GHB Addiction, Abuse, Detox and Treatment

GHB Addiction, Abuse, Detox and Treatment drug rehabilitation and alcohol rehabilitation

Gamma-Hydroxybutyrate (GHB) is a sedative and classified as a central nervous system depressant. The drug is known to occur naturally in the body and may have a role in inducing sleep. GHB is a controlled drug in the USA and is classified as a schedule I controlled substance.


Gamma Hydroxybutyrate (GHB) is an illicit chemical that has become a major cause of drug-related comas in the US. GHB is fast becoming the most common cause of illicit drug induced coma. The drug traffickers also claim that the drug is an antidepressant, can help reduce weight and has anabolic properties - none of which is substantiated by scientific data.


The drug was initially used in anesthesia but because it’s severe toxicity and unreliable clinical affects, the drug is no longer used. However, the drug was highly touted as an anabolic steroid and thus is frequently sold at gyms and exercise parlors. In fact, the majority of abusers claim that it is the anabolic properties which first led them to use the drug. To date, there is no scientific data to suggest that the drug has any body building properties.


Most individuals who abuse GHB are also abusers of other drugs like valium and alcohol. The drug has also been widely used as a date rape drug.


History

GHB was first manufactured in Europe and was planned to be used as an intravenous anesthetic and for use in narcolepsy. However, clinical studies soon revealed that the drug had major side effects and its results were highly unpredictable.


For the past two decades the drug has been used for illicit purposes. Over the years, the drug was classified as a club drug and is widely available at parties, raves, bar and night clubs. It’s most recent fame has come from its use as a date rape drug. Restrictions on its manufacture and availability have allowed proliferation of GHB-look-alike drugs which proliferate all over America.


Analogs of GHB

In recent years, various States have passed legislation to control the sale of GHB, thus making it a criminal offence to possess the drug. This forced limitation in the supply of GHB has resulted in a proliferation of related chemicals, like Gamma Butyrolactone (GBL) and 1, 4-butanediol (BD). These chemicals are converted to GHB in the body. They are widely available at gyms, parties and night clubs across the nation.


Users of GHB

The most frequent users of GHB are college students and young teenagers. A majority of users attend dance clubs, parties, or rave parties. Recent data indicate that body builders, exotic dancers, strippers and some professional athletes are also frequent users of this drug. Recent seizures indicate that professional business men also consume the drug for sleep. In addition, the gay and lesbian population also uses GHB on an increasing basis.


Dosing

GHB is available as a liquid, powder, tablet and or capsule. It is colorless, odorless and has a salty taste. It is generally swallowed as a pill. The physiological effects of GHB occur within a few minutes after taking it by mouth. The duration of GHB’s actions usually last between six to eight hours.


Street Names

GHB has the street names Georgia Home Boy, Liquid Ecstasy (though it is not the liquid form of ecstasy), Easy Lay, Gamma-Oh, Salty Water and Scoop.


Side Effects of GHB

In low doses GHB is a CNS depressant and has similar effects like alcohol. It can induce a sense of calm, relieve anxiety and cause generalized relaxation. When combined with alcohol and other CNS depressants, it can cause severe lethargy, mental confusion, coma and even breathing difficulties


Other adverse effects of GHB use include:

  • Lightheadedness
  • Vomiting
  • Weakness
  • Loss of peripheral vision
  • Agitation
  • Hallucinations
  • Unconsciousness and coma

 


GHB OVERDOSE

Overdose can and does occur in individuals who consume GHB. At high doses and especially in combination with alcohol, respiratory depression and coma can occur rapidly. A number of deaths have been reported from GHB overdose.


Tolerance and Dependence

Even short term use of GHB is associated with the development of dependence. When GHB is abruptly stopped, the individual may develop:

  • Profuse sweating
  • Anxiety attacks
  • Blood pressure increases
  • Fast heart rate


These symptoms persist for a few days and in many cases require a benzodiazepine for relief. The symptoms may subside on their own after two or three days or in response to medication. Unlike other club drugs, GHB withdrawal symptoms also occur on a delayed basis or second phase symptoms. In the delayed phase of withdrawal the individual may have extreme mental clouding, anxiety, confusion and paranoia. The second phase of withdrawal usually lasts another 2-4 days and may require drug treatment.


GHB DETOXIFICATION PROTOCOLS

Treatment of the GHB withdrawal syndrome is empirical and no standard protocols have yet been devised. However, most treatment centers have utilized benzodiazepines, anti-seizure medications and sedative to help with the detoxification/withdrawal symptoms. In addition, it is highly recommended that medications to control the blood pressure be available because of the extreme levels of BP that can occur. Most individual studies indicate that detoxification is a lot safer with the use of antipsychotic medications.


It is also recommended that GHB detoxification be done as an inpatient, so that the individual can be carefully monitored. Most detoxification programs ensure that the individual is slowly tapered of GHB to help reduce the symptoms of withdrawal during detoxification. A number of fatalities have occurred when GHB has been abruptly stopped because GHB withdrawal symptoms may be severe and unpredictable. The help of an addiction specialist is highly recommended during the detoxification procedure. The detoxification program usually takes 10-14 days.


