Overview

Gamma-hydroxybutyrate (GHB) is a recreational drug that may be used for various reasons, including to feel “high” and increase sex drive. It is also known as a “date-rape drug” because it can make someone more passive, open to suggestion, and lose their memories. Common side effects include decreased alertness or coordination, confusion, drowsiness, nausea, vomiting, decreased appetite, memory loss, and wetting the bed. Serious side effects include dependence and withdrawal, hallucinations, changes in behavior, seizures, and breathing problems. If you are concerned that you were given GHB without your knowledge, seek medical help right away.

Uses

What is gamma-hydroxybutyrate (GHB) used for?

Gamma-hydroxybutyrate (GHB) is used recreationally to feel “high” or increase sex drive. It is known as a “date-rape drug” because it may be given to other people to make them more passive, open to suggestion, and unable to remember what took place (amnesia).

Although GHB may also be used for other reasons, it can cause serious health problems, and its benefits for any use are not well defined.

A prescription form of GHB, called sodium oxybate, is approved for the treatment of narcolepsy. See Sodium Oxybate (Xyrem) and Lumryz for more information.

Note: Nonprescription GHB products are not approved by the FDA. The FDA also does not consider GHB to be a legal dietary ingredient in the U.S. GHB is a schedule I controlled substance, which means that it does not have an acceptable medical use and has a high risk for misuse. Learn more about the legal status of GHB here.

How does GHB work (mechanism of action)?

GHB is a type of chemical known as a central nervous system (CNS) depressant. It works by slowing down the messages that are sent by your brain, relaxing your muscles, and bringing on a feeling of calm. It can also cause an intense feeling of excitement or happiness (euphoria) for a short time.

As a street drug, GHB is most commonly used to cause a “high” or a sense of calm. It may also be used to increase sex drive. But GHB can cause serious health problems, including dependence, withdrawal, breathing problems, hallucinations, changes in behavior, seizures, coma, and death. See the Side Effects section for more information.

GHB is also used as a “date-rape drug,” meaning it is given to other people without their knowledge to make them more passive, open to suggestion, and unable to remember what took place (amnesia). If you are concerned that someone gave you a date-rape drug or that you were sexually abused or assaulted, seek medical help right away.

A prescription form of GHB, called sodium oxybate, has been approved in the U.S. for the treatment of narcolepsy. This prescription product is different from the GHB that is available as a street drug. Street drugs have not been tested to confirm that they contain the ingredients or the amounts stated on their labels. These products should not be used to replace treatment with sodium oxybate.

How should I store GHB?

You should store GHB according to the product label. Most dietary supplements should be kept in a cool, dry location that is out of the reach of children and pets and not in direct sunlight.

Side Effects

What are the most common side effects of GHB?

The most common side effects of GHB are listed below. These side effects may vary depending on the dose you are taking or the specific product you are using. Tell your health care provider if you have any of these side effects that bother you.

• An intense feeling of happiness (euphoria)
• Confusion
• Drowsiness
• Decreased appetite
• Memory loss (see below)
• Nausea or vomiting
• Wetting the bed

There may be other side effects of GHB that are not listed here. Contact your health care provider if you think you are having a side effect of a supplement. In the U.S., you can report side effects to the FDA at www.safetyreporting.hhs.gov or by calling 888-SAFEFOOD (888-723-3366). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of GHB?

While less common, the most serious side effects of GHB are described below, along with what to do if they happen.

Severe Allergic Reactions. GHB may cause allergic reactions, which can be serious. Stop taking GHB and get help right away if you have any of the following symptoms of a serious allergic reaction.

• Breathing problems or wheezing
• Racing heart
• Fever or general ill feeling
• Swollen lymph nodes
• Swelling of the face, lips, mouth, tongue, or throat
• Trouble swallowing or throat tightness
• Itching or skin rash
• Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
• Nausea or vomiting
• Dizziness, feeling lightheaded, or fainting
• Stomach cramps
• Joint pain

Decreased Alertness or Coordination. GHB can affect your alertness or coordination within 5-15 minutes of taking a single dose. Do not drive or do other activities that require alertness or coordination for at least six hours after taking GHB.

Central Nervous System (CNS) Depression. GHB may slow down your CNS, which controls many vital functions in your body. These effects can worsen if you drink alcohol or take certain medicines with GHB. Higher doses of GHB can also lead to serious problems such as coma and death. Since GHB is a street drug, it is not always possible to know what dose you are getting. You may take too much GHB even if you think you are taking the same amount as last time. Seek medical attention right away if you have any of the following symptoms of CNS depression.

• Confusion
• Excessive sleepiness or trouble staying awake
• Memory problems
• Slow or shallow breathing
• Slowed response or reaction time
• Slurred speech
• Fainting or loss of consciousness

Breathing Problems. GHB may cause slow or shallow breathing, especially if you have breathing problems from a medical condition or take medicines that can slow your breathing. It can also cause sleep apnea, which is when your breathing stops and starts while you are asleep. Get emergency help if you or someone you know has any of the following symptoms.

• Changes in the color of your skin, including bluish color to your lips and fingernails
• Confusion
• Shortness of breath
• Feeling dizzy or lightheaded or fainting
• Changes in your heart rate or rhythm, such as a fast, slow, pounding or skipping heartbeat
• Slow or shallow breathing
• Excessive sleepiness or trouble staying awake

Dependence and Withdrawal Reactions.Some people who use GHB may develop physical dependence, which means your body comes to rely on it. This risk is higher in people who use GHB regularly. If you stop GHB suddenly, it could lead to withdrawal symptoms. Your health care provider may be able to help you stop GHB in a way that will reduce the risk of having withdrawal reactions. Speak with your health care provider if you have any of the following symptoms of withdrawal.

