GHB Withdrawal and Treatment
Gamma-hydroxybutyrate (GHB), a commonly used club drug, is a central nervous system (CNS) depressant commonly used for its euphoric, sedating, and disinhibiting effects.1, 2, 3
Most GHB is categorized as a Schedule I controlled substance, which means that it has no accepted medical uses and has a high potential for misuse.2 However, a Schedule III formulation of the drug (sodium oxybate; trade name Xyrem) is used in the treatment of cataplexy or the excessive daytime sleepiness associated with narcolepsy.1, 2, 3
What is GHB?
GHB is often used in party settings for the euphoric and calming feelings it produces.2 Because it has strong sedative effects, this drug has been used to facilitate sexual assault by incapacitating unaware victims.1, 2, 3 It was historically used by bodybuilders who thought the substance would stimulate the release of growth hormone to help them increase muscle mass and reduce body fat.1, 5
Common Alternative Names for GHB include:2
- Grievous Bodily Harm
- Georgia Home Boy
- Liquid ecstasy
GHB is typically taken orally in a clear liquid form. It has a slightly salty taste and is often mixed with another liquid, such as juice or alcohol, to cover up the flavor.1, 2, 3
GHB may be used alone or mixed with other drugs, especially alcohol. Some people use it in combination with stimulants, marijuana, and hallucinogens, which can compound the dangers of misusing GHB alone.1, 2, 5
Can You Overdose on GHB?
When taken in excessive amounts, symptoms of GHB overdose can range from unconsciousness and slowed heart rate to seizures, coma, and death.2 Combined use with other drugs including alcohol can result in breathing difficulties.1 Since GHB comes in liquid form, it can be difficult to have an accurate measure of the amount of drug being ingested—leading to a higher likelihood of overdose. GHB overdose can be dangerous and frequently requires medical treatment.2
Following regular use, attempting to quit or decrease the use of GHB can result in several withdrawal symptoms.1 Because of the risk of overdose and the existence of a GHB withdrawal syndrome, people who compulsively use GHB and those who are attempting to quit should consider supervised detox and withdrawal to keep them safe during withdrawal and help prevent relapse.2 Individuals misusing GHB are advised to seek addiction treatment as continued GHB misuse can be fatal.2
Short-Term GHB Effects
In small amounts, GHB is produced naturally in the body as a metabolite of the inhibitory neurotransmitter GABA. Though the way GHB works isn’t entirely clear, the molecule itself may have some activity as a GABA-B receptor agonist.1, 5 When consumed as a drug, the intoxicating effects of GHB may be difficult to distinguish from those of other CNS depressants which may include:2, 3, 6
- Reduced anxiety
- Increased sociability
Although there are some people who see the intoxicating effects of GHB as desirable, it can be an extremely dangerous substance. The range between safe and toxic is very small and there is no antidote for GHB overdose.2 At high doses, GHB can result in a variety of hazardous side effects, including:1, 2
- Memory loss
- Visual hallucinations
- Nausea and vomiting
- Reduced body temperature
- Slowed heart rate
- Respiratory depression
- Decreased muscle tone
As with other CNS depressants like benzodiazepines, some people who use GHB may be at risk of a paradoxical reaction characterized by aggressive or excited behavior.2 Their actions may be unpredictable and, with impaired judgment and coordination, can increase their risk of injury due to accident or assault.6
Is GHB Addictive?
Yes, illicit GHB is a Schedule I substance, which means it has a high potential for misuse. However, FDA-approved GHB products are Schedule III substances, which means their potential for misuse is lower.2 Chronic GHB users can develop physical dependence and could experience the onset of withdrawal symptoms if they suddenly stop or reduce their use.1, 5
GHB Withdrawal Symptoms
GHB has a short duration of effects and is cleared from the body quickly.4, 10 Because of this, people may experience a relatively rapid onset of withdrawal—typically within a few hours after the last use of the drug.5 The acute GHB withdrawal syndrome may include signs and symptoms such as:1, 2, 8
- Increased heart rate (tachycardia)
- Increased blood pressure (hypertension)
Though somewhat rare, severe cases of withdrawal from GHB can be life-threatening if not appropriately managed.5 For this reason, detoxing under supervision is imperative, especially if you’ve used it regularly or in high doses.8
How Long Does GHB Withdrawal Last?
