GHB AUSTRALIAN DRUG FOUNDATION
07 HOW DRUGS AFFECT YOU
This pamphlet is part of the “How Drugs Affect You� series. It aims to provide the facts about gamma hydroxybutyrate (GHB) for anyone interested in understanding more about this drug. It has been written for the general public, including employees, employers, health professionals and their clients.
Other titles in this series include alcohol, amphetamines, analgesics, benzodiazepines, caffeine, cannabis, cocaine, drugs and their effects, ecstasy, hallucinogens, heroin, ice, inhalants, ketamine and tobacco.
07 HOW DRUGS AFFECT YOU
What is GHB? GHB is a depressant drug. Depressant drugs do not necessarily make a person feel depressed. They slow down the activity of the central nervous system and the messages going between the brain and the body. Other depressants include alcohol, benzodiazepines, cannabis and heroin.
GHB occurs naturally in the brain, but it was first manufactured and studied in the 1960s. Although it has been used in several countries as a general anaesthetic, GHB was withdrawn from use in most countries—including Australia— because of unwanted side effects. Other names “G”, fantasy, grievous bodily harm or GBH, liquid ecstasy, liquid E, liquid X, salty water, Georgia Home Boy, soap, scoop, cherry meth, blue nitro and vitamin G.
What it looks like GHB commonly comes as a colourless, odourless, bitter or salty liquid, usually sold in small bottles or vials. It also comes as a bright blue liquid (sometimes called “blue nitro”) and less commonly as a crystal powder.
How and why is it used? GHB is generally swallowed, although a small number of people inject it. In the 1980s GHB was marketed as a dietary supplement for body builders. GHB has also been used as a treatment for the sleep disorder narcolepsy and in the treatment of alcohol dependence. It is currently available on prescription (for narcolepsy) in the United States of America but it is very strictly monitored. GHB has been used to facilitate sexual assault. Due to its appearance, GHB is easy to slip into a drink, and it can cause drowsiness, sleep and short-term memory loss. This means that victims may not be able to resist or recall a sexual assault. Some people use GHB to help with the symptoms of the “comedown” after using stimulants such as amphetamines and ecstasy. Others take GHB for its ability to increase relaxation, sociability and disinhibition.
GHB in Australia According to the National Drug Strategy Household Survey1, in 2010:
»» 0.8 per cent of Australians aged over 14 years had used GHB at some stage in their life
»» 0.1 per cent had used it in the previous 12 months »» the average age at which Australians had first tried GHB was 23 years.
Australian Institute of Health and Welfare (AIHW) 2011 2010 National Drug Strategy Household Survey: Report, Canberra: Australian Institute of Health and Welfare.
1
Effects of GHB The effects of any drug (including GHB) vary from person to person. How GHB affects a person depends on many things including their size, weight and health, whether the person is used to taking it and whether other drugs are taken. The effects of any drug also depend on the amount taken. This can be very hard to judge as the quality and strength of drugs can vary greatly from one batch to another. This is a particular concern with GHB, as there can be a very small difference between the dose required for a “high” and an overdose.
Immediate effects The effects of GHB may start to be felt within 15–20 minutes and last for approximately 3–4 hours. Low to moderate doses Some of the effects that may be experienced after taking GHB include:
See diagram
Higher doses A high dose of GHB can cause a person to overdose. This means that a person has taken more GHB than their body can cope with. The effects can include:
» vomiting » sweating » seizures » irregular or shallow breathing » confusion, irritation and agitation » hallucinations
» blackouts and memory lapses » unconsciousness (where people can’t be roused) that can last for 3–4 hours » loss of coordination (ataxia) » respiratory arrest (stop breathing) and death.
Using GHB carries a high risk of overdose due to the small difference between the amount required to produce a “high” and that which causes overdose. Not knowing the strength of GHB increases the risk of overdose.
» dizziness » headache
Bowel & bladder » diarrhoea & urinary incontinence
Stomach » nausea
Heart » decreased body temperature, blood pressure & heart rate
Muscles » tremors
Psychological effects » feelings of euphoria » increased libido » lowered inhibitions
Brain » memory lapses » drowsiness » sleep
Low to moderate doses
Long-term effects Little is known about the long-term effects of GHB use, but it is possible to become both psychologically and physically dependent on it. Tolerance and dependence People who use GHB heavily on a regularly basis may become dependent on GHB. They may also develop a tolerance to it, which means they need to take larger amounts of GHB to get the same effect. Dependence on GHB can be psychological, physical, or both. People who are dependent on GHB crave the drug and find it very difficult to stop using it. People who are psychologically dependent on GHB may find they feel an urge to use it when they are in specific surroundings or socialising with friends. Physical dependence occurs when a person’s body adapts to GHB and gets used to functioning with the GHB present. Withdrawal If a dependent person stops taking GHB, they may experience withdrawal symptoms because their body has to get used to functioning without GHB. Withdrawal symptoms usually start about 12 hours after the last dose and can continue for about 15 days. Some of the withdrawal symptoms that may be experienced include:
»» confusion, agitation, anxiety and panic »» paranoia »» restless sleep »» tremors
»» muscle cramps »» perspiration »» hallucinations »» rapid heartbeat.