• Headaches
• Nausea, vomiting, or stomach pain
• Irritability, anger, or aggression
• Nervousness or anxiety
• Sleep problems or restlessness
• Tremors
• Fast heartbeat or high blood pressure
• Depression or low mood

Hallucinations or Behavior Changes. GHB may cause hallucinations or behavior changes. This risk may be higher in people who also use other street drugs. Seek medical help right away if you have any of the following symptoms or have been told by others you have these symptoms.

• Hearing, seeing, smelling, tasting, or otherwise perceiving things that others do not
• Delusional thoughts, such as false beliefs that you are being controlled
• Disorganized thoughts, such as jumping between topics or having a hard time focusing
• Aggressive or agitated behavior
• Disconnecting from reality (psychosis)
• Feeling paranoid
• Other changes in behavior or mood, such as feeling guilty or worthless

Memory Loss and Sleepwalking.GHB may cause amnesia, meaning that you may forget the things that happened while you were taking GHB. It may also cause you to do activities you are not aware of while you are not fully awake, such as sleepwalking. These activities may cause harm to you and others. Seek medical help right away if you are concerned that you may have been given GHB without your knowledge.

Seizures. Some people who have used GHB have reported having seizures. There are many types of seizures, and some of them are not easy to recognize. Get medical help if you have any of the following signs that a seizure is happening or could happen.

• Muscle twitching, jerking, spasms, tremors, or other uncontrolled movements
• Stiffening of your arms and legs
• Feeling anxious, nervous, confused, or a sense of dread
• Feeling dizzy or lightheaded
• Falling or losing consciousness

Precautions

Who should not use GHB?

Allergies to Ingredients. People who are allergic to any of the following should not take GHB.

• Gamma-hydroxybutyrate (GHB)
• Gamma-hydroxybutyric acid
• Any of the ingredients in the specific product

Ask your health care provider if you are not sure what ingredients are in a GHB product.

Alcohol Use. You should not take GHB if you drink alcohol. See the Interactions section for more details.

Drug Interactions. GHB should not be taken while you are using certain other medicines. Before taking GHB, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Succinic Semialdehyde Dehydrogenase Deficiency. You should not take GHB if you have this rare condition. People with this condition are not able to break down GHB.

What should I know about GHB before using it?

The federal government does not consider GHB to be a legal dietary ingredient. Nonprescription GHB is a schedule I controlled substance, which means that it does not have any approved medical uses and is at high risk for misuse. These products are not regulated and have not been tested to confirm that they contain the ingredients stated on their labels.

Keep GHB out of the reach of children, pets, and other people. Nonprescription forms of GHB are illegal to purchase, use, or provide to others.

Some other chemicals may be sold as alternatives to GHB, such as gamma-butyrolactone (GBL) and 1,4-butanediol (1,4-BD). Your body turns these other chemicals into GHB, and they cause similar effects and side effects. Read product labels closely to see what ingredients they contain.

What should I tell my health care provider before using GHB?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if GHB is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions.Tell your health care provider if you have any of the following.

• History of misusing prescription medicines or street drugs
• Drink large amounts of alcohol
• Lung or breathing problems
• Mental health problems, such as depression, a past suicide attempt, anxiety, hallucinations, paranoia, or psychosis
• Aggressive behavior or agitation
• Kidney or liver problems

Pregnancy. It is not known if or how GHB could affect pregnancy or harm a fetus. Tell your health care provider if you are pregnant or plan to become pregnant.

Breastfeeding. GHB passes into breast milk and may cause harm to your baby. Tell your health care provider if you are breastfeeding or plan to breastfeed.

Interactions

Does GHB interact with foods or drinks?

There are no known interactions between GHB and foods or drinks.

Alcohol can increase the effects of GHB. The risk of having serious side effects, including coma and death, may also be increased if you drink alcohol while taking GHB.

Does GHB interact with medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking GHB.

• Any other medicine that causes dizziness and sleepiness, such as prescription pain medicines, sleep medicines, or medicines for anxiety
• A barbiturate, such as butalbital, phenobarbital, or primidone, which is a medicine that may be used to treat insomnia, migraines, or seizures
• A benzodiazepine, such as clonazepam (Klonopin), diazepam (Valium and others), or lorazepam (Ativan and others), which is a medicine used for anxiety, muscle spasms, or seizures
• An opioid, such as codeine, fentanyl, morphine, or oxycodone, which is a medicine used to treat certain types of pain
• A muscle relaxant, such as carisoprodol (Soma), cyclobenzaprine, metaxalone, or tizanidine (Zanaflex)
• Any other street drug, such as cocaine, heroin, or methamphetamine
• Sodium oxybate (Lumryz, Xyrem), which is a medicine used to treat narcolepsy

The interactions between GHB and medicines are not fully understood. As with most dietary supplements, the research on drug interactions with GHB is incomplete. Always check with your health care provider before taking GHB with any medicines.

Dosing

What should I do if I accidentally use too much GHB?

If you or someone else has used too much GHB, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

In the U.S., GHB is a controlled substance that is known to cause serious side effects and health problems. It is not the same as a prescription product (called sodium oxybate) that is approved for the treatment of narcolepsy. It is best to avoid the use of nonprescription GHB entirely.