GHB Misuse, Addiction, and Rehab Treatment

What is GHB?

GHB that is not produced as a pharmaceutical product with approval from the U.S. Food and Drug Administration (FDA) belongs to the class of drugs known as central nervous system (CNS) depressants.³ It falls under the Schedule I classification under the Controlled Substances Act, which means that GHB currently does not have an accepted medical use and it has a high potential for misuse.^2,5

The therapeutic, FDA-approved product containing GHB, known as Xyrem, is a Schedule III substance, which means it has a moderate to low potential for physical and psychological dependence.^2,5 Xyrem is used to treat daytime sleepiness in individuals with narcolepsy and to reduce the incidence of cataplexy (the sudden loss of muscle tone while a person is awake).²

When used illicitly, GHB may be referred to by many street names, including “G,” “Georgia Home Boy,” “Grievous Bodily Harm,” and “Liquid G.” ^1,2,6

GHB Side Effects

Typically taken by mouth as a liquid, GHB effects may be felt within 15–30 minutes of ingestion and last 3–6 hours.² GHB effects can include:^1-3,6

Is GHB Addictive?

When used over a long-period of time, GHB can lead to addiction.^2,6

GHB produces a complex effect on the brain and works on different neurotransmitters, or brain chemicals, including, among others, gamma-aminobutyric acid (GABA), a chemical that inhibits brain activity and causes effects like drowsiness and relaxation.^4,7

Chronic GHB use can cause dependence, meaning an individual’s brain and body have adapted to GHB and they need it to function and feel normal.^7,8 When an individual, who is dependent on GHB, stops using the drug, they can experience withdrawal, which can cause various unpleasant symptoms. Therefore, they may continue using GHB to prevent withdrawal symptoms.⁷

This can make it difficult for an individual to stop using GHB, and it can fuel the cycle of addiction, which means continuing to engage in compulsive substance use despite the negative effects.⁸

Symptoms of GHB Addiction

As previously mentioned, chronic use of CNS depressants like GHB can lead to addiction, which is diagnosed as a substance use disorder (SUD).⁴ Clinicians use the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, DSM-5, to diagnose individuals with a SUD. This criteria includes:⁹

1. Using a substance in larger amounts or for a longer time than originally intended.
2. Expressing a desire to—but being unable to—cut down or stop using the substance.
3. Spending a lot of time obtaining, using, and recovering from the substance’s effects.
4. Experiencing intense urges or desires to use the substance (known as cravings).
5. Failing to fulfill obligations at home, work, or school due to substance use.
6. Continuing to use the substance even though it causes or worsens social or interpersonal problems.
7. Giving up social, recreational, or occupational activities due to substance use, and withdrawing from family or friends in order to use the substance.
8. Using the substance in dangerous situations (such as while driving).
9. Continuing substance use even though the person knows they have a physical or psychological problem likely caused or worsened by substance use.
10. Needing to use more of the substance to experience the same desired effects, also known as tolerance.
11. Experiencing unpleasant or uncomfortable symptoms if they stop using the substance, also known as withdrawal.

2 or more of the above exhibited in a year may result in a positive diagnosis for an SUD.⁹

GHB Withdrawal

Dependence is a physiological adaptation of the body to a substance, wherein the body becomes so used to the drug being present in the system that when the individual cuts back on their use or quits, withdrawal symptoms emerge. With significant levels of physiological dependence, a person may continue to compulsively drink or use drugs to avoid unwanted withdrawal symptoms.

GHB Withdrawal Symptoms

The signs and symptoms of GHB withdrawal can include:^1,2,4

• Seizures.
• Anxiety.
• Insomnia.
• Overactive reflexes.
• Increased heart rate, blood pressure, and body temperature with sweating.
• Psychotic thoughts or hallucinations.
• Delirium.
• Severe cravings.

GHB Overdose

It’s possible to overdose on GHB, and the potential for overdose is greater when using it with other CNS depressants such as alcohol or benzodiazepines, or when taking high doses over short periods of time.¹⁰ Signs of GHB overdose can include:²

• Loss of consciousness.
• Seizures.
• Slowed heart rate.
• Severe respiratory depression.
• Low body temperature.
• Vomiting.
• Nausea.
• Coma.
• Death.

If you suspect that someone is experiencing an overdose, you should call 911 and seek immediate medical attention.⁴

GHB Addiction Treatment and Rehab

GHB misuse and addiction may be treated in a variety of ways:

• Detox is typically the first step in the recovery process. If you are dependent on GHB, you may benefit from supervised medical detox as the first step in recovery. You should not attempt to detox at home alone due to the risk of potentially severe symptoms.^4,10 During detox, you may receive supportive care and benzodiazepines or other medications to help you stabilize, rid your body of the substance, and withdraw from it as safely and comfortably as possible.¹⁰Detox is often followed by some form of inpatient rehab or outpatient substance use treatment to address the behavioral and emotional components of addiction.^3,11,12
• Inpatient rehab requires you to live onsite at the facility, where you will receive 24/7 care, support, and treatment. This may include individual and group counseling, behavioral therapies, and education.¹²
• Outpatient services mean that you live at home or in a sober living environment but travel to the facility to attend the same treatments, programs, and therapies as in the inpatient setting.¹²

Regardless of the rehab setting, you may participate in different behavioral therapies. Cognitive-behavioral therapy, or CBT, has been found to be especially useful for addiction to CNS depressants.⁴ CBT helps you identify and make changes to unhelpful or negative thoughts and behaviors that can impact substance use and teaches you coping, stress management, and relapse prevention skills so you can stay sober and avoid substance use.⁴

You may also receive other forms of counseling and psychotherapy in individual and group formats such as treatment for polysubstance misuse (if you misuse other substances in addition to GHB) or co-occurring treatment to address substance use and mental health disorders at the same time.⁴

Health insurance should cover at least part of the cost of treatment. The Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 requires health insurers and group health plans to provide the same level of benefits for mental and/or substance use treatment and services that they do for medical and surgical care.¹³

Do not let the cost of treatment deter you if you or someone you care about uses GHB and wants to seek help.

Call an admissions navigator to verify insurance and start treatment today.