GHB harm minimisation
It's important to remember that there is no totally safe way to use any drug. This fact sheet outlines some of the risks involved and how to reduce these risks if you do make the decision to try GHB.
Stuff to keep in mind
There are many factors which may influence the effects that GHB can have on you. The effects are different for every person and can differ each time you take it. Outlined below are some tips and things to keep in mind to reduce associated risks if you choose to use GHB.
Dose, strenth and purity
Generally, the more of the drug you take, the higher the dose and the more intense the effects of the drug will be. One of the most dangerous aspects of using GHB is the small difference between an amount that produces the desired effect and the amount that results in overdose. To be on the safe side, always take GHB in very small doses.
When you buy GHB, it may not actually be GHB but related chemicals called 1,4B (1,4-Butanediol) or GBL (gamma-Butyrolactone). 1,4B and GBL needs to be converted in the body to GHB and this takes time. This time for conversion means the effects are not felt immediately. The effects are FURTHER delayed if you drink alcohol. To be on the safe side, wait at least 60 - 90 minutess after your first dose of GHB.
Even experienced users are at a very high risk of overdose due to the unknown concentration of liquid GHB . As with most drugs, it’s usually impossibly to know if GHB is manufactured correctly. Improperly-made GHB may result in an extremely toxic mixture of GHB and the chemical sodium hydroxide.
Using GHB with other drugs
Other depressants: Avoid using GHB with other depressants. Taking GHB with other depressants such as alcohol, valium, cannabis or heroin greatly increases risk to a user because of the extra strain on the body.
Mixing GHB and alcohol is particularly risky because it not only increases your risk of overdose but also might delay the onset of the overdose.
Stimulants: If GHB is mixed with a stimulant such as amphetamines, ecstasy, cocaine, or ice the effects of the stimulant drug , will usually mask the effects of GHB. This means that the effects of the GHB drug may not be felt. Mixing depressants and stimulants also puts a lot of extra strain on the body and can lead to overdose.
Prescribed medication: Using GHB with any sedatives, including benzodiazepines (such as Valium, Xanax, Serepax, Mogadon), anti-psychotics (such as Seroquel), some anti-depressants (such as Luvox), some anxiety medication and older tricyclics, will make you feel a lot more drowsy compared to if you had twice the amount of just GHB. Using sedatives and GHB may also make you collapse, pass out or die from your brain's control of breathing stopping. Paradoxically, you might enter a high energy state - as if you were much more affected in terms of disinhibition without being as sleepy - and you might be violent or do violent things without having any memory of what you've done.
If you are planning to take any illicit substance or alcohol while you are going to be on medication that is about to be prescribed to you, talk with your doctor. Unless they have immediate concerns for your safety it will remain confidential. Each drug is different and interactions can be unpredictable and very dangerous. This is especially so if you’re on any highly specialised drugs (e.g. for heart problems, neurological – brain and nerves – problems, blood thinning medications or drugs for cancer).
Overdose- what it looks like and what to do
Even experienced users are at a very high risk of overdose due to the unknown concentration of liquid GHB. Signs of an overdose may include:
- person appears to be in a deep sleep and cannot be woken
- person has confused, slurred speech
- person is sweating a lot more than usual, is vomiting and has shallow breathing
- person can no longer stand up or is having involuntary muscle contractions.
If you suspect a friend may have overdosed on GHB to call an ambulance on '000' (in Australia) as fast as you can. When it arrives tell the ambulance officer exactly what your friend has been taking.
The ambulance officer is interested in helping the ill person - they are not interested in giving you lectures. They can help the sick person the best if they know what they've taken - it only slows down the process and puts the sick person in more danger, if the ambulance officers are given the wrong information.
They are not required to call the police unless they are in danger or there is evidence of criminal activity not relating to the drugs.
If the person has collapsed whilst waiting for the ambulance lay the person on their side in the recovery position to keep their airway open. Try to keep the person cool - you can do this by using cold water or ice packs.
Environment
The setting in which you choose to use GHB can influence the effect it will have on you.
- Be careful with your drink when at a bar or club because it is almost impossible to notice signs of GHB in your drink if it has been spiked.
- Don’t leave your drink unattended and be extra careful when moving through crowded areas.
- Use the drug in a place where you feel safe and relaxed to reduce the chance of anxiety attack or paranoia.
- Have a close friend (who knows what you’ve taken) nearby in case anything goes wrong.
- Have condoms on you – you never know what might happen.
- Plan – keep some money aside for a taxi so you can get home safely if you’re out.
- Watch for signs of drink spiking with GHB, such as drowsiness, reduced muscle tone and dizziness.
- Do not leave a friend unattended if you believe their drink may have been spiked.
Personal factors
Personal factors such as weight, height, sex and general health all influence the way in which a drug may affect you.
Drink plenty of fluids, eat well and sleep well if you are planning on taking drugs to better equip your body to deal with the substance. Don’t take GHB on an empty stomach as this will result in stronger effects and increase the likelihood of overdose.
Mood
How you are feeling when you use GHB can influence how the drug will affect you. If you are feeling anxious or depressed the drug may only enhance these feelings.
Tolerance and withdrawal
You can quickly develop a tolerance to GHB, so that you need increasingly larger amounts to achieve the same effect.
If you are using GHB again after taking a break keep in mind that your tolerance for the drug may have gone down and you may not need the same dose as previously to get the same effects.
Withdrawal symptoms usually start about 12 hours after the last dose and can continue for about 15 days.
Some of the withdrawal symptoms that may be experienced include:
- confusion, agitation, anxiety, panic, feelings of doom
- paranoia
- insomnia
- tremor
- muscle cramps
- perspiration
- delirium
- hallucinations
- tachycardia (rapid heartbeat).
Sudden withdrawal from high doses may also result in bowel and bladder incontinence and blackouts, and may require medical assistance.
Method
One of the most dangerous aspects of using GHB is the small difference between an amount that produces the desired effect and the amount that results in overdose. To be on the safe side, always take GHB in very small doses.
Driving
GHB is a depressant. This means it affects the central nervous system by slowing down the messages going between the brain and the body.
Driving after using GHB is as dangerous as driving while drunk because it slows down reaction times, affects coordination, it affects your ability to concentrate, it slows the processing of information and often causes confusion and impaired thinking.
Combining GHB with other depressants such as alcohol can multiply these effects.
Like driving under the influence of any drug, driving under the influence of GHB is illegal.
Pregnancy
Little is known about the effects of GHB on the unborn child. As is the case with many other drugs and medication, it is not recommended that people use GHB while pregnant or breastfeeding.
Many drugs can cross the placenta and therefore have some effects on the unborn child. In general, drug use during pregnancy can increase the incidence of premature labour, resulting in low birth-weight babies.
This fact sheet was prepared with assistance from the Australian Drug Foundation.
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