GHB Addiction

GHB Addiction

GHB Addiction

GHB AddictionSamantha Reid had just turned 15 years old in January 1999 when she attended a party with two girlfriends and several boys at an apartment in Detroit, Michigan. The boys, also high school students, put GHB into the girls’ soft drinks because, as they later told police, they thought the drug would “loosen things up.” One girl did not drink her Mountain Dew. The second landed up in a coma and recovered. But Samantha Reid died around 3:30 A.M. the next morning. The boys were later convicted of involuntary manslaughter and sentenced to 15 years in prison.[i]

As a result of Samantha’s death, Congress passed the Hillory J. Farias and Samantha Reid Date Rape Prohibition Act of 2000. GHB was classified as a Schedule I Controlled Substance, which meant you could face the most severe drug penalties possible for trafficking in GHB, including 20 years in prison and life in prison if a death occurs.[ii] GHB has been around since the 1920s, but for the first time, it was finally recognized as the dangerous addictive drug that it is.

What Is GHB?

GHB, an abbreviation for gamma-hydroxybutyric acid,  is an illegal addictive drug that depresses the central nervous system. It is in the same family as Ketamine and Rohypnol.  GHB acts in the brain receptors for Gamma Aminobutyric Acid (GABA) and at GHB binding sites.[iii] GHB naturally occurs in the cells of humans and animals, and can be a byproduct in the fermentation of wine and beef.[iv]

GHB was synthesized in the 1920s, and once used as an anesthetic, sleeping pill, pain reliever for childbirth, and as a way to relieve cravings for alcohol. In the 1970s it was prescribed for narcolepsy. In the 1970s until 1990, GHB was sold as a dietary supplement use by athletes, bodybuilders, and people who wanted to lose weight, because it increased human growth hormone.  As people began to die from using GHB products with names like Revitalize Plus, Gamma G, Remforce, Blue Nitro, GH Revitalizer, Revivarant, Serenity, Enliven, Somatopro, and Weight Belt Cleaner, the United States Food and Drug Administration declared GHB unsafe in 1991, and asked that all these supplements be removed from the market.[v]

Throughout the 1990s, GHB and Ecstasy were widely abused in nightclubs and at “raves.” As deaths from GHB used either in clubs or as a supplement increased, the FDA asked all GHB manufacturers to stop producing it in January 1999, and recalled any products remaining on the market.  On March 2000, GHB was declared to be a Schedule I Controlled Substance with no medical uses, no proven safety record, and with a high potential for abuse.[vi]  If certain provisions of the original drug law are applied, analogs of GHB are also classified as Schedule I Controlled Substances.[vii] GHB was classified as a Schedule IV within the international guidelines of the 1971 Convention of Psychotropic Substances in 2001.[viii]

What Are the Medical Uses of GHB?

A form of GHB called sodium oxybate is found in a drug trademarked by Jazz Pharmaceuticals called Xyrem.  In 2002 the FDA approved it only for narcolepsy and cataplexy, which is a loss of muscle strength. Xyrem is available only through a mail order program called the Xyrem Success Program.[ix]

Taking  Xyrem is tricky in that you have to mix it in water and drink a dose at bedtime, and then take another dose two and a half to four hours later.  Patients usually mix the second dose in advance and keep it near their beds.[x]

In 2010 the FDA refused to approve Xyrem as a treatment for fibromyalgia, which would have opened the drug up to five million more patients.  The Advisory Panel recommended that Xyrem be used only for the two rare conditions because the dosing is such that containers are left where children could accidentally ingest Xyrem, and because the drug is addictive and dangerous.  Trinka Porrata, the director of Project GHB, testified against selling Xyrem for fibromyalgia, saying, “Approving this will create a new batch of addicts and deaths.”[xi]

What Are the Effects of GHB?

