Description
γ-Hydroxybutyric acid (GHB) is a naturally occurring neurotransmitter and depressant substance; it slows down the body’s reactions and functions in many different ways. GHB is a medication (sodium oxybate, brand names: Xyram, Xywav) used to treat narcolepsy, and in some countries as a general anaesthetic and treatment of alcohol dependence and withdrawal.
γ-Butyrolactone (GBL) and 1,4-butanediol (1,4-BD) are both GHB prodrugs, which are converted into GHB in the body.
Desirable Effects
- uninhibited
- mild euphoriant
- relaxed feeling
- aid sleep
- a supplement for bodybuilding
Undesirable Effects
- loss of body control – effects similar to alcohol which can last for several hours
- feeling sick and being sick
- numb muscle and disorientation
- seizures and collapsed
- psychosis and severe agitation
- tachycardia
- delirium
- audio and visual hallucinations
- paranoia
There is a strong sexual component associated with the drug’s action, which is related to it being used as a ‘date rape’ drug.
What does it look like?
GHB is a white crystalline powder. The powder is rarely sold at street or club level. Instead the salt is mixed with water to produce a clear liquid – often sold in small plastic bottles.
GHB can be easily manufactured from GBL which is typically sold in plastic bottles, sometimes labelled but often unmarked.
Method of Use
Swallowed: GHB, GBL and 1,4-BD are most commonly taken orally in liquid form; the powder is not commonly snorted due to the high risk of overdose, but instead dissolved in fluid.
It can take up to an hour for the effects to be fully felt, dosing is person-specific but very small quantities can cause people to overdose, GBL is typically two to three times stronger than GHB. For example: if your 1 mL dose of GHB is actually GBL, the strength may be the equivalent of taking 2–3 mL. This level is more likely to lead to overdosing (unconsciousness and coma) particularly if you have not tried it before or have a lower tolerance. The reverse is also true: if your 1 mL dose of GBL is actually GHB the actual strength may be 2–3 times less.
GBL and 1,4-BD are both converted to GHB in the body, appear in the same liquid form and produce equivalent effects to GHB.
For advice on GHB, GBL and Chemsex please visit our friends at MEN R US.
Pharmacology
GHB has an interesting but still greatly undiscovered pharmacology. It was created with the intention to produce an analogue of (or a related compound to) the inhibitory neurotransmitter GABA and thought to act via GABA receptors (mainly GABA-B). However, we now know that it stimulates its own distinct GHB receptor, that naturally present in the brain, and that GHB actually has a weak affinity (ability to bind) for the GABA receptors.
GHB also interacts with the dopaminergic system, and can alter levels of dopamine. In some areas of the brain, it increases, and in others it decreases the levels of dopamine. It is also thought to act on serotonergic and opioidergic systems. Interestingly, naloxone and naltrexone have been shown to reverse the effects of GHB (and GBL) on dopamine release. Much of the research requires further investigation.
GBL and 1,4-BD are both converted into GHB in the body. GBL is more lipophilic (mixes with fat/lipids easily) than GHB, and therefore is absorbed faster in the body than GHB. This means that, paradoxically, GBL can have a faster onset than GHB. On the other hand, 1,4-BD has a slower onset but a longer duration of effects.
Harm Reduction
The difference between a recreational dose and an overdose is very small. It’s recommended to assume you have GBL (the strongest of the three) and dose accordingly.
- Start low, go slow: Take a small test dose and wait until you can feel the effects before taking more/anything else. The strength of GHB varies a great deal. It is therefore advisable to take a small amount at first in order to avoid unexpectedly taking more than intended. After use, there is likely to be a lack of energy for hours or even days.
- Keep track: It is very easy to overdose on GHB receptor agonists. Measure doses accurately and write down when doses are consumed to avoid taking too much. Add food colouring to liquid containing G and do not leave unattended.
- Try not to use alone: If something goes wrong, someone is there to get help
- Be careful mixing: Mixing GHB receptor agonists with other depressants increases overdose risk – avoid if you can, otherwise take less of each, as they can increase the effects and risks
- Carry naloxone: Some counterfeit benzos in the UK have been found to contain strong opioids
- Test your stuff: You can’t tell by eye if you have GHB, GBL or 1,4-DB. Find out how to send a sample to WEDINOS for testing here: https://www.wedinos.wales or pick up some test strips at our Harm Reduction Hub
- Avoiding spiking: The best way to protect yourself is to not accept a drink/drug unless you’ve seen it be prepared and you know the person. If you think you may have been “spiked”, it is best to stay with a trusted friend (not someone you have just met) and go to a safe place (your home/hospital/police station).
- If you’ve been prescribed GHB (sodium oxybate) and you notice a tolerance starting to develop (you need to keep taking more to get the same effect) speak to your doctor – don’t just start increasing your dose yourself.
- Don’t suddenly stop taking them, or you may start to experience symptoms of withdrawal: these can range from a return of your original symptoms (possibly even worse than before) to totally new symptoms.
- If you have become physically dependent on GHB or a related drug, the symptoms of abruptly stopping are likely to be even worse. It’s important to get proper medical advice on how to reduce your intake slowly.
- It’s also possible to become psychologically dependent on the drug (feeling like you need it all the time). If you think this is happening, see your doctor as soon as possible, but don’t suddenly stop taking it.
History
Synthesis of the chemical GHB was first reported in 1874. GHB was re-investigated in France more than 50 years ago as a possible anaesthetic and introduced into medicine between 1960-63 when it was discovered as a naturally occurring chemical in the human brain and scientists noted its effect on the neurotransmitter GABA. Throughout much of the 1960s it was held likely to have considerable anaesthetic properties, but was abandoned by doctors following discoveries of its limited clinical analgesic effects and its very short duration of action. In the 1970s, GHB was recommended for the treatment of narcolepsy/cataplexy, though it was again found to be flawed, primarily due to its euphoric side effects.
During the 1980s it was marketed as a fat burner and muscle developer and interest was stirred in the body-building/steroid using community to enhance the body’s production of growth hormone. It became adopted by ‘rave’ culture during the late 1980s and early 1990s, particularly because of its euphoric and aphrodisiac properties. It is occasionally used in the treatment of alcoholism. Its effects have been noted in clubs with incidents reported of people losing consciousness and the use of the drug as a ‘spiking’ agent in sexual assaults. These have contributed to wariness of the drug, and it has waned in popularity across the last 10 years. It was made a Class C drug in June 2003.
GBL and 1,4-BD are chemicals that have widespread legitimate uses (for example, in nail polish, paints and as industrial solvents) but are also misused. They are pro-drugs of the Class C drug gamma-hydroxybutyrate (GHB), meaning that when either substance is ingested it is rapidly converted to GHB. The effects and risks associated with their misuse are unconsciousness, a risk of death by intoxication and a dependence syndrome if used regularly. The risks are increased if combined with alcohol or other depressant substances. GBL and 1,4-BD have therefore been controlled as Class C drugs.
Law
Possible offences
- Possession
- Maximum sentence – 5 years/fine/both
- Possession With Intent To Supply
- Maximum sentence – 14 years/fine/both
- Supply (including being concerned in supply, conspiracy to supply, aggravated supply and offer to supply)
- Maximum sentence – 14 years/fine/both
- Production
- Maximum sentence – 14 years/fine/both
- Sexual Offences
- The Sexual Offences Act 2003 states that it is an offence to administer a substance, like GHB and GBL, to a person with intent to overpower that person to enable sexual activity with them. This is punishable by up to 10 years imprisonment.
In practice maximum sentences are rarely used, for more detailed and accurate information go to our sentencing page.
