GHB

How is GHB used?

GHB is usually swallowed, but it is sometimes plugged (squirted up the bottom).⁴

Effects of GHB

The use of any drug can have risks. It’s important to be careful when taking any type of drug.

GHB affects everyone differently, based on:

• size, weight and health
• whether the person is used to taking it
• whether other drugs are taken around the same time
• the amount taken
• the strength of the drug (varies from batch to batch)
• the environment (where the drug is taken).

Onset and duration of effects

How fast a drug takes effect and how long it lasts can vary depending on how it's taken – for example, whether it's swallowed or plugged. It will also vary depending on what form you have: GHB, GBL, or 1,4-BD.

Effects of GHB begin within 10 to 15 minutes after taking it, with peak effects occurring around 30-60 minutes and lasting from 1.5 to 4 hours.^{1, 4}

GBL is typically stronger than GHB, and the effects may be felt more quickly. But it doesn’t last as long as GHB.^5-7

1,4-BD typically has a lower potency and slower onset, compared to GHB, but its effects last longer.⁸

Effects

Effects can include:

• increased happiness and confidence
• increased sex drive
• relaxation
• slurred speech
• drowsiness
• clumsiness
• muscle twitches
• slow breathing
• sweating
• nausea
• blackouts and memory loss
• diarrhoea.^{1, 4}

The chemical makeup of GHB can vary a lot and it’s very easy to take too much. The difference between the amount needed to get high and the amount that causes an overdose can be hard to judge.

Being under the influence of GHB also increases the risk of injury due to confusion, dizziness, or sudden blackouts.^{2, 9}

Impact of mood and environment

Drugs that affect a person’s mental state (psychoactive drugs) can also have varied effects depending on a person’s mood (often called the ‘set’) or the environment they are in (the ‘setting’): 

• Set: a person’s state of mind, previous encounters with the drug, and expectations of what’s going to happen. For example, feelings of stress or anxiety before using GHB may result in an unpleasant experience and make those feelings worse.
• Setting: the physical and social environment where you take GHB – whether it’s known and familiar, who you're with, if you're indoors or outdoors, the type of music or sounds, and lighting. The ideal setting to take GHB will vary based on the individual and drug they’re using. One person might enjoy GHB in a loud social setting like a party, while another may prefer a quieter place with close friends.¹⁰

Being in a good state of mind, with trusted friends and a safe environment before taking GHB reduces the risk of having a bad experience.¹⁰

Overdose

If you take a large amount of GHB or use a strong batch, you could overdose. Your risk of overdose can also increase if you mix GHB with alcohol or other drugs, including medications.

GHB can cause death.

Call triple zero (000) and request an ambulance if you or someone else has any of the following symptoms (emergency services are there to help and can provide more instructions).

• unconscious or non-responsive
• confusion, irritation and agitation
• hallucinations 
• vomiting
• slow breathing, abnormal breathing, or not breathing at all
• slow or no heartbeat and pulse
• seizures
• GHB-induced coma.^{3, 4, 9}

A GHB overdose can cause someone to go into a coma, where they can’t be woken for around 1-4 hours. This is a medical emergency – always call triple zero (000) and ask for an ambulance if somebody is unresponsive. Some people who use GHB frequently may experience multiple instances of GHB-induced coma.^{11, 12}

Learn more on overdose and drug-related emergencies

Mixing GHB with other drugs

Mixing GHB with other drugs can have unpredictable effects and increase the risk of harm. Mixing includes using more than one drug (including alcohol or medications) at the same time, or one after another. You should also consider what drugs you’ve taken in the last 24 hours.

• GHB and stimulants (such as cocaine/methamphetamine): GHB slows down breathing and heart rate, while stimulants speed them up. Both drugs will work against each other, increasing risk of heart strain and seizures. Stimulants (especially methamphetamine) can also mask the effects of GHB, which can lead to people using higher doses. If the stimulant wears off first, then the GHB effects may cause an overdose.
• GHB and empathogens (such as MDMA/MDA): GHB slows down breathing and heart rate, while empathogens speed them up. Both drugs will work against each other, increasing risk of heart strain and seizures.
• GHB and depressants (such as alcohol/benzodiazepines/opioids): very high risk of overdose. Can cause difficulty breathing, passing out, and possible death.
• GHB and dissociatives (such as nangs/ketamine): can cause impaired coordination, memory loss, passing out, vomiting, possible death.^{4, 13, 14}

Using more than one drug or type of drug at the same time is also called polydrug use.⁹

Reducing harm 

There are ways you can reduce the risk of harm when using GHB:

