to last between a few days and 2-3 weeks as the body comes back into balance.
GHB and Sex
GHB can enhance orgasm, help to sustain erections, and can have disinhibiting effects. As a result, sex sessions may be more rigorous or prolonged. It is easier to get rips and tears to the skin tissues in and around your genitals, which are not always detectable with the eyes. This can create routes of transmission for viruses like hepatitis or HIV. Stay equipped with condoms and extra lube!
Consider too that the amount of GHB needed for sexual enhancement is much less than what might be used in a party setting or as a sleep aid. If you’re going to use, start with a low dose!
Mixing GHB with Other Substances
GHB use can be dangerous when used improperly or when mixed with other drugs. Combining GHB with alcohol, opiates, benzodiazepines, and antipsychotics can be lead to an overdose, even at lower doses. There have been deaths attributed to GHB use in Toronto. Mixing downers with other downers slows your heart and respiratory rates, sometimes to dangerous levels. At the overdose level, you may experience extreme grogginess (nodding in and out of consciousness) or unconsciousness, extreme dizziness and disorientation, and vomiting. During “higher” overdoses (these are actually considered to be “poisonings”-too much GHB in the bloodstream) can cause unconsciousness, convulsions, vomiting, and potentially depressed breathing. Consider not using GHB if you have a slow heartbeat, high blood pressure, and heart problems, or seizures. You are more likely to experience complications with your GHB use.
Detecting G in your Drink
While GHB is most often used as a recreational drug, it unfortunately is sometimes accidentally consumed or intentionally slipped into another person’s drink or water bottle. While in a club or party setting, avoid putting drinks down to go dance or use the washroom. It only takes a second to slip something into a drink and it can be hard to know where the drink was left and who was around it, in a crowded place. Usually the drugs slipped to someone are colorless and almost tasteless. GHB has a SALTY taste so if a drink tastes strange or unusually salty, toss it! Drinks may be expensive, but it’s not worth the risk of getting messed up on substances unplanned for, especially when harm can be done.
If GHB is dissolved in water, be mindful and respectful – store the G in container that could never be mistaken for drinking water, or colour the mixture BLUE using food colouring, so as to avoid it being mistaken for water, juice or alcohol, and putting someone in an unpleasant, mixed up situation. Accidental ‘G’ Consumption is more common than ya’d think!
An overdose is what happens when you take more drugs than your body can handle. GHB overdoses can often be avoided by measuring doses more accurately, or by not mixing GHB with other drugs. Still, there are other variables that come with doing drugs that are often out of our hands, such as purity and potency issues. The questionable concentration of street GHB makes it much harder to find the correct dosage, and avoid over-dosing. For this reason, caution must be exercised when dosing, and users are advised to follow the number one rule when using GHB – START LOW!
Things to Look For
Someone who is overdosing may look very pale, be incoherent, unable to stand or sit up, have shortness of breath, vomit, be shaking or perhaps seizuring, their eyes may roll back into their head, or they may collapse and become unconscious.
Often times, someone who is overdosing on a few different substances will show a mix of overdose signs, which can confuse onlookers. For this reason, it is wise to listen to your intuition. If someone looks UNWELL, get the person some help. Waiting for the person to ‘just get over it’ or to ‘come around’ could mean the difference between life and death. Trying to counteract the overdose with more drugs will only lead to further complications and could be fatal. Seriously!
If someone is overdosing, act quickly. Get someone who is willing and able to call 911 or get paramedics on site. Be sure to have them report back to you and confirm that they’ve called.
- While someone gets help, keep the person as alert as possible
- Check to see if they can open their eyes or speak to you
- Squeeze their hand
- Talk to them
If they’ve passed out, check the person’s pulse and breathing. Can you feel their breath on your hand? Is their chest moving up and down? Lay the person in recovery position so they don’t choke on vomit. If you cant get him/her into recovery position, tilt the body forward instead of leaning it back so that the airway will be clear and fluid will come out of the mouth. Ask if anyone around knows CPR or rescue breathing, and have him/her GET TO IT.
You may need to barge through the crowd to find a payphone, a cell phone, or a security guard that will call for you. Security guards can often be found at entrance/exit sites to the party. If paramedics are hired onsite for the party, they can usually be found at the entrance to the party as well
When you call, be clear and concise. Tell the dispatcher that someone has stopped breathing. That’s enough to get the paramedics zippin’ through the streets. If you’re calling from a location that’s been the scene of prior OD’s, the dispatcher may know this. If the dispatcher asks if it’s an overdose situation, you can tell them that you think the person may have taken something but you aren’t sure what. This may reduce the chance of the cops getting involved. Give the dispatcher the location of where you are.
While you’re waiting, do rescue breathing if you know how. If for some reason you cant do rescue breathing, try to wake your friend up by shaking his/her shoulders or yelling his/her name, etc. If your friend wakes up, try to keep him/her alert by talking. It’s really important that s/he still get some medical attention. In many cases, the person who has overdosed can go out again after waking up.
When help arrives
If it’s just the paramedics: Give the paramedics as much info as possible: what you believe the person took and any medical conditions you may know about. Remember that the paramedics are NOT THE COPS and cannot bust you for using drugs or being high. Their job is to save lives!
If the cops come too: You have the option to tell the police everything you know about the incident. If you aren’t in a situation where you can do that (like if you have a warrant out for your arrest) you have the option to tell the police that you just arrived and don’t have much information as to what happened, “though it looks like this person may be overdosing”. You may want to pull the paramedics aside to inform them of what you believe the person took. Try not to be intimidated by the cops, and remember it’s better not to say anything than to lie to the cops. The key is to remain calm, not have any attitude, and be as polite as you can without getting yourself into trouble. In the end, if you save a life, it will be worth it.
A Last Word
In the past few years, a stigma has developed around GHB use. While many people use GHB with no problem, there have been reported cases of people who’ve miscalculated their dose or who’ve mixed GHB with other substances. Both can lead to an overdose. As a result, people in the scene have dubbed GHB as being a ‘dirty’ and ‘unsafe’ drug, and those who use GHB are being demonized for the type of high that they seek. No drug is 100% safe, especially when you’re grabbing it off of the street. The fact that people have overdosed on GHB at parties means that people need to be more informed around dosage and quality issues, so that they can take precaution and avoid messy situations. It doesn’t mean that we point fingers or play ‘good drug/bad drug’. Imposing our morals on others only creates tension and division, and as a marginalized group, tension and division are the last thing we need. It is important that we encompass drug use of all types, whether it’s injection or oral, every day or once in a blue moon, crystal meth or Coca-Cola. Each drug comes with its own unique risks, and we need to recognize that this is the case with GHB. GHB is a tricky drug to work with-it has variable potency and purity, and correct dosage is tough to achieve, especially if you’re dosing it in an environment that’s not well lit or you aren’t paying full attention to what you are doing. At TRIP, we believe that the harms associated with GHB use can be significantly reduced if users are more informed about the substance and are aware of the risks involved, this way people can make wise decisions and take precautions when using.