Post Detoxification Treatment

GHB withdrawal is comparatively new to the medical field. Withdrawal is often hazardous and even life threatening. Seeking medical attention from an experienced physician is highly recommended. Even after detoxification, multiple relapses are common in the majority of GHB addiction cases. Sleeping difficulties, depression and anxiety usually require some form of medical therapy. Work with a multidisciplinary group is essential to prevent relapses.

Topic Discussion

  1. Addict

    i had in my practice very good results in treating patients with GHB addiction with combination of seroquel and gabapentine and valium it was surprisingly effective i would like to hear from other doctors about there experience.

  2. Addict

    You are bang on with the withdrawals! My buddy now has to take clonazapan everyday so he can sleep and be clear minded. He is a mess! I've seen crack and meth addicts with less problems then this guy! He was taking between 40-60 mg a day for a year (5mg is considered a normal dose).

  3. Addict

    I work as a nurse in Holland and currently we treat GHB withdrawal first with frequent regular doses of Rivotril and Gabapentine before sleep. Usually patients who then develop a delirium will be given Zyrem ("GHB").

    As a nurse I am very dissatisfied with the drug regimes used here in Holland as the patients are usually going for days without sleeping and spending too much time in a delirium.

    I definitely believe that an anti-psychotic also needs to be used and perhaps more sedation to induce sleep. Even with the regimes that we use patients are experiencing prolonged high pulse rates.

    Personally I believe that they are attempting to detox the patient too quickly and are also under-dosing with the zyrem (average 1500mg every 2 to 3 hours)

    Would be very interested to hear from others.

    Mark Bennett
    Registered Nurse (Addiction and Psychiatry)

    • Addict

      Mark, I am trying to help a friend in Holland. He is at a critical stage. The hospital will not help him detox. He said his heart has stopped 7 times in7 days. I am in US. It is Sunday and everything is closed. It is urgent.

  4. Addict

    Hi guys,
    I have detoxed several times at home and twice in hospital. I have just finished my 2nd hospital detox which was BY FAR the best treatment by a mile. All the other detox's before were starting dose of 10mg Valium ten times a day along with 40mg for first 3 days, then reduced over 10-14 days.of which I still had severe withdrawals (extreme anxiety, insomnia, sweats, tremors, hallucinations psychosis) but this last time they gave me Chlordiazepoxide 220mg pd for first 4 days then tapered down over 14 days along with IV Vit B Complex 4x daily for first 5 days, 40mg Baclofen (also tapered) Thiamine and multivitamins. This is the same treatment they give to severe alcoholics for withdrawals. Apart from a bit of insomnia, slight shakes and anxiety and the odd hallucination I sailed through it and for the first time in my life feel I can cope without the wretched drug I first started taking 4 years ago. Zinc and magnesium supplements also help and a spoonful of baking soda in a glass of water a day along with a first generation antihistamine. If you can't get help from professionals I recommend trying to obtain diazepam (Valium) and baclofen or progablin along with everything else I mentioned and detox at home under supervision of a friend. And be strong enough to taper everything over 8-14 days depending on how addicted you are. UK readers can call clubdrugclinic.com for help who can email you a letter to take to your a and e to be taken seriously. I'm now more or less over the physical addiction but start 3 months in rehab next week for mental addiction but am more then happy to answer any questions and would like to hear any stories. When I leave rehab I would like to create awareness and some sort of ambassador for the severe harm GBL/GHB creates as I wouldn't wish what I've been through for the last 3 years on my worst enemy. Good luck to all of you who are trying to get clean.

    Michael
    michaelmorrisson@hotmail.com

  5. Addict

    You need 3 things for the detox: Valium (high dose), baclofen (high dose) and depakine.
    But the worst part is after the detox, the anxiety and depressions are the worst. So many relapses
    Good luck to everyone!!

  6. Addict

    Treating a GHB detox with Xyrem (GHB) is not going to detox them at all since Xyrem IS just GHB. That's putting them back on the drug itself. Weaning off of GHB seldom works for anyone. We see the most suicides when that is attempted at home alone. Project GHB works with this around the world and have the detox protocols that work. we also have a Power Point presentation for promoting awareness about GHB withdrawal syndrome and what it takes to beat it.

  7. Addict

    By the way, this site has more accurate info re GHB withdrawal than most that I see. I'm glad to see it!!! We've worked hard for years to get this info out that about how prolonged and severe the withdrawal can be. I've never heard of one that actually resolved in three days, even with medication, but good that this site discusses the second phase and potential for 10-14 days.

  8. Addict

    I used to use GHB almost every weekend when I was younger. I figured it was harmless . I thought,

    "What could happen? Right?"

    Luckily, I wasn't harmed by it, but several friends had to go to the emergency room and others started not to associate with me anymore. It really ended up being a bad experience in the end!

    Great article.