• Start low, go slow – try a little bit first to see how you feel and wait at least 2 hours before taking more. GHB can build up in your body, so even if the effects feel like they’re wearing off, the drug is still active in your system. Taking another dose can cause it to build to dangerous levels, increasing the risk of overdose. Always use a lower your dose if you plan on having more.
• Wait at least 2 hours after eating before using GHB – food changes the way GHB is absorbed.
• If you’re taking GBL – it is more potent and requires a smaller dose for the same effects. 
• If you’re taking 1,4B-D – wait longer before trying more as the effects are slower to kick in.
• Use a slip syringe barrel (without needle) to measure your doses to the 0.1ml (millilitre) – this can help to prevent accidentally taking a dose that is too much. It is best to do your own dose, so you can track the exact amount you’ve taken. If you’re looking for advice on GHB dosing, see here: Harm Reduction Victoria – GHB.
• Use somewhere safe and around people you trust – if something goes wrong, others can help.
• Stay hydrated by taking small sips of water regularly – to avoid dehydration.
• Avoid operating machinery, driving, or swimming.
• Test your GHB if there is an available drug checking (pill testing) service near you, to find out what the drug contains and how strong it is.^{4, 13, 14}

Coming Down

After using GHB you may experience some comedown or hangover effects. People have reported feelings of anxiety, however more research on GHB comedown effects is needed.¹³

Long-term effects

There is limited evidence on the long-term effects of GHB. However, regular use can lead to dependence, and some studies suggest that frequent, heavy use (especially repeated episodes of GHB-induced coma) may be linked with longer-term memory and thinking problems.^{1, 9, 12, 15}

GHB and mental health

GHB can make existing mental health symptoms worse, or bring on symptoms like anxiety, confusion or hallucinations — especially during withdrawal. 

If you are finding it hard to cope or worried you are experiencing these symptoms, talk to your GP and ask if you can access specialist mental health support.^{9, 16}

Tolerance

Regularly taking GHB can lead to developing a tolerance, which means you need to take larger amounts to get the same effects.⁹

Dependence

People who regularly use GHB may become dependent. They may feel they need to use GHB to go about usual activities like working, studying and socialising, or just to get through the day.

Withdrawal

Withdrawal refers to the symptoms that can occur when someone who is dependent on GHB or has been using it regularly over time, stops or reduces their use.¹⁷

Withdrawal can include physical symptoms (such as headaches, or nausea) and psychological symptoms (such as anxiety, or depressed mood).¹⁷

Symptoms –  including how strong they are and how long they last – will vary depending on the type of drug and a person’s history of use.¹⁷

Withdrawal from GHB can be potentially life-threatening. ^{2, 9}

If you, or someone you care about, is planning to stop taking GHB after using it for a long time, it’s important to speak with a medical professional for guidance and supervision. 

Reducing, or stopping using GHB after a period of regular use can lead to withdrawal symptoms, including:

• insomnia
• sweating
• confusion and agitation
• anxiety and panic
• rapid heart rate
• tremors and seizures
• vomiting
• paranoia
• hallucinations
• delirium.^{2, 9}

Withdrawal symptoms usually start about 6-72 hours after the last dose and can continue for about 5-15 days.⁹

After withdrawing from GHB, your body is no longer used to it and your tolerance drops. This means if you use the same amount as before, it can be too much for your body and cause an overdose. Always start with a lower dose after a break from GHB.

Pregnancy and breastfeeding

Before pregnancy 

There is little research that shows the impact of GHB use on fertility. 

During pregnancy

Although there is limited research on the effects of GHB use on pregnancy outcomes, it is still not recommended due to potential impact on the baby’s health. GHB also has a high risk of overdose and carries severe withdrawal symptoms if stopped suddenly, both of which can cause serious complications.¹⁸

After pregnancy

If a baby was exposed to GHB during pregnancy, they may need to stay in hospital post-birth so doctors can monitor withdrawal symptoms.¹⁸

There is limited research on GHB and breastfeeding, so the safest option is not to use GHB while breastfeeding. All substances, including GHB, can pass through breastmilk to some extent.¹⁸

Getting help

If your use of GHB is affecting your health, family, relationships, work, school, financial or other life situations, or you’re concerned about someone, there is help and support.  

• Call the National Alcohol and Other Drug Hotline on 1800 250 015 for free and confidential advice, information and counselling about alcohol and other drugs.
• Use the confidential Path2Help portal to get matched with information and services specific to your needs <find out more>
• Search our Help and Support directory to find your preferred support, by adding your location or postcode and filtering by service type.