The effects of GHB depend upon how much you have taken.  At low doses, GHB produces euphoria and decreased inhibitions. At doses between one and two grams, you might have slurred speech and motor interference. At over four grams, you may become agitated, disorientated, combative, confused, uncoordinated, experience respiratory depression, loss of memory, incontinence, wavering consciousness, coma and death.[xii]  Effects begin within ten to 20 minutes of taking GHB, peak at 45 to 90 minute point, and then level off. Many people feel groggy and sleepy for as long as 12 hours after taking GHB. Just a small dose produces quick and dramatic effects.[xiii]

GHB causes a strange side effect in that the user’s head will suddenly and uncontrollably snap back. It also causes people to lose the gag reflex, making them more susceptible to choking.[xiv]

The sleep produced by GHB imitates natural sleep, except that rapid eye movement sleep is enhanced and slow wave sleep increases.[xv]

GHB stimulates that the pituitary gland to release growth hormones, and elevates growth hormones during pregnancy.[xvi]

The side effects of Xyrem can be headache, urinary incontinence, numbness, tremors, vertigo, sleepiness, confusion, cold symptoms, shortness of breath, nausea, dizziness, diarrhea, and reduced sense of touch. People who experience hallucinations, sleepwalking or suicidal thoughts should stop taking the drug.[xvii] Since Xyrem is taken only before sleeping, most people do not have many side effects.

What Drugs Interact with GHB?

On December 17, 2012, the United States Food and Drug Administration issued a warning that the drug Xyrem should never be taken with alcohol. The person’s breathing can slow to the point of stopping, and he or she can lose consciousness, enter a coma and die.[xviii]

For the same reason GHB should never be mixed with alcohol or central nervous system depressants such as benzodiazepines, certain antidepressants, antipsychotics drugs, anesthesia, muscle relaxants, pain killers, sleeping medicines, cold and flu medicine, sedatives, and medication or anxiety, depression or seizures.[xix]

What Are the Dangers of GHB?

The main danger of GHB is death by overdose because it does not take more than a few extra grams to kill someone. GHB is particularly deadly with alcohol. If you use it on a long-term basis with alcohol, you can permanently damage your liver.[xx] Since the drug is illegal, you can never be sure of the strength or purity of what you are taking, which increases your risk for overdose.  People have burned their mouths on GHB made from acids.

GHB is addictive in the sense that if you abuse the drug, you will develop cravings for it, a tolerance for its effects so that you have to use more to achieve the same effects, and a withdrawal syndrome when you stopped using it.[xxi]

GHB users are more likely to get into car accidents and practice unsafe sex. The drug causes  “head snapping,” in which the head suddenly snaps back involuntarily, and people injure themselves when their heads snap against walls.

How Is GHB Used in Rapes?

GHB is the most commonly used drug for rapes.[xxii] One website, originating in China, advertises GHB as the “the obedience liquid. If she drinks this, she’ll be yours. Afterward she’ll have no memory. Only two pills will send her into a deep sleep.”[xxiii]

A perpetrator usually puts liquid into his victim’s drink, which renders her unconscious for three to four hours. When she wakes up, she has no memory of the incident.[xxiv] The drug is also difficult to detect  after a few hours have passed since usage.

Signs of having been raped while unconscious can be bruises on legs, mouth or breasts, injury to vagina, torn clothing, clothing buttoned wrong, and nightmares about being raped.[xxv]

Penalties for using drugs to facilitate a rape are severe. Andrew Luster, heir to the Max Factor cosmetics fortune, is serving 124 years in prison for three GHB-connected rapes.[xxvi]

What People Should Not Take GHB?

People who should not take GHB or Xyrem are those with breathing disorders, sleep apnea, histories of drug abuse or alcoholism, depression, suicidal attempts, mental illness, or diseases of the heart or liver.[xxvii]

Does GHB Show up in Urine Tests at Work or School?

GHB does not show up in routine urine tests administered at school or work. It passes through the body within 24 hours, and through urine within eight to 12 hours. It lasts four to eight hours in blood.[xxviii]  Because it is hard to detect, GHB is used in rapes. Police can later detect GHB in the victim’s hair or vomit, but blood and urine tests have to be done almost immediately after ingesting GHB.

What Is a GHB Overdose?

