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GHB Detox Guide: Symptoms, Timeline, and Effects

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Club DrugsGamma-hydroxybutyrate (GHB), also known by street names such as ‘Grievous Bodily Harm,’ ‘Georgia Home Boy,’ ‘Soap,’ ‘X,’ and ‘Liquid Ecstasy’ is a commonly used club drug. GHB is a Schedule I controlled substance, which means that it has no accepted medical uses and has high potential for abuse.4 However, the FDA-approved analogue of GHB called oxybate (marketed as Xyrem) is a Schedule III drug with legitimate medical purposes.4 GHB is often abused in party settings for the pleasurable feeling it produces. Because it has strong sedative effects, this drug has been used by sexual predators at bars or parties to incapacitate rape victims. It was historically abused by bodybuilders who thought the substance would stimulate the release of growth hormone to help them increase muscle mass and reduce body fat.4,5

GHB is usually 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 taste.4

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 abusing the substance alone.4

Following regular use, attempting to quit or decrease use of GHB can result in a number of withdrawal symptoms 1. Individuals abusing this drug are advised to seek treatment for addiction, as continued abuse of GHB can be fatal. 

What are Immediate Effects of GHB?

GHB occurs naturally in the body as a metabolite of the inhibitory neurotransmitter GABA. However, as a drug, GHB functions as a CNS depressant, which means that it slows down brain activity. GHB produces the following short-term effects, which may last up to six hours:4

  • Drowsiness
  • Memory impairment
  • Euphoria
  • Confusion
  • Reduced anxiety

Although some of the effects may be desirable, GHB is an extremely dangerous substance. This is because the range between safe and toxic is very small and there is no antidote for GHB intoxication.5 At high doses, GHB can result in a variety of hazardous side effects, including:4,5

  • Nausea and vomiting.
  • Dizziness.
  • Visual hallucinations.
  • Seizures.
  • Decreased muscle tone.
  • Reduced body temperature.
  • Decreased heart and respiratory rate.
  • Unconsciousness.
  • Coma.

As with other sedatives, such as benzodiazepines, GHB users can experience a paradoxical reaction characterized by aggressive or excited behavior.4 Their actions may be unpredictable which could increase their risk of injury due to accident or assault.

The Hazards of Long-term Use & Abuse

The long-term use of GHB and its analogues is associated with serious negative consequences. These include:4

  • Liver damage.
  • Kidney failure.
  • Increased risk of “black outs.”
  • Higher risk of seizures.
  • Increased risk of death due to overdose.

Chronic GHB users can develop physical dependence, and could experience the onset of withdrawal symptoms with the abrupt cessation of or reduction in use.4 Further, if someone who is dependent on the drug continues to abuse it, they can develop an addiction. Once someone is addicted to GHB, a number negative consequences may result, such as:6

  • Failing to quit using the drug in spite of a persistent desire to stop.
  • Neglecting home, school, or work responsibilities in favor of GHB use.
  • Experiencing a strong desire to use GHB.
  • Neglecting hobbies or social activities.
  • Continuing to use GHB despite having a serious medical or psychological problem that is worsened or caused by using the drug.

These consequences of chronic GHB abuse can be prevented by entering a formal detox or addiction treatment program that can help you withdraw safely and comfortably.

Effects and Symptoms of  Withdrawal

GHB has a short duration of effects and is cleared from the body quickly. Because of this, users may experience a relatively rapid onset of withdrawal – often within 1-6 hours of the last use of the drug. GHB can lead to withdrawal symptoms such as 2, 3:

  • Trouble sleeping.
  • Sweating.
  • Increased heart rate (tachycardia).
  • Increased blood pressure (hypertension).
  • Tremors.
  • Anxiety.
  • Agitation.
  • Psychosis.
  • Severe delirium.
  • Seizures.

In rare and very severe cases, withdrawal from GHB can be life-threatening if not appropriately managed 3. For this reason, detoxing under supervision is imperative, especially if you’ve used it regularly or in high doses.

What is the Detox Timeline and Protocol for GHB?

In a supervised detox program, medical professionals are there to oversee the process of detox to ensure that any side effects can be managed appropriately. In many cases, GHB produces few serious physical symptoms; however, in some cases, symptoms can escalate and may even be fatal.

Less severe withdrawal syndromes will typically involve supportive care in combination with low doses of benzodiazepines; however, more severe cases may require not only higher doses of benzodiazepines but also quick medical action to address potential complications like tachycardia and seizures 3.

Do I Need a Detox Program?

Man trying to fall asleep
It can be difficult to know if you or a loved one is addicted to GHB. However, a strong craving for it, along with physical symptoms of withdrawal (such as anxiety, insomnia, and tremors) when trying to stop using GHB may indicate a substance dependence has formed. Continued use of it despite a deterioration in health or other adverse effects could signal the existence of an addiction, or substance use disorder.

As you continue abusing GHB, an increased risk of overdose is an ongoing concern, as is the possibility of neurological damage and debilitating psychological effects such as psychosis 3. If you’ve been abusing GHB, a number of physical and psychological symptoms may arise that will require management in the moment. A supervised detox program affords you the ability to quit GHB while ensuring that your needs will be taken care of and that you’ll remain safe as you clear the drug from your system.

How Does Supervised Detox Help?

A supervised detox program will provide the necessary medical and emotional support someone needs when detoxing from GHB

A supervised detox program will provide the necessary medical and emotional support someone needs when detoxing from GHB. For one thing, the support given by staff is invaluable in meeting the emotional needs of someone in detox. The 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.

A professionally supervised detoxification program will also facilitate the administration of medications to help manage sleep, control anxiety, and treat any other severe or troublesome symptoms that may arise.

Formal detox removes the element of needless suffering from — and minimizes the potential risks of — GHB withdrawal.

Finding a GHB Treatment Program

Detox often transitions into a longer treatment program that runs from a few days to a few weeks, depending on the severity of the patient’s addiction to GHB and/or other drugs. Treatment programs involve counseling and therapy, which may occur on a group and/or individual basis. Continued therapy and counseling work to help a person in recovery continue to stay free of substances, such as GHB. Patients are taught skills and techniques to help:

  • 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.

Some inpatient or residential programs are set up very much like a hospital, and others are more spa-like. 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 initiating and maintaining sobriety from drugs such as GHB.

After inpatient treatment (or as an alternative to inpatient care), some people seek ongoing 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.

Outpatient treatment programs typically utilize the same therapeutic services as inpatient treatment, including visits with physicians, nursing supervision, and personal counseling. 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 other mental health issues in addition to substance abuse.


References:

[1] National Institute on Drug Abuse. (2016). Commonly abused drugs: GHB.

[2] Drug Enforcement Administration. Drug Fact Sheet. GHB.

[3] Center for Substance Abuse Treatment. Detoxification and Substance Abuse Treatment. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2006. (Treatment Improvement Protocol (TIP) Series, No. 45.) 4 Physical Detoxification Services for Withdrawal From Specific Substances:.Club Drugs.

[4] Drug Enforcement Administration. (2017). Drugs of Abuse: A DEA Resource Guide. 60-61.

[5] Kapoor P, Deshmukh R, Kukreja I. (2013). GHB acid: A rage or reprieve. Journal of Advanced Pharmaceutical Technology & Research. 4(4):173-178.

[6] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

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