Sudden withdrawal from high doses may also result in blackouts and bowel and bladder incontinence, and may require medical assistance.
GHB and driving It is dangerous to drive after using GHB. The effects of GHB, such as feeling drowsy and dizzy, can affect driving ability. People with reduced inhibitions may take more risks when driving which increases the chance of an accident. The symptoms of coming down and withdrawal can also affect a person’s ability to drive safely.
GHB and the workplace Under occupational health and safety legislation, all employees have a responsibility to make sure they look after their own and their co-workers’ safety. Many workplaces are introducing alcohol and drug policies, so employees need to be aware of the potential consequences of their drug use.
The effects of GHB such as memory lapses, drowsiness, dizziness and tremors can affect a person’s ability to work safely and effectively. The symptoms of coming down and withdrawal can also affect a person’s ability to work safely and effectively.
Pregnancy and breastfeeding Many drugs can cross the placenta and affect an unborn child. In general, using drugs when pregnant can increase the chances of going into labour early. This can mean that babies are born below the normal birth weight. If a mother uses GHB while breastfeeding, the drug may be present in her breast milk. This may have an effect on the baby’s health.
GHB and other drugs The chances of an overdose are increased if GHB is taken with other depressant drugs such as alcohol, benzodiazepines or opiates. If GHB is taken with stimulants such as amphetamines and ecstasy the body is put under a lot of stress as it tries to deal with the competing effects. Using GHB to help with the symptoms of the “comedown” after using stimulants can lead to a cycle of dependence on both kinds of drugs.
GHB and social problems All areas of a person’s life can be affected by drug use.
»» Disagreements and frustration over drug use can cause family arguments and affect personal relationships.
»» Legal and health problems can also add to the strain on personal, financial and work relationships.
GHB and the law GHB is illegal in Australia. Federal and state laws provide penalties for possessing, using, making, selling or driving under the influence of GHB. Penalties can include fines, imprisonment and being disqualified from driving. Some states and territories have programs that refer people with a drug problem to treatment programs where they can receive help rather than going through the criminal justice system. For more information contact a legal aid service in your state or territory.
Treatment options In Australia, there are many different treatment options for drug problems. Some aim to help a person to stop using a drug, while others aim to reduce the risks and harm related to their drug use. Treatment is more effective if adapted to suit each person’s situation. Some of the different options include individual counselling, group therapy, medication (pharmacotherapy) and supervised/home withdrawal.
Preventing and reducing harms Many Australians take at least one psychoactive drug on a regular basis—they might take medication (i.e. over-the-counter or via a prescription), drink alcohol, smoke tobacco or use an illegal drug. All drugs have the potential to cause harm. As use increases, so does the potential for harm. Australia’s national drug policy is based on harm minimisation. Strategies to minimise harm include encouraging people to avoid using a drug through to helping people to reduce the risk of harm if they do use a drug. The policy aims to reduce all types of drugrelated harm to both the individual and the community.
There is no safe level of drug use Use of any drug always carries some risk—even medications can produce unwanted side effects. It is important to be careful when taking any type of drug.
What to do if you are concerned about someone’s drug use If you are concerned about someone’s drug use, there is help available. Contact the alcohol and drug information service in your state or territory. The telephone numbers are listed on the back of this pamphlet.
What to do in a crisis If someone overdoses or has an adverse reaction while using GHB, it is very important that they receive professional help as soon as possible. A quick response can save their life.
»» Dial triple zero (000) to call an ambulance. Ambulance officers are not obliged to involve the police.
»» Stay with the person until the ambulance arrives.
Find out if anyone at the scene knows cardiopulmonary resuscitation (CPR). »» Ensure that the person has adequate air by keeping crowds back and opening windows. Loosen tight clothing. »» If the person is unconscious, don’t leave them on their back—they could choke. Turn them on their side and into the recovery position. Gently tilt their head back so their tongue does not block the airway. »» If breathing has stopped, apply CPR. »» Provide the ambulance officers with as much information as you can—such as how much GHB was taken, how long ago and any pre-existing medical conditions.
For information, counselling or other assistance, contact the alcohol and other drug service in your state or territory.
ACT (02) 6207 9977
Tas. 1800 811 994
NSW (02) 9361 8000 (Sydney) 1800 422 599 (NSW)
Vic. 1300 85 85 84 (information)
NT 1800 131 350
QLD 1800 177 833 SA
1300 131 340
1800 888 236 (counselling)
WA (08) 9442 5000 (Perth) 1800 198 024 (WA)
Produced by the Australian Drug Foundation Š 2013. Celebrating more than 50 years of service to the community, the Australian Drug Foundation is Australia’s leading body committed to preventing alcohol and other drug problems in communities around the nation. www.adf.org.au For further copies of this pamphlet: Post: PO Box 818, North Melbourne, VIC 3051 Street: Level 12, 607 Bourke Street, Melbourne, VIC 3000 Email: shop@adf.org.au Web: www.shop.adf.org.au