GHB (gamma-hydroxybutyrate) is a central nervous system depressant. It acts by slowing down the travelling of messages between the brain and the body. This causes feelings of drowsiness and a decrease in heart rate. The drug is colloquially known as ‘date rape’ and has come to be associated with the facilitation of sexual offences as well as personal substance abuse.
In a notable development, GHB was reclassified from Class C to Class B in an amendment to the Misuse of Drugs Act in 2022. The circular announcing this states that GHB is associated with ‘serious crimes’ as well as ‘a wide range of health harms.’ As a Class B substance, GHB is categorised as a drug with reasonable risk under legislation in England, Scotland, and Wales.
What is GHB?
GHB is short for gamma-hydroxybutyrate. Gamma-hydroxybutyrate (or gamma-hydroxybutyric acid) is a depressant drug. This means that the main mechanism of action of GHB is its ability to ‘depress’ or inhibit function.
GHB has historically been linked with ‘music festival, party and ‘chemsex’ settings,’ resulting in the drug’s categorisation as a ‘club drug.’
GHB has a range of street names, including:
- blue nitro
- cherry meth
- fantasy
- fishies
- G
- georgia home boy
- grievous bodily harm (GBH)
- jib
- juice
- liquid e
- liquid ecstasy
- liquid x
- salty water
- scoop
- soap
Street names for a substance can be culturally dependent and location-specific, meaning that GHB may be known under other colloquialisms in your area, depending on where you live.
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Effects of GHB use:
- Feeling drowsy or dizzy
- Feeling nauseous
- Sickness
- Changes to sight
- Euphoria / elated mood
- Aggression or hostility
- Memory loss
- Reduced inhibitions capacity to make safe decisions
- Hallucinations
- Sedative effects (loss of consciousness)
Whilst these effects already come with risks, GHB can also lead to more severe effects, such as coma, seizures, and, in some cases, death by overdose.
Methods of use
GHB can be purchased in two different forms, either as
- a liquid,
- or a crystal powder
Liquid GHB can be clear and scentless (with a bitter taste). It can also be found as ‘blue nitro,’ liquid GHB with a potent blue colour. The crystal version of GHB is less common.
GHB is typically ingested through swallowing, but it can also be taken through injection or inserted into the anus.
GHB: The chemistry
GHB is ‘produced endogenously’ in the human body and brain. This means that GHB is naturally occurring in our systems. However, the levels of GHB produced inside us are very small.
GHB is derived from a neurotransmitter known as GABA. GABA is a brain chemical that blocks signals in the nervous system. Our bodies survive through a system of cell communication. Our cells send and receive signals to ‘talk’ to each other. In some situations, these cells are too active.
Neurotransmitters like GABA are useful in these cases, as they can inhibit the over-excited cells. This quells their activity and settles cell communication to a more typical level.
In the body, GHB levels are relatively low. The risks of GHB come when exogenous versions of the substance are taken into the body. That is when people take GHB in the form of drugs.
GHB is very similar to two other substances: gamma-butyrolactone (GBL) and 1,4-butanediol (1,4BD). Under the Drug Classification active in the UK, these three substances are all grouped and are collectively known as GHBRS.
GHB: The statistics
In 2022, previous home Secretary Priti Patel announced that GHB would move drug class to Class B. The supporting statement reported that ‘In the UK in recent years, GHBRS have been used to facilitate serious crimes, including murder, rape, sexual assault and robbery.’
Statistics for GHB abuse are not as readily available as statistics surrounding other drugs. This may be because the true danger of GHB is only recently being unveiled, and more research and campaigning are needed for these datasets to become more readily available.
Some of the data we do have considers the prevalence of GHB use in America. A survey of the US public illustrated that 1.2 million people over the age of 12 had used GHB at some point in their lives. In the same survey, 136,00 people (aged 12 and above) reported using GHB in the past 12 months.
The same data set indicates that the ‘average age of initiation’ into sedatives is 28.3.
Medical professionals suggest that the prevalence of addiction to GHB is relatively low, as GHB is not used as regularly as some other substances. However, recent papers on the drug identify that there are ‘rising rates of presentations to [..] treatment, detoxification services, ambulance and emergency department settings or GHB intoxication and associated injuries,’ which indicates an increase in GHB abuse.
GHB: The law
Classification
As previously stated, recent amendments to drug legislation mean GHB is now a Class B substance. That means that the possession, supply or production of GHB is a legal offence in the UK.
Possession of GHB can incur an unlimited fine and/or up to 5 years in prison.
Supply and production of GHB can incur an unlimited fine and up to 14 years in prison.
Association with criminal activity
The key reason for the shift in GHB’s drug classification is its association with violent crime. It has been linked to sexual offences such as rape and assault, as well as burglary and even murder.
GHB has been linked to 159 sexual offences in the UK, with a journalist for the news outlet BuzzFeed referring to the drug as a ‘rapist’s weapon of choice.’
