Gamma hydroxybutyrate (GHB) is a powerful, rapidly acting central
nervous system depressant. It was first synthesized in the 1920s
and was under development as an anesthetic agent in the 1960s. GHB
is produced naturally by the body in small amounts but its physiological
function is unclear.
GHB was sold in health food stores as a performance enhancing additive
in bodybuilding formulas until the Food and Drug Administration
(FDA) banned it in 1990. GHB is abused for its ability to produce
euphoric and hallucinogenic states and for its alleged function
as a growth hormone that releases agents to stimulate muscle growth.
GHB became a Schedule I Controlled Substance in March 2000.
In the United States, GHB is produced in clandestine laboratories
with no guarantee of quality or purity, making its effects less
predictable and more difficult to diagnose. GHB can be manufactured
with inexpensive ingredients and using recipes on the Internet.
Gamma butyrolactone (GBL) and 1,4-butanediol are analogs of GHB
that can be substituted for it. Once ingested, these analogs convert
to GHB and produce identical effects. GBL, an industrial solvent,
is used as an immediate precursor in the clandestine production
of GHB. The FDA has issued warnings for both GBL and 1,4-butanediol,
stating that the drugs have a potential for abuse and are a public
GHB is usually taken orally. It is sold as a light-colored powder
that easily dissolves in liquids or as a pure liquid packaged in
vials or small bottles. In liquid form, it is clear, odorless, tasteless,
and almost undetectable when mixed in a drink. GHB is typically
consumed by the capful or teaspoonful at a cost of $5 to $10 per
dose. The average dose is 1 to 5 grams and takes effect in 15 to
30 minutes, depending on the dosage and purity of the drug. Its
effects last from 3 to 6 hours.
Consumption of less than 1 gram of GHB acts as a relaxant, causing
a loss of muscle tone and reduced inhibitions. Consumption of 1
to 2 grams causes a strong feeling of relaxation and slows the heart
rate and respiration. At this dosage level, GHB also interferes
with blood circulation, motor coordination, and balance. In stronger
doses, 2 to 4 grams, pronounced interference with motor and speech
control occurs. A coma-like sleep may be induced, requiring intubation
to wake the user. When mixed with alcohol, the depressant effects
of GHB are enhanced. This can lead to respiratory depression, unconsciousness,
coma, and overdose.
Side effects associated with GHB may include nausea, vomiting,
delusions, depression, vertigo, hallucinations, seizures, respiratory
distress, loss of consciousness, slowed heart rate, lowered blood
pressure, amnesia, and coma. GHB can become addictive with sustained
Patients with a history of around-the-clock use of GHB (every 2
to 4 hours) exhibit withdrawal symptoms including anxiety, insomnia,
tremors, and episodes of tachycardia (abnormally fast heart rates),
and may progress to delirium and agitation. Because GHB has a short
duration of action and quickly leaves the user's system, withdrawal
symptoms may occur within 1 to 6 hours of the last dose. These symptoms
may last for many months.
GHB-related deaths have occurred in several Community Epidemiology
Work Group (CEWG) sites. In 1999, there were three reported deaths
involving GHB in Texas and two in Minnesota. Missouri has reported
five GHB-related deaths and two near deaths in which GHB was used
to facilitate rapes. In Florida, during 2000, GHB was detected in
23 deaths and identified as the cause of death in 6 cases. Since
1990, the U.S. Drug Enforcement Administration (DEA) has documented
more than 15,600 overdoses and law enforcement encounters and 72
deaths relating to GHB.
GHB is often ingested with alcohol by young adults and teens at
nightclubs and parties. It is used as a pleasure enhancer that depresses
the central nervous system and induces intoxication. It also can
be used as a sedative to reduce the effects of stimulants (cocaine,
methamphetamine, ephedrine) or hallucinogens (LSD, mescaline) and
to prevent physical withdrawal symptoms.
In 2000, according to the National Drug Intelligence Center (NDIC),
GHB availability was stable or increasing in nearly every DEA Field
Division and High Intensity Drug Trafficking Area. Many areas reported
that the increased availability of GHB occurred in concert with
a rise in rave activity. Law enforcement also reported increases
in the number of cases involving GHB analogs.
According to Pulse Check: Trends in Drug Abuse, GHB users and sellers
tend to be between the ages of 18 and 30. Most users are middle-class
white males. GHB is typically packaged in plastic bottles (mostly
water or sports drink bottles) and distributed by the capful for
$5-$20 per dose. Additional packaging includes eyedropper bottles,
glass vials, and mouthwash bottles.
Drug-facilitated rape is defined as sexual assault made easier
by the offender's use of an anesthetic-type drug that renders the
victim physically incapacitated or helpless and unable to consent
to sexual activity. Whether the victim is unwittingly administered
the drug or willingly ingests it for recreational use is irrelevant-the
person is victimized because of their inability to consciously consent
to sexual acts.
According to NDIC, GHB has surpassed Rohypnol (flunitrazepam) as
the most common substance used in drug-facilitated sexual assaults.
GHB can mentally and physically paralyze an individual, and these
effects are intensified when the drug is combined with alcohol.
To date, DEA has documented 15 sexual assaults involving 30 victims
who were under the influence of GHB. Of the 711 drug-positive urinalysis
samples submitted from victims of alleged sexual assault, 48 tested
positive for GHB.
This fact sheet was prepared by Jennifer Lloyd of the ONDCP Drug
Policy Information Clearinghouse. The data presented are as accurate
as the sources from which they were drawn. Responsibility for data
selection and presentation rests with the Clearinghouse staff. The
Clearinghouse is funded by the White House Office of National Drug
Control Policy to support drug control policy research. The Clearinghouse
is a component of the National Criminal Justice Reference Service.
For further information about the contents or sources used for
the production of this fact sheet or about other drug policy issues,
Write the Drug Policy Information Clearinghouse, P.O. Box 6000,
Rockville, MD 20849-6000
or visit their web site at: www.whitehousedrugpolicy.gov