Gamma-hydroxybutyrate (GHB) is a depressant drug that slows down messages between the brain and the central nervous system. At low doses it acts as a sedative, and at higher doses it acts likes an anaesthetic.
GHB is usually a clear odourless liquid, though dealers and manufacturers often add coloured food dye to differentiate the drug from other liquids. It is often sold in small bottles or vials, and tastes salty or bitter. The liquid is usually mixed into a drink and taken orally.
GHB was first used in 1960 as an anaesthetic before surgery, and as a treatment for narcolepsy (uncontrolled periods of deep sleep). It was also trialled as an aid to relieve alcohol and opiate withdrawal.
GHB is now more commonly used recreationally, with some people using it instead of alcohol. It is well known as a date rape drug because large doses can be easily mixed with drinks, and its anaesthetic properties impair the memory of the victim.
Slang
Grievous Bodily Harm, Fantasy, Liquid Ecstasy, GBH, Liquid E, G-riffic, Goop, Liquid G, Sodium Oxybate, Date Rape Drug, Blue Nitro.
Short-term effects
The effects of GHB vary each time it is taken and it affects each person differently. Within 15 minutes of taking it, the user usually experiences feelings of euphoria and relaxation. Immediate effects may last up to three hours depending on how much was taken. Other effects include:
An increase in dosage can significantly alter the short-term effects. Feelings of euphoria are replaced by sedative effects which can last up to 48 hours. If the user takes GHB regularly, this period may be followed by withdrawal symptoms. Effects of higher doses include:
There can be considerable variation in the purity and strength of GHB doses, and there is a very small difference between taking enough to achieve the desired effect and an overdose.
Hospitalisations have been reported after heavy use of GHB, with some cases resulting in death. Vomiting is common with overdoses and can result in the user choking. It is important to know that the effects of GHB are significantly heightened, and the likelihood of overdose increases when it is combined with other drugs, especially alcohol or other depressants.
GHB can increase libido and reduce inhibitions, increasing the risk of users engaging in unsafe sex. This increases risk of spreading diseases such as hepatitis B, HIV/AIDS or other sexually transmitted infections. It also increases the risk of unplanned pregnancies.
Long-term effects
To date there has been little research into long-term effects of GHB on a user's health and social environment.
Dependence and addiction
GHB can become both physically and psychologically addictive. Regular users say they often feel like they need a little GHB to feel normal.
If people suddenly stop using GHB, symptoms of withdrawal will occur including anxiety, inability to sleep and irregular heartbeat. Many heavy users say they were able to taper off their use to zero by reducing their intake slowly over a two week period.
Withdrawal effects may include hallucinations, insomnia, anxiety, tremors, sweating, edginess, chest pains and tightness, muscle and bone aches, sensitivity to sounds and colours and mental blocks. These side effects will last between two and 21 days depending on usage. Some people might experience bowel or bladder incontinence and blackouts. Anyone experiencing these symptoms should seek medical assistance.
Overdose
GHB has a very steep dose-response curve, meaning that there is only a small difference between the amount required to provide the desired effect and an overdose. Also, the same dose may affect different people in different ways.
Once users overindulge in GHB the effects act as a sleep aid and there is the potential for vomiting, blocked airways, and severe respiratory depression.
See our How to get help section for advice on dealing with an overdose.
In 2000 GHB was easily available in New Zealand. On 1 April 2000 the media reported the first GHB fatality in New Zealand, and this was followed by numerous admissions to hospital of people with severe respiratory depression and coma after taking it. GHB and its related substances were scheduled as a Class B drug in May 2002 under the Misuse of Drugs Act 1975.
Penalties include:
According to the latest Drug Use in New Zealand Survey 2007/2008 published in 2009:
The Drug Foundation’s message is clear: no drug use is the safest drug use. However, we know there will be occasions when people ignore warnings and use drugs in a dangerous manner. To help keep communities safe we therefore provide information about proven methods of drug harm reduction.
Because it is difficult to judge the concentration of GHB there can be a very fine line between the amount required to achieve the desired effect and the amount which leads to overdose and coma.
Extreme care should be taken with GHB, and use avoided if there is any doubt or uncertainty.
GHB should not be combined with other drugs, especially alcohol and other depressants. Combining it with other drugs intensifies its effects and increases risk of respiratory collapse and vomiting. If vomiting or convulsions occur immediate medial attention must be given and emergency staff must be promptly informed of what the user has taken. See our How to get help section for more information on managing an overdose or bad reaction to GHB.
The Expert Advisory Committee on Drugs has produced key messages for GHB users:
GHB should be kept in a container that cannot be mistaken for a drinking container or water bottle. People have been known to colour their GHB with blue food colouring (hence the term ‘blue nitro’) to distinguish it from water. It is also recommended that those using GHB write ˜G" or ˜GHB" on their hand so that if trouble occurs, others including medical staff will be aware it has been taken.
If you feel you or anyone you know needs help, there are a number of treatment organisations you can contact in strict confidence.
DrugHelp is a uniquely New Zealand website for people looking for help with their own or someone else’s drug use. DrugHelp shares the stories, experiences, insight and hope of people who have been there – people who have abused drugs and found a way through. www.drughelp.org.nz
The Alcohol Drug Helpline (0800 787 797) provides free and confidential support for any person concerned about their own or another person's alcohol or drug use. When you call you will talk to an experienced counsellor who is there to listen. You can trust the helpline to provide you with confidential and non-judgemental help when you need it.
The helpline is open from 10am–10pm, every day.
What to do in a crisis
If someone overdoses, becomes unwell, or has a bad reaction to GHB or any other drug, do not hesitate to get emergency medical assistance. A quick response could save their life:
GHB (and its related substances) can be used as a date rape drug because large doses can be easily mixed with liquids including water. GHB by itself has a soapy or salty taste but when mixed with a drink it can be very difficult for a victim to detect by sight or smell.
High doses of GHB can induce a sleep like coma where the victim is in an unconscious state and very vulnerable to sexual assault.
The extent to which GHB is used as a date rape drug in New Zealand is unknown, largely due to the short life of the drug in the body and routine toxicology tests often do not detect GHB and related compounds.
If you suspect you have had your drink spiked, or have been sexually assaulted while under the influence of a date rape drug, you should report it to the Police as soon as you are able.
A list of relevant links to further information and resources about GHB:
www.moh.govt.nz/moh.nsf/indexmh/drug-use-in-nz-key-results-of-the-0708-nzadus: Drug Use in New Zealand: Key results of the 2007/08 New Zealand Alcohol and Drug Use Survey.
www.ndp.govt.nz/moh.nsf/indexcm/ndp-publications-eacdfantasy The Expert Advisory Committee on Drugs advice on Gamma-Hydroxybutyric acid and related substances (fantasy), 2001.
www.emedicine.medscape.com/article/820531-overview The Emergency Medicine website’s toxicology/overview of Gamma Hydroxybutyrate.
www.druginfo.adf.org.au/druginfo/drugs/drugfacts/ghbfantasy.html The Australian Drug Foundation’s Drug Info Clearinghouse GHB factsheet.
www.drughelp.org.nz Uniquely New Zealand Website that helps people who use drugs, and their loved ones, find solutions to the problems drug use has caused.