There is no set timeline for how long GHB withdrawal can last. Timelines and severity of withdrawal will vary depending on one’s age, the dose taken, the frequency of the doses, how long GHB was taken, concurrent substance use, and any co-occurring mental or physical health disorder. It’s important to discuss with one’s doctor the expected length of withdrawal and detox.
GHB Detox and Withdrawal Treatment
As part of a supervised detox program, medical professionals monitor withdrawal progress to ensure that significantly troublesome symptoms and any complications be managed appropriately. In many cases, GHB withdrawal is associated with few serious physical symptoms; however, in some cases, certain withdrawal effects may escalate and may even be fatal.2
Less severe withdrawal syndromes will typically involve supportive care; however, in addition to supportive care, more severe cases may require quick medical action to address potential complications like seizures and agitation.5, 8 In supervised detox programs, close monitoring of withdrawal symptoms allows medical and mental health professionals to ensure your safety. They will also be able to prescribe supportive medications when needed, such as sleep aids for insomnia and sedatives for severe anxiety and seizure management.3, 5
Do I Need GHB Detox?
GHB is a dangerous substance, and its chronic use can negatively impact your health and well-being. When it comes to compulsive use, simply quitting can be difficult and, due to the presence of potentially dangerous withdrawal symptoms, may not be advisable. To decide if a detox program is right for you, contact your medical doctor to discuss treatment options.
A medical professional can evaluate the details of your substance use history and establish addiction severity, level of physical dependence, and the likelihood of a severe and/or complicated withdrawal to guide their recommendations for the appropriate level of treatment.
Benefits of GHB Detox Programs
A supervised detox program can provide the necessary medical and emotional support someone needs when detoxing from GHB.9 For one thing, the support given by staff is invaluable in meeting the emotional needs of someone in detox. Counselors, nurses, and doctors can encourage and help a person to keep going with a detox from GHB—whereas alone, someone could easily become discouraged and relapse to relieve the withdrawal symptoms.9
Drug and alcohol detox can help remove needless suffering from the withdrawal process and minimize the potential risks of GHB withdrawal.
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Finding a GHB Addiction Treatment Program
After the detox period, people often transition into other treatment programs, which could run for varying amounts of time depending on the severity of the person’s addiction to GHB and/or other drugs.
Treatment programs often emphasize counseling and therapy, which may occur on a group and/or individual basis. Continued therapy and counseling work to help a person in recovery avoid relapse and continue to stay free of substances, such as GHB. People are taught skills and techniques to help:9
- Change maladaptive thinking and self-destructive behavioral patterns.
- Identify triggers for their substance abuse.
- Find ways to avoid relapse.
- Find and participate in healthy activities that promote sobriety.
- Build a supportive network to help maintain abstinence.
Inpatient Treatment for GHB Misuse
Inpatient settings vary with some locations being hospital-based and others more residential—an example of programs at one extreme being spa-like, luxury rehabs. Program specifics will vary, but the more expensive programs do tend to be more luxurious. However, regardless of whether a program offers private rooms and a variety of amenities or a more standard environment, all programs will have trained staff who work closely with the patients to help them through the process of achieving and maintaining sobriety from drugs such as GHB.
Outpatient Treatment for GHB Misuse
Some people seek recovery help from outpatient substance abuse programs. Outpatient programs range from a few hours a week to several hours per day, up to seven days per week.
Depending on the level of intensity, some outpatient treatment programs may utilize a similar range of therapeutic approaches to their inpatient treatment counterparts, including group and individual counseling and access to medical and mental health services, when needed. However, a person in outpatient treatment will continue to have the ability to return home at night and possibly also continue in their job or in school while going through treatment.
The course of either inpatient or outpatient substance recovery will vary greatly, depending on the needs of the individual, including how severe their addiction to GHB is, if they are using other drugs, and if they have co-occurring mental health disorders.