A law passed in 2003 (The Sexual Offences Act) means that it is illegal to use GHB to enhance sex acts without the consent of all parties involved.
GHB: A quick history
Today, GHB is most commonly linked with violent, nonconsensual use. However, the substance did not always have this sordid association. The substance was initially used in a medical context and has also been linked with bodybuilding.
There has been some discussion around the usefulness of GHB as a treatment for narcolepsy. Research suggests that when taken in a very specific way at a specific dosage, GHB use for narcolepsy can be low risk. However, due to the medical and social discussions around the drug, GHB would be prescribed, if at all, as a last resort for sleep conditions.
In 1990, the selling of GHB was banned in the States. This was due to an increase in misuse and evidence of a rising trend of GHB addiction.
GHB users report that using the drug during sex increases their confidence, helps them to relax and acts as a sexual enhancer; users also report being able to have sex for extended periods of time. Due to the nature of GHB’s effects, it has become linked with sexual engagement with more than one partner. This has subsequently been associated with an increased risk of developing sexually transmitted diseases and infections such as HIV/AIDS.
Why is GHB so addictive?
There are many reasons why GHB is an addictive substance; its depressant effects work on the brain in various ways, causing a multifaceted high that can be desirable for many individuals.
Sedative effects are calming
One of the key reasons for using any sedative is that it elicits an inhibitory response in the brain. That means that things feel a little slower and calmer for a while. This can be particularly desirable for individuals dealing with mental health conditions such as anxiety, bipolar disorder and psychosis.
Sexual use
As previously discussed, GHB is used to facilitate sexual acts. This can happen in consensual circumstances or the context of sexual offences. GHB can make it easier for perpetrators of crime to engage in certain acts as victims can become more relaxed and less likely to commit violent acts.
This means an individual can use –and potentially become dependent – on GHB without actively seeking the substance themselves. Individuals using the substance willingly may use GHB regularly due to the sexual satisfaction it can provide, which can then lead to dependency as the system becomes used to the presence of the drug.
Short half-life
GHB has a very short half-life. It only takes between 30 and 50 minutes for half of the substance to leave the body. That means GHB high is fast-acting and potent, meaning that GHB users may take several doses to sustain the high. Doing so will prolong the effects of the drug but can also lead to the building of tolerance, which is one of the foundations of addiction.
Polydrug use
It is common for GHB to be used alongside other substances, especially alcohol and methamphetamines. The interaction of substances that occurs during polydrug use can be a particularly potent cocktail, which is very likely to lead to addiction. This is especially risky as using GHB alongside other drugs increases the risk of seizures as a result of overdose.
Signs of GHB addiction
Like other disorders, addiction comes with its own set of signs. Some can be more subtle than others. The signs of addiction are fluid; they can change from drug to drug.
Here is an overview of some of the signs of GHB addiction you can look out for, as well as some signs of addiction more generally:
- Euphoria
- Feeling relaxed
- Increased confidence
- Becoming more social
- Increased sex drive
- Reduced ability to assess risk
- Heightened perception, especially of touch
- Appearing confused or disoriented
- Appearing angry or annoyed
- Tremors and shaking
- Feeling or being sick
- Blacking out
- Lack of coordination and motor skills
- Hallucinations
- Seizure
- Difficulty breathing
- Risk of coma
- Increased anxiety and panic
- Complications with heart health
- Complications with respiratory health (breathing problems)
- Sustained issue with memory
- Physical dependency
Treatment for GHB addiction
Approaches to addiction can fall into three categories. They can be;
- Pharmacological
- Psychological
- Holistic
Pharmacological treatments are any support that involves using medicines to manage symptoms. This can include detox or the prescribing of long-term medications to treat symptoms like anxiety, panic, or depression.
Psychological treatments approach mental health differently. They utilise the power of talking and sharing in order to uncover what may have led to addiction whilst also establishing how therapy can be best utilised to help us move forward.
Holistic treatments consider addiction as something that impacts our body, mind and soul. Through holistic and alternative therapies, the goal is to nurture the self as a whole in order to restore physical, mental and psychic balance.
Common examples of these three kinds of therapies are:
- Cognitive behavioural therapy (CBT)
- Detox
- Dialectical Behavioural Therapy (DBT)
- Experiential Therapy
- Group Therapy
- Individual Therapy
- Prescription medication
- Psychodynamic Therapy
- Psychotherapy
- Twelve Step Facilitation Therapy (TSF)
- Alcoholics Anonymous (AA)
- Narcotics Anonymous (NA)
With a blend of therapies, addiction treatment can help you come to terms with your situation, learn more about your relationship with drugs, and continue forward without the additional weight of GHB addiction.
If you’re ready to begin your recovery journey from GHB addiction, contact your GP or addiction rehabilitation specialist today. Together you can find what treatment would best suit you.
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