GHB Addiction, Abuse, Detox and Treatment
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.
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.
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).
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)
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.
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
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!!
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.
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.