Symptoms of GHB Overdose & Effective Treatment Options

How GHB is Used

The drug GHB (gamma-hydroxybutyrate) occurs in two forms:

• Sodium oxybate or gamma-hydroxybutyrate sodium goes by the trade name Xyrem and is approved for the treatment of the sleep disorder narcolepsy. Xyrem is classified as a Schedule III controlled substance.
• GHB also refers to a synthetic and illicit version of the drug that is classified as a Schedule I controlled substance by the DEA. This article focuses on the issues associated with the illicit version of GHB.

How GHB Works

Colorless and odorless, the drug is often used to spike the drinks of women, knocking them out or making them unable to stop a sexual advance. Once ingested, it takes effect within 10 to 20 minutes and lasts up to four hours. The drug causes those who have ingested it to suffer a complete blackout, making it difficult to press charges against an aggressor. 

Some experts consider GHB more dangerous than other so-called date-rape drugs because it can be easily manufactured in home labs from readily available ingredients. The ingredients are frequently sold over the Internet to teens and young adults. The drug can be extremely dangerous, causing seizures, severe respiratory depression, and fatal comas. The U.S. Drug Enforcement Administration has documented 72 deaths relating to GHB and its derivatives.

GHB comes in a few forms including:

• A colorless, odorless, bitter, or salty-tasting liquid – sold in small bottles or vials
• A colored liquid
• Crystals or powder (this is less common).

Common Effects of GHB

Generally, the effects of GHB are felt within 15 minutes and last for around three hours. GHB effects vary greatly depending on the amount used. A small increase in amount can result in a dramatic increase in its effects. This is one of the most dangerous aspects of using GHB. There is a very small difference between the amount a person may take to produce the desired effect and the amount that results in GHB overdose.

In moderate amounts, GHB can produce feelings of:

High Dose Effects of GHB

High doses of GHB can result in: 

Can I Become Dependent on GHB?

Regular users of GHB can develop a tolerance to the drug very quickly. This means they need more of the drug to get the same effects. It is also possible to become dependent on GHB, which means people spend a lot of time thinking about the drug and trying to get it.

Can GHB Cause Long-term Problems?

Using GHB long-term can cause memory problems, heart disease, hallucinations, anxiety and breathing problems. Using GHB long-term can cause memory problems, heart disease, hallucinations, anxiety and breathing problems. Using GHB long-term can cause memory problems, heart disease, hallucinations, anxiety, and breathing problems.

Can You Overdose on GHB?

Yes. Overdosing on GHB is a common side effect because of the potency of the chemical and unpredictability between batches. Symptoms of liquid GHB overdose include confusion, hallucinations, seizures, and comatose unconsciousness. Severe GHB overdose results in respiratory distress.

Overdosing on GHB is very easy. There is a fine line between how much is needed to feel its euphoric effects and how much could send a person to the hospital. GHB is dangerous to overdose on because it is an efficient sedative that can cause the heart and breathing to stop.

Symptoms of GHB Overdose

The potential for GHB overdose is possible and can be heightened by a mixture of other drugs and/or alcohol.

Symptoms of GHB overdose may include:

Seek medical attention immediately if you believe you or someone you love may be experiencing a GHB overdose.

Signs of GHB Overdose

The risk of GHB overdose increases when this drug is combined with other drugs such as alcohol. Taking GHB with other depressant drugs is particularly dangerous. Combining GHB with alcohol can lead to nausea, vomiting, and unconsciousness, even at low-dose levels.

Signs of GHB overdose include that the person:

• Appears to be asleep but cannot be woken
• Is incoherent, sweating profusely, vomiting, and has irregular or shallow breathing
• Is not able to stand, has involuntary muscle contractions, or both. 

GHB that is not manufactured correctly may result in a highly toxic mixture of GHB and sodium hydroxide.