GHB overdose occurs when a person takes too much at one time, usually over 4000mg. GHB overdoses are fairly common, and most people come to emergency rooms after combining GHB with alcohol or central nervous system depressants such as tranquilizers, heroin, or narcotic pain killers. An overdose can with occur within minutes, and it may be important to keep the person from swallowing his own vomit by turning his head if he is lying down.[xxix]

Symptoms of GHB overdose are headache, nausea, vomiting, hallucinations, seizures, amnesia, slow respiration, loss of consciousness, coma, and then death. Death can occur within minutes as the person’s breathing slows down to the point of stopping.[xxx] The effect on breathing will depend on the dosage taken.[xxxi]

It is extremely important to get to an emergency room as quickly as possible.  A label for Blue Nitro, a product that contains GHB, advises “ensure those around you that you may be unarousable and that is normal. Unless drugs or alcohol had been taken with Blue Nitro, the only treatment necessary is to sleep it off.” This is untrue and dangerous.[xxxii] Samantha Reid died because the boys who gave her GHB debated too long about taking her to a hospital.[xxxiii]

If GHB has been taken with methamphetamine, the person will have seizures that can be treated with diazepam or lorazepam.  If the person has combined GHB with alcohol, he may have difficulty breathing.[xxxiv]

What Is GHB Withdrawal?

GHB withdrawal occurs when a person who is addicted to the drug tries to stop using it. The symptoms can be very severe, and doctors specializing in addiction advise people to get professional help with GHB withdrawal.[xxxv] Symptoms will depend on the person’s health, age, weight and other factors, and how much and how often he or she was using GHB. An addict who was using the drug every two or three hours will have more severe symptoms.

Symptoms begin within one to six hours of the last dosage of GHB, and can last two to 21 days, but the average is five to 15 days.[xxxvi] Days four to six are usually the most difficult.[xxxvii] Symptoms are anxiety, restlessness, moodiness, edginess, tight chest, muscle aches, loss of appetite, vomiting, loss of appetite, rapid heartbeat, depression, irritability, and insomnia.[xxxviii]  Some people have convulsions, delirium, disorientation, hallucinations, and even psychoses, which is why you need professional help during withdrawal.[xxxix]

What Is GHB Abuse and Addiction?

GHB abuse was more prevalent in the “rave era” of the 1990s, when young people were getting high on club drugs at large parties and nightclubs.  GHB was called “liquid X” even though it is a depressant, unlike the stimulant “X” or Ecstasy.[xl]

Today people use GHB in social situations the way they use alcohol — to relax and reduce inhibitions.  It produces a dreamy “sexy” state, which is why exotic dancers like it. It is sometimes used to reduce the effect of stimulants or hallucinogenic drugs such as cocaine, methamphetamine, LSD, or ephedrine.[xli]

People who use GHB socially can become addicted to it, but according to Project GHB, most addicts are young white males who participate in sports and body building and use the drug as a hormone supplement or those who start by taking Xyrem for medical reasons. Others are people in chronic pain or senior citizens who buy anti-aging products.[xlii]  Several high-profile professional athletes have faced criminal charges for using GHB.[xliii]  According to the annual survey of 15,000 high school students performed by Monitoring the Future Study from the University of Michigan, about 1.4% of students used GHB in 2009, whereas the percent was over 5% in the 1990s.[xliv] About 1800 people a year seek emergency room treatment because of GHB-related incidents and 54% are young adults. Declaring GHB to be a Schedule I Controlled Substance in 2000 and the passage of the Drug Induced Rape Preconvention Act of 1996 curtailed the abuse of GHB, but allowing Xyrem on the market in 2002 increased it.[xlv]

Statistics on GHB abuse, deaths and emergency room treatment are probably low because toxicologists often do not detect the drug. Many GHB-induced rapes go unreported because the victims did not remember the incidents.[xlvi]

GHB is produced in foreign and domestic laboratories, and sold at raves, bars, gyms, sex shops, and on college and high school campuses. It is easily made even in private homes by mixing GHB analogues with various alkalis.[xlvii] The analogues GBL (gamma butyrolactone) and BD (1,4 butanediol) are easily available as ingredients in cleaning and manufacturing chemicals, such as paint removers, nail polish removers and drain cleaners. The Internet is full of recipes and even kits for making GHB,[xlviii] mostly by using the precursor chemicals sodium oxybate and sodium oxybutyrate.[xlix]

