Posted: 01 November 2017

GHB – going over and getting hooked

Dr Adam R Winstock

Founder and Managing Director Global Drug Survey

Consultant Psychiatrist and Addiction Medicine Specialist


1 in 5 users report passing out after using GHB. We give you the low down on the fine line between happy and horny, and becoming unconscious (or worse).

What is GHB?
Gamma-Hydroxybutyrate or GHB (and its closely related cousins GBL and 1,4 butane-diol) has been a part of the drugs’ culture in many western countries since the 80s. More commonly, but not exclusively, used by gay men, and big on the chemsex scene in some of the larger Western cities, GHB has pro-social mood enhancing, sexually liberating and general dis-inhibiting effects, much like alcohol.

While risks of overdose have always been well recognised, in recent years more attention has been paid to its negative associations with sexual assault and the high risk of developing dependence, and life threatening withdrawal. During 2013-2015, when running a chemsex clinic in central London, we saw a huge rise in the number of people seeking help for these reasons. Although clinical experience and research services are getting better at managing this and treating overdose, there is still so much we don’t know.

The risks and how to avoid them
GHB (and GBL/1,4 butanediol) are colourless, odourless liquids usually taken orally in doses of between 0.5 and 1.5ml. Many people who use GHB know the risk and are careful about how they take it. But it is a risky drug, and dose for dose, probably carries greater risk than other drugs at leaving you unconscious and vulnerable to sexual assault and, albeit rarely, fatal overdose. There is a tiny difference (less than one millilitre) between the amount that makes you happy and/or horny and that which leaves you unconscious, so we always advise to measure doses with a syringe. Additionally, alcohol increases the effect GHB has on slowing a person’s breathing, making the risk of overdose much higher.

Because the effects of GHB come on very quickly – within about 15 minutes – and only lasts a few hours, another hit too soon can be dangerous, so leaving a minimum of 2-3 hours in between is recommended. The other thing to be aware of is that GHB can affect memory so we advise people to set a reminder on their phone rather than guess when they last took it. Like all illegal drugs, the purity and potency of different batches vary, so we suggest always taking a smaller than usual amount from a new batch to test its effect. Our top tips on safer G use can be found on our animated harm reduction video There’s More to G Than Cock

Avoiding dependence
The best way to avoid developing tolerance and dependence is to refrain from taking GHB for more than 2-3 days in a row. You can become dependent after as little as a few weeks of daily use. It should be remembered that sudden, unplanned withdrawal from GHB can be deadly. If you become anxious, shaky and sweaty when you stop taking GHB, seek medical advice.

When to call for help
Finally, the best way to stay safe is to keep an eye on your mates and if you’re using the drug for sexual purposes then use a condom, plenty of lube and ask for consent (not saying no is not the same as saying yes!). If you’re not sure what you got up to the night before, take yourself off to a sexual health clinic. And of course, if you find you can’t wake someone up, never be afraid to call for help. Place them in the recovery position, call 999 (or the equivalent emergency number in your country) and stay with them until help arrives.

If you’ve ever wobbled, dribbled or dropped on GHB and want to help us keep people safe, please take 15-30 minutes to share your opinion and take part in the world’s largest drug survey at Global Drug Survey 2018

For more advice on how to reduce the risks, see our YouTube video on how to put someone in the recovery position and our harm reduction guide, The Global Drug Survey Highway Code

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