GHB (gamma-hydroxybutyrate) is a central nervous system depressant that causes euphoria and sedation, and it has been used to commit sexual assault. Its biggest danger is overdose: GHB can slow breathing and the heart, cause unconsciousness, coma and death, and there is no antidote. Mixing it with alcohol makes it even more dangerous.
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GHB is a depressant that slows down the brain and body. Very small amounts occur naturally in the brain as a byproduct of GABA, a chemical messenger. The GHB sold illegally is made in clandestine labs. It is usually sold as a white powder or a clear liquid. In liquid form it is colorless and has a slightly salty taste.
Street names include G, liquid ecstasy, liquid X, liquid G, Georgia home boy and grievous bodily harm. GHB misuse became popular in the 1990s in dance clubs and at raves, and the drug became notorious for its use as a “date rape” drug.
Two related chemicals, gamma-butyrolactone (GBL) and 1,4-butanediol (BD), are sold in place of GHB. Once swallowed, the body turns them into GHB, so they carry the same risks.
The approved medical form
In 2002, the FDA approved Xyrem (sodium oxybate), a prescription form of GHB, to reduce cataplexy (sudden muscle weakness) and improve daytime sleepiness in people with narcolepsy. It is distributed through a central pharmacy under tight limits. GHB is not approved in the United States as a treatment for alcohol or opioid withdrawal.
If you think a drink was spiked
If someone suddenly becomes very drowsy, confused or unable to stay awake after a drink, especially after only a small amount of alcohol, don’t leave them alone. Call 911 if they are hard to wake or breathing slowly.
How GHB Affects the Body and Brain
The DEA describes GHB as producing depressant effects similar to barbiturates and methaqualone, and the effects grow stronger as the amount increases. People misuse it for its euphoric and sedative effects. Lower amounts can cause drowsiness, nausea and visual distortion. Higher amounts can lead to unconsciousness and dangerously slow breathing.
Because illegally made GHB, GBL and BD vary in strength, it is hard to judge how strong a given liquid is. The gap between the effect someone wants and a life-threatening overdose can be small.
Short- and Long-Term Risks
- Overdose. GHB can cause unconsciousness, seizures and severely slowed breathing, and there is no antidote.
- Dangerous combinations. Alcohol intensifies GHB’s effects. Other depressants, opioids and ketamine add to the danger.
- Sexual assault. Heavy sedation can leave a person unable to protect themselves.
- Addiction and withdrawal. Sustained use can lead to addiction, and stopping after regular use can cause a withdrawal syndrome that needs medical care.
Overdose: Signs and What to Do
A GHB overdose can cause:
- Unconsciousness or being unable to wake up
- Seizures
- A slowed heart rate
- Severely slowed or shallow breathing
- Low body temperature
- Nausea and vomiting
- Coma and death
If you see these signs:
- Call 911 right away. There is no antidote for GHB, so emergency medical care is essential.
- Stay with the person and follow the dispatcher’s instructions.
- Tell responders what was taken, including alcohol or any other drugs.
- Give naloxone (Narcan) if opioids may also be involved. Naloxone reverses opioid overdoses. It does not reverse GHB, so it is never a reason to delay calling 911.
Why Mixing GHB with Alcohol and Other Drugs Is So Dangerous
The DEA warns that alcohol intensifies GHB’s effects and that the combination causes respiratory depression, meaning dangerously slow breathing, and may lead to coma. Both drugs slow the brain and body, so together they add up. NIDA reports that among health problems linked to ketamine, the most serious involved mixing it with other drugs, especially opioids or GHB. Combining GHB with sedatives, opioids or ketamine raises the risk further.
Is GHB Addictive? Dependence and Withdrawal
Yes. According to the DEA, sustained use of GHB products can lead to addiction. People who use it regularly can develop tolerance, needing more to get the same effect, and can go into withdrawal when they stop.
The DEA describes GHB withdrawal as including:
- Insomnia
- Anxiety
- Tremors
- A racing heart and high blood pressure
- Occasional psychotic thoughts
Because withdrawal can become severe, a person who has been using GHB regularly should not try to stop on their own at home. Talk with a doctor first. Medical detox in Florida monitors heart rate, blood pressure and other vital signs, and medical staff treat symptoms as they come up.