GHB is typically sold in small bottles the size of nail polish containers, with one capful or dropper-full equal to one dose, usually around 3,000mg.  However, it is also sold in powder or pill form or even as lollipops and “squirts” from water guns.[l] One dose costs between $5 and $30.[li]

Some of the street names for GHB reflect its use as a date rape drug: Georgia Home Boy, Grevious Bodily Harm, Great Hormones at Bedtime, Get Her to Bed, Easy Lay, Clear X, Liquid X, Salty Water, Everclear, Chemical X, Xrater, Scoop, and Scoop Her. As an intoxicant, people call it G, GHB, liquid dream, Liquid E, Fantasy, Gamma OH, Soap, Water, Liquid Ecstasy, Soap, G-Riffick, Organic Quaalude, Jib, and Somatomax. When mixed with amphetamines, it’s called Cherry Meth and Max. Body builders sometimes call it Juice or Goop or Growth Hormone Booster,

What Treatments Are Available for GHB Addiction?

People who are severely addicted to GHB may drink caps of it every few hours. If this describes you, you need to undergo withdrawal only under medically-supervised conditions.  The majority of GHB addicts need to be hospitalized during their chemical withdrawal for seven to 14 days,[lii] because they experience bizarre mental states similar to schizophrenia or paranoia with hallucinations.[liii] The best thing to do is to enter a residential treatment center.

On the first day at a residential treatment center, you undergo various psychological and physical examinations to determine your protocol of treatment. The next step will undoubtedly be detoxification or chemical withdrawal from GHB. Then you will begin an intense program of psychotherapy, classes and recreation to enable you to understand addiction and its challenges. Drug use has been consuming such a large percent of your time and concentration that you will need help finding new pursuits to replace it.  Your psychotherapist will help you understand how you became addicted and what you need to do to create a new life for yourself.

The vast majority of people who enter residential treatment have undiagnosed psychological or mental problems that contribute to but do not cause their drug abuse. Typical comorbidities are clinical depression, childhood trauma, bipolar disorder, and posttraumatic stress syndrome, which are treated in protocols separate from the treatment for drug addiction.

Residential treatment should not only be life-changing, it should also be fun. You experiment with new hobbies and sports, get yourself into top physical condition, make new friends who are on the same journey you are, and enjoy social activities.  You’ll also learn how to relax without drugs by using stress- reducing techniques such as meditation and yoga. When you return home, you usually remain in an aftercare program that includes attending support meetings in your community and psychotherapy.

What Are the Signs That I or a Loved One Need Help for GHB Abuse?

People who abuse the GHB can appear drunk with slurred speech and poor coordination. They may act silly or confused, or appeared to be in a stupor. Look for the characteristic head snapping, and for small bottles with clear liquid in them.[liv]

If you can answer yes to any of the following questions, it may be time to seek help for your problem with GHB.

  • Do you believe you cannot achieve the muscular body you want without taking supplements like GHB?
  • Do you experience withdrawal symptoms, such as headaches or insomnia, when you stop taking GHB?
  • Do you keep having to use more GHB in order to achieve the effects you want?
  • Do you find it hard to relax without taking GHB?
  • Are the side effects of GHB bothersome to you?
  • Are you spending too much money on GHB?
  • Do your friends or family members criticize you for your drug use?
  • Do you prefer to be with people who use GHB?
  • Do you drive or otherwise endanger yourself physically because of drugs like GHB?
  • Do you think about GHB too often?
  • Do you worry that you will face arrest or other legal consequences from your use of GHB?
  • Are you buying GHB from illegal sources?

 


[i]”Daughter’s Death Prompts Fight on ‘Date Rape’ Drug,” The New York Times, October 16, 1999.

[ii] Bradsher, Keith. “Guilty of Manslaughter in Slipping Drug to Girl,” The New York Times, March 15, 2000.

[iii] “GHB,” Brown University Health Administration, see http://brown.edu/Student_Services/Health_Services/Health_Education/alcohol,_tobacco,_&_other_drugs/ghb.php

[iv] Weil, Dr. Andrew. From Chocolate to Morphine. (New York: Howard Mifflin), 1998, pg. 279.

[v] Stout, David. “New Drug Can Induce Coma or Death,” The New York Times, January 22, 1999.

