What is GHB?
GHB or (gamma-hydroxybutyric acid) is an illegal drug in Slovakia belonging to the group with sedative (suppressing) effects. In the brain, it binds to GHB (stimulating) and GABA (suppressing) receptors. It is used in medicine to treat narcolepsy (a neurological disorder causing an inability to regulate cycles of sleeping and being awake) and fibromialgia (chronic pain and drowsiness). It is most often sold in the form of a colorless, odorless liquid that has salty or hot taste. Exceptionally, it is also sold in the form of powder and paste.
What are the effects of GHB?
It has a relaxing effect, causes feelings of euphoria, increases the desire for sex and reduces inhibitions. At lower doses it acts more like a weak stimulant, but at higher doses the effect changes to a strong sedative. Side effects include lethargy, chills, nausea, diarrhea, slow-down of the respiratory system and dehydration. The consequences of a long-term use (especially in case of higher doses) were unknown until recently, but research has shown that among these consequences belong impaired long-term memory, impaired working memory, and increased stress and anxiety. The risk group are mainly users who fall into coma after using GHB. Long-term frequent use can cause uncontrolled muscle movement and seizures that may end in death. Mental and physical dependence can be created on GHB. Never take GHB during pregnancy. If you do not take GHB, you will avoid all risks.
How do I reduce the risks associated with use?
The usual dose is around 1-3 g depending on your weight. At a dose of 0.04 g per 1 kg of your weight, you will achieve a good ratio of positive effects and relative safety. The recommended upper limit is 0.06 g per 1 kg of your weight or 4 g (for heavier people). If you exceed these limits, you run a much higher risk of overdose. GHB is often sold dissolved in a liquid (i.e. per milliliter), but this liquid can have different concentrations (because in 5 ml there can be 2 g or even 4 g of GHB). Therefore, make sure you know the exact concentration of GHB in liquid form (from a concentration of 0.7 g per 1 ml, the water becomes dense, but at low concentrations such a mixture is indistinguishable from pure water). The onset of effects lasts 5-30 minutes, while the effects themselves last 1.5-2.5 hours. GHB in its pure form causes burns to the mouth and throat, so it is taken orally mixed with soft drinks. GHB is not sniffed or injected because oral use is the most effective and does not directly damage vein and mucosal tissues. If you are going to take GHB for the first time, start with a lower dose and gradually find the one that suits you. If you want to take GHB repeatedly in a few hours, wait at least 2.5-3 hours from the beginning. After some experience, you can shorten this time, but never take another dose earlier than after 1.5 hours. The next dose should always be lower than the first one, and never take more than 3 consecutive doses. As with alcohol, the effects of GHB are stronger on an empty stomach. Never take GHB for several days in a row due to the high risk of addiction, and keep a minimum interval of 2 months between uses. Unfortunately, GHB is also rarely used for rape. If someone throws it in your drink, you can recognize the salty taste, but you don’t have to. Therefore, never leave your drink unattended, and if you start to feel lethargy, drowsiness, feelings of confusion, etc., immediately tell your friends or employees of the bar or festival, etc.
What to do in case of a crisis situation?
In the event of an overdose, it is best to call for medical help immediately and share information about the type of drug used and its amount (drug use alone is not a criminal offense). Symptoms of overdose include vomiting, irregular/shallow breathing, severe hallucinations, short-term loss of consciousness/memory and loss of consciousness, which may last for up to 4 hours. Lay unconscious people in a stable position and make sure they have nothing in their mouths. Also, do not give them any fluids, as this will only increase the risk of suffocation.
Combination of GHB and other psychoactive substances – what to avoid?
GHB must never be used in combination with other sedatives, alcohol (all types, not only spirits), opioids, ketamine, and benzodiazepines (Xanax, Lexaurin). Combination with MDMA, amphetamines, meta-amphetamines, DXM, cocaine and MXE may cause respiratory arrest and sudden falling off and subsequent vomiting, which may also lead to respiratory arrest. Stimulants can mask the signs of an overdose, for example, you may not lose consciousness, but you may still gradually fail to breathe. Symptoms of excessive lethargy and confusion will also weaken.
GBL (gamma-butyrolactone) – a frequent replacement for GHB
GBL is a precursor (a substance from which the final product is made, for example by metabolism in the body) for GHB in a liquid form, it changes to GHB in your body, but it has a different dosage. It is also taken only orally and, unlike GHB, is dosed in milliliters, with the usual dose being around 0.5-1.5 ml (dosing values per kilogram are not known). Never dose GBL straight from the bottle, because a pleasant experience and an overdose are only a milliliter apart. Always use a syringe for dosing and mix one exact dose with a soft drink. Never mix multiple doses with the drink at once, as GBL does not have to be mixed evenly and you can inadvertently take much more than you wanted (this is a single milliliter!). The onset lasts 10-30 minutes and the effects last 1-2 hours. GBL looks the same as GHB dissolved in water, but has a strong chemical odor, which makes it possible to distinguish the two substances ale for a layman. GBL dissolves most plastics, so store it in glass, gelatin capsules or recyclable plastic type “# 2” (the type of plastic is always on the bottom of the bottle). GBL has similar effects to GHB, but more often causes nausea, stomach pain and breathing problems.
Raposo Pereira, F., McMaster, M. T. B., Polderman, N., de Vries, Y. D. A. T., van den Brink, W., & van Wingen, G. A. (2018). Adverse effects of GHB-induced coma on long-term memory and related brain function. Drug and Alcohol Dependence, 190, 29–36. http://doi.org/10.1016/j.drugalcdep.2018.05.019
Raposo Pereira, F., McMaster, M. T. B., Polderman, N., de Vries, Y. D. A. T., van den Brink, W., & van Wingen, G. A. (2018). Effect of GHB-use and GHB-induced comas on dorsolateral prefrontal cortex functioning in humans. NeuroImage: Clinical, 20, 923–930. http://doi.org/10.1016/j.nicl.2018.09.022
Abanades, S., Farre, M., Segura, M., Pichini, S., Barral, D., Pacifici, R., Pellegrini, M., Fonseca, F., Langohr, & K.,Torre, R. D. L. (2006). Gamma-Hydroxybutyrate (GHB) in Humans: Pharmacodynamics and Pharmacokinetics. Annals of the New York Academy of Sciences, 1074(1), 559–576. http://doi.org/10.1196/annals.1369.065
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