  9. Addict

    My son of 37 yrs. old is addicted to GHB and I had to put him in the hospital he was talking to people that weren't there, having full conversations listening to them laughing at their jokes, him making jokes with them, some gibberish and such, picking things out of space and eating whatever that wasn’t there, a full mental case. He is now sedated on Valiums for the next 4 - 5 days. This is his 1st time he has gone this far and I pray it's his last. He's very intelligent but that doesn't make him smart enough to know how to use this kind of substance. He has been telling me about it and saying how good it has been for him with a transition he has been going through in his life. I wasn't aware how addictive it is, how much he was using because of his tolerance level and how it is ruining his body. His heart is enlarged and has damaged his kidneys and they hope this will reverse itself and his organs heal themselves. His roommates called me to tell me he is acting crazy and he needs help. I'm reading this is just the 1st stage he is going to go through and it's going to get worse and his life is still in danger.
    He's broke and I work check to check like a lot others in these times so he falls in cracks where there is no help for him as an inpatient help which he needs badly. I talked to the social services at the hospital and I realized they can't help him. She said he doesn't have any money so she doesn't know any place that will take him to get the help he needs. I couldn't stop there so I called a friend who is a rehab counselor, so he is going to try to get him a scholarship at a real good hospital he used to work. My son will need to call the director of the hospital and ask if he can help him and then continue to call a couple times a day to prove he is serious before they will admit him. I believe he will want this help, he is smart enough to know when he is over his head and he is lucky to be alive right now. Thanks for this site I can understand what he is going through and how serious this really is. The next stages is going to be very difficult for him and not want to use this crap again to get him out of his trap he has set. With support from his friends and family he will be hopefully be fine. If there is any other advice anyone can give me so he will know what to expect in his next stages when he gets out of the hospital. I don't think they know what he is going through or know about GHB to know what to look for in his drug induct sleep. Right now his blood pressure is real great 102/43. So it could go way high all of a sudden? They believe he will be fine in a couple of days to be released. I don't think so myself. What I understand, it could take a couple of week before he will be coherent enough to take care of himself then they will release him but can't do so until he is on his own feet. Now what this mean to me might mean something different to them on how he takes care of himself but with friends he should be fine. I don't live where he does and it would be very difficult for me to be here when he is able to get out. I will probably come back just to make sure he is fine and willing to get help but the ball will be in his court, I can't do this for him, I would if I could.

  10. Addict

    I am a 4 day user about 7 caps a day. The past 3 weeks I continually go into the "G" hole.

    I live in South Florida, am a professional model and work in the medical field.

    I first take pure MDMA with the GHB. I am aware I HAVE A PROBLEM AND AM READY TO FIX IT.

    Any guidance would be great.

    Thank you

  11. Addict

    Detox without withdrawal symptoms:

    3 times 25mg baclofen/day and 3 times 150 mg Lyrica (pregabalin)/day

    No benzo's needed.

    ghb/gbl use can be stopped immediately.

    Lyrica can be tapered over weeks. Baclofen to be continued as in relapse prevention (Dr. Ameisen)
    (GHB/GBL is a gaba-b agonist, just like alcohol)

    • Addict

      Has anyone tested/tried out baclofen for GHB withdrawal? Can't find anything on its use on GHB (versus alcohol). Thanks!

  12. Addict

    Hi

    I'm on the bike at the gym while I write this. GHB became a real problem when I had serious stress issues at work. I been using it for about 1 year day to day with a few days off. I can't relate to withdrawal symptoms but I sometimes lack energy and motivation. What is used to improve mental drive and motivation? I'm not depressed I pray a lot but rather I lack motivation and am bored and also sometimes lack drive. Any help would be great. Peace and love.

  13. Addict

    Hello,

    I have been spending time with someone I care very much about lately and have witnessed her "G ing" out a number of times. It is frightening and I am unsure what I can do to help her. I have discovered her with seizure like symptoms after hearing her fall or bang into furniture. She blames her episodes on mixing G with other substances e.g Cocaine and claims that the benefits she obtains from G or "George" as she calls it far exceeds her existence without it. I lam visiting Ottawa, Canada temporarily and hope and pray someone can give me advice on what I need to do to help her. Thanks.

  14. Addict

    I have been prescribed Xyrem for several years now for my treatment of Narcolepsy. There have been several times over the years that I have had to go without this medication due to insurance difficulties. I was unaware of how severe detox may be until reading some of the comments. It worries me as to what might happen if I ever stop taking this medication.

  15. Addict

    My 31 year old brother has had many GHB episodes...I like to call them. He has done everything from running around in the neighborhood talking to himself to banging doors and hitting himself. He passes out and goes into coma like states. It's so bad that he passed out on the freeway in his car, luckily he didn't hurt anyone. The firefighters had to break his window to get him out . He was over dosing on GHB and choked on his vomit, which went into his lungs. He is now in ICU on a ventilator. Its sickening to me that this drug has gotten him to this point. I pray this is the last "episode" we have. I really just want my brother back.

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