[vi] “Gamma-Hydroxybutyrate,”  The Center for Substance Abuse Research at the University of Maryland, see http://www.cesar.umd.edu/

[vii] “Gamma-Hydroxybutyrate,”  A Pamphlet from the United States Drug Enforcement Agency, Office of Drug Diversion, see http://www.deadiversion.usdoj.gov/drug_chem_info/ghb/ghb.pdf

[viii] “GHB Statistics,” The White House Office of Drug Policy, see http://www.dhra.mil/perserec/adr/drugs/gamma_hydroxybutyrate.htm

[ix] “FDA Drug Safety Communication: Warning against use of Xyrem (sodium oxybate) with alcohol or drugs causing respiratory depression,” The United States Food and Drug Administration, December 17, 2012, see http://www.fda.gov/Drugs/DrugSafety/ucm332029.htm

[x] “Xyrem,” official information from the United States Food and Drug Administration, Drugs.com, see http://www.drugs.com/xyrem.html

[xi] Walker, Emily. “FDA Roundly Rejects CNS Drug for Fibromyalgia,” MedPage Today, August 20, 2010.

[xii] “GHB Trafficking and Abuse,” The National Drug Intelligence Center, the United States Department of Justice, see http://www.justice.gov/archive/ndic/pubs10/10331/10331p.pdf

[xiii] Emmett, David and Graeme Nice. Understanding Street Drugs: A Handbook of Substance Abuse, London: Jessica Kingleys Publishers, 2005, page 240.

[xiv] “Project GHB,” see http://www.projectghb.org

[xv] “GHB Trafficking and Abuse,” The National Drug Intelligence Center, the United States Department of Justice, see http://www.justice.gov/archive/ndic/pubs10/10331/10331p.pdf

[xvi] Weil, Dr. Andrew. From Chocolate to Morphine. (New York: Howard Mifflin), 1998, pg. 279.

[xvii] “Xyrem,” Official Information from the United States Food and Drug Administration, Drugs.com, see http://www.drugs.com/xyrem.html

[xviii] “FDA Drug Safety Communication: Warning against use of Xyrem (sodium oxybate) with alcohol or drugs causing respiratory depression,” The United States Food and Drug Administration, December 17, 2012, see http://www.fda.gov/Drugs/DrugSafety/ucm332029.htm

[xix] “Xyrem,” Official Information from the United States Food and Drug Administration, Drugs.com, see http://www.drugs.com/xyrem.html

[xx] “GHB,” Brown University Health Administration, see http://brown.edu/Student_Services/Health_Services/Health_Education/alcohol,_tobacco,_&_other_drugs/ghb.php

[xxi] See section on GHB addiction, “Project GHB,” see http://www.projectghb.org

[xxii] “GHB Trafficking and Abuse,” The National Drug Intelligence Center, the United States Department of Justice, see http://www.justice.gov/archive/ndic/pubs10/10331/10331p.pdf

[xxiii] Kristof, Nicholas. “Cheap Guns, Cheap Meth,” The New York Times, January 2, 2013.

[xxiv] Emmett, David and Graeme Nice. Understanding Street Drugs: A Handbook of Substance Abuse, London: Jessica Kingleys Publishers, 2005, page 241.

[xxv] “Project GHB,” see http://www.projectghb.org

[xxvi] Emmett, David and Graeme Nice. Understanding Street Drugs: A Handbook of Substance Abuse, London: Jessica Kingleys Publishers, 2005, page 242.

[xxvii] “Xyrem,” Official Information from the United States Food and Drug Administration, Drugs.com, see http://www.drugs.com/xyrem.html

[xxviii] “GHB Trafficking and Abuse,” The National Drug Intelligence Center, the United States Department of Justice, see http://www.justice.gov/archive/ndic/pubs10/10331/10331p.pdf

[xxix] “GHB: A Club Drug to Watch,” The United States Substance Abuse and Mental Health Administration, see http://www.kap.samhsa.gov/products/manuals/pdfs/GHB-Advisory.pdf

[xxx]”Project GHB,” see http://www.projectghb.org

[xxxi] Morse BL, Vijay N, Morris ME. γ-Hydroxybutyrate (GHB)-induced respiratory depression: combined receptor-transporter inhibition therapy for treatment in GHB overdose. Mol Pharmacol. 2012 Aug;82(2):226-35. doi: 10.1124/mol.112.078154. Epub 2012 May 4.