GHB and the Law
Under the federal Controlled Substances Act, GHB is a Schedule I controlled substance. Xyrem, the prescription form, is in Schedule III, but trafficking Xyrem still carries Schedule I penalties. GBL and 1,4-butanediol may be treated as controlled substance analogues when they are intended for people to consume.
Florida law lists GHB, GBL and 1,4-butanediol in Schedule I. FDA-approved drug products that contain GHB are listed in Schedule III (Florida Statutes s. 893.03). Possessing or selling GHB outside a valid prescription can lead to criminal charges.
Treatment for GHB Addiction in Florida
Treatment usually starts with medically supervised detox because of the risks of withdrawal. After detox, recovery continues with counseling and behavioral therapy to address the reasons behind use, cravings and triggers, plus care for any anxiety, depression or sleep problems.
Many people move from detox into inpatient or residential rehab in Florida, where they have round-the-clock support in the early weeks. Others step down to outpatient care once they are medically stable. You can search licensed Florida detox and treatment programs by county and level of care in our free rehab directory.
If you have been sexually assaulted, medical care matters now and later. Go to an emergency room or call 911. You can also ask a treatment program or your doctor about counseling for trauma alongside substance use care.
Choosing a Treatment Program in Florida
Not every program is the right fit for GHB addiction. When you call a program, it’s fine to ask direct questions before you commit. Useful questions include:
- Is the program licensed in Florida?
- Does the program offer medically supervised detox for GHB, or will it coordinate with one?
- Does it treat anxiety, sleep problems and trauma along with substance use?
- What levels of care does it offer, and how does it decide which one is right for me?
- Does it accept my insurance, and what will I owe out of pocket?
- What support does it offer after the program ends?
For a step-by-step checklist, read our guide on how to choose a rehab in Florida.
Getting Help Now
- SAMHSA National Helpline: 1-800-662-4357. Free, confidential treatment referrals, 24/7, in English and Spanish.
- Call or text 988 if you or someone you know is in crisis or thinking about suicide.
- Call 911 for a possible overdose, a possible spiked drink, or any medical emergency.
Sources
Frequently Asked Questions About GHB: Effects, Overdose Risks and Treatment for GHB Addiction
What is GHB?
GHB (gamma-hydroxybutyrate) is a central nervous system depressant that causes euphoria and sedation. It is usually sold as a white powder or a clear liquid that is colorless with a slightly salty taste, and it is swallowed mixed in a drink. Street names include G, liquid ecstasy and Georgia home boy. Related chemicals, GBL and 1,4-butanediol, turn into GHB in the body.
Can you overdose on GHB?
Yes, GHB overdose is a real danger, and there is no antidote. An overdose can cause unconsciousness, seizures, a slowed heart rate, severely slowed breathing, low body temperature, vomiting, coma and death. Because the strength of illicit GHB varies, the line between the intended effect and an overdose is hard to judge. If someone cannot be woken or is breathing slowly, call 911.
Is it dangerous to mix GHB with alcohol?
Yes, mixing GHB with alcohol is especially dangerous. Alcohol intensifies GHB's effects, and the DEA warns the combination causes respiratory depression and may lead to coma. Combining GHB with other sedatives, opioids or ketamine raises the risk further. If someone who has used GHB and alcohol is hard to wake or is breathing slowly, call 911 right away.
Is GHB addictive?
Yes, sustained GHB use can lead to addiction, according to the DEA. People who use it regularly can develop tolerance and need more to get the same effect, and they can go into withdrawal if they stop. Because withdrawal can be severe, a person who has been using GHB regularly should get medical advice before trying to quit.
What are GHB withdrawal symptoms, and how is it treated in Florida?
GHB withdrawal can cause insomnia, anxiety, tremors, a racing heart, high blood pressure and sometimes psychotic thoughts. Because it can become severe, it should be managed under medical supervision rather than at home. Florida has licensed medical detox programs that monitor vital signs and treat symptoms, followed by counseling. Learn what to expect from medical detox in Florida.
Is GHB legal in the US?
No, GHB is a Schedule I controlled substance under federal law and Florida law. The only legal form is a prescription medication, sodium oxybate (Xyrem), which the FDA approved for people with narcolepsy and is Schedule III with tightly limited distribution. Trafficking Xyrem still carries Schedule I penalties. GBL and 1,4-butanediol may also be treated as controlled substances when intended for human consumption.