GHB Overdose Treatment

Can too much GHB kill you? The answer is yes, a person can die from a GHB overdose if their heart rate or breathing stops. However, the likelihood of a GHB death is low if the person can receive medical care soon after overdosing.

Blood drawn from patients admitted to emergency departments for a GHB overdose has found levels of the drug ranging from 29 to 490 mg/L, with several fatalities reported at levels of 400 or above. The International Association of Forensic Toxicologists estimates a level of 280 mg/L is sufficient to lead to death.

Emergency departments see many cases of GHB overdose that present virtually indistinguishably from other substance overdoses (e.g., generally a profoundly decreased level of consciousness and potential respiratory compromise).

As such, GHB overdose treatment will begin by maintaining the airway through a breathing tube, gaining IV access for fluid replacement, and other supportive measures. No antidote is available for GHB intoxication.

Pending blood toxicology reports to confirm the specific substance involved, other overdose treatments may be used, including:

• Activated charcoal to eliminate the drug and prevent further absorption.
• Ethanol drip (should patients be acidotic and methanol ingestion has yet to be ruled out).

In addition, withdrawal may complicate recovery following GHB overdose treatment. However, there are GHB treatments for withdrawal and its related symptoms which include benzodiazepines. Symptoms of GHB withdrawal can include insomnia, tremors, increased heart rate, and psychotic thoughts.

Treatment for a GHB Overdose and Addiction

How long does GHB stay in your system? GHB is quickly eliminated from the body. If a person receives medical care soon after overdosing, they are likely to regain consciousness and fully recover within 1.5 to 6 hours.

Since many people who experience symptoms of GHB overdose are abusing the drug or other substances, it is recommended that recovering users seek help at an addiction treatment program. A wide variety of options are available to help the person stop using drugs or alcohol and avoid serious side effects from substance abuse. Many GHB users respond well to residential rehab programs. 

If you are experiencing withdrawal GHB, it’s crucial to first get an accurate assessment of all the symptoms. When the symptoms have been evaluated by a mental health professional, it may be determined that another form of mental condition is present and needs a particular type of treatment. Very often, some combination of psychotherapy, medication, and/or lifestyle changes are effective for coping with functional. 

Medically-Assisted Detox

Detox is often considered the first stage of treatment. It will help you navigate the complicated process of GHB withdrawal, but it doesn’t address patterns of thought and behavior that contribute to drug use. Various treatment approaches and settings can help provide the ongoing support necessary to maintain long-term sobriety after you complete detox.

Cravings are very common during detox and can be challenging to overcome. This often leads to relapse. Constant medical care provided during inpatient treatment helps prevent relapse. Clinicians can provide necessary medication and medical expertise to lessen cravings and the effects of GHB withdrawals.

Psychotherapy 

Several different modalities of psychotherapy have been used in the treatment of mental health disorders along with addiction, including:

• Cognitive Behavioral Therapy (CBT) – is an effective treatment that involves making changes in both the patterns of negative thoughts and the behavioral routines which are affecting the daily life of the depressed person for various forms of depression.
• Dialectical Behavioral Therapy – is a comprehensive mental health and substance abuse treatment program whose ultimate goal is to aid patients in their efforts to build a life worth living. The main goal of DBT is to help a person develop what is referred to as a “clear mind.” 
• Person-Centered Therapy – is a strategy that allows and encourages clients to understand and resolve their concerns in a safe, supportive environment.
• Solution Focused Therapy – is an approach interested in solutions that can be quickly implemented with a simple first step leading to further positive consequences.

Dual Diagnosis Treatment

Drug abuse and mental health disorders often co-occur. In many cases, traumatic experiences can result in a mental health disorder and substance abuse. Dual diagnosis rehabilitation treats both of these issues together. The best approach for the treatment of dual diagnosis is an integrated system. In this strategy, both the substance abuse problem and the mental disorder are treated simultaneously. Regardless of which diagnosis (mental health or substance abuse problem) came first, long-term recovery will depend largely on the treatment for both disorders done by the same team or provider.