[xxxii] “Project GHB,” see http://www.projectghb.org

[xxxiii]”Daughter’s Death Prompts Fight on ‘Date Rape’ Drug,” The New York Times, October 16, 1999.

[xxxiv] Emmett, David and Graeme Nice. Understanding Street Drugs: A Handbook of Substance Abuse, London: Jessica Kingleys Publishers, 2005, page 242.

[xxxv] “GHB,” Brown University Health Administration, see http://brown.edu/Student_Services/Health_Services/Health_Education/alcohol,_tobacco,_&_other_drugs/ghb.php

[xxxvi] “GHB: A Club Drug to Watch,” The United States Substance Abuse and Mental Health Administration, see http://www.kap.samhsa.gov/products/manuals/pdfs/GHB-Advisory.pdf

[xxxvii] “Project GHB,” see http://www.projectghb.org

[xxxviii] Bellenir, Karen. Drug Abuse Sourcebook. Detroit: Omnigraphics, 2000, page 128.

[xxxix]”GHB,” Brown University Health Administration, see http://brown.edu/Student_Services/Health_Services/Health_Education/alcohol,_tobacco,_&_other_drugs/ghb.phb

[xl] “GHB: A Club Drug to Watch,” The United States Substance Abuse and Mental Health Administration, see http://www.kap.samhsa.gov/products/manuals/pdfs/GHB-Advisory.pdf

[xli] “GHB Statistics,” The White House Office of Drug Policy, see http://www.dhra.mil/perserec/adr/drugs/gamma_hydroxybutyrate.html

[xlii] “Project GHB,” see http://www.projectghb.org

[xliii] Schmidt, Michael and Duff Wilson. “Fernandez and Rose Jr. Linked to Radomski,” The New York Times, December 11, 2005.

[xliv] “GHB Trafficking and Abuse,” The National Drug Intelligence Center, the United States Department of Justice, see http://www.justice.gov/archive/ndic/pubs10/10331/10331p.pdf

[xlv] Walker, Emily. “FDA Roundly Rejects CNS Drug for Fibromyalgia,” MedPage Today, August 20, 2010.

[xlvi] “Project GHB,” see http://www.projectghb.org

[xlvii] “GHB Trafficking and Abuse,” The National Drug Intelligence Center, the United States Department of Justice, see http://www.justice.gov/archive/ndic/pubs10/10331/10331p.pdf; see also”Club Drugs,” The National Criminal Justice Report System, see https://www.ncjrs.gov/spotlight/club_drugs/facts.html

[xlviii] Bradsher, Keith. “Guilty of Manslaughter in Slipping Drug to Girl,” The New York Times, March 15, 2000.

[xlix] “GHB: A Club Drug to Watch,” The United States Substance Abuse and Mental Health Administration, see http://www.kap.samhsa.gov/products/manuals/pdfs/GHB-Advisory.pdf

[l]”GHB: A Club Drug to Watch,” The United States Substance Abuse and Mental Health Administration, see http://www.kap.samhsa.gov/products/manuals/pdfs/GHB-Advisory.pdf

[li]”Gamma-Hydroxybutyrate,”  A Pamphlet from the United States Drug Enforcement Agency, Office of Drug Diversion, see http://www.deadiversion.usdoj.gov/drug_chem_info/ghb/ghb.pdf

[lii] “GHB: A Club Drug to Watch,” The United States Substance Abuse and Mental Health Administration, see http://www.kap.samhsa.gov/products/manuals/pdfs/GHB-Advisory.pdf

[liii] “Gamma-Hydroxybutyrate,” Drugs and Human Performance Fact Sheet from the National Highway Traffic Safety Administration, http://www.nhtsa.gov/People/injury/research/job185drugs/gamma-hydroxybutyrate.htm

[liv] Emmett, David and Graeme Nice. Understanding Street Drugs: A Handbook of Substance Abuse, London: Jessica Kingleys Publishers, 2005.

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