What Is GHB? Signs, Consent Risks, and Overdose

GHB (gamma-hydroxybutyrate) is a powerful central nervous system depressant that occurs naturally in the brain in trace amounts. In higher concentrations, it produces euphoria, sedation, and unconsciousness. The margin between a dose that produces a “high” and a dose that stops breathing is extremely thin. GHB is classified as a Schedule I controlled substance (Schedule III when prescribed as Xyrem for narcolepsy). It is also one of the drugs most commonly involved in drug-facilitated sexual assault. About 14,800 people search for GHB each month. This guide covers effects, overdose signs, consent risks, and when use becomes addiction.

GHB Key Facts

• GHB is a clear, odorless liquid or white powder that is easy to slip into drinks.
• Effects begin within 15 to 30 minutes and last 3 to 6 hours.
• The difference between a recreational dose and a lethal dose can be less than a gram.
• Combining GHB with alcohol or benzodiazepines dramatically increases death risk.
• Physical dependence develops with daily use and can produce life-threatening withdrawal.

How GHB Affects the Body

GHB acts on GABA-B receptors and its own GHB receptor system. At low doses (0.5 to 1.5 grams), it produces relaxation, euphoria, and increased sociability. At moderate doses (1.5 to 2.5 grams), sedation and memory impairment become prominent. Above 2.5 grams, loss of consciousness, respiratory depression, and coma are possible.

The drug’s dose-response curve is steep. A small miscalculation, especially with unlabeled homemade solutions, can shift the outcome from pleasant to fatal. When GHB is mixed with alcohol, the depressant effects stack and respiratory failure becomes far more likely.

GHB and Sexual Assault

GHB is one of the most common drugs used in drug-facilitated sexual assault. Its properties make it effective for this purpose: it is colorless, nearly tasteless when mixed in drinks, produces amnesia, and renders victims unconscious or unable to resist. The drug also clears the body quickly (6 to 12 hours in urine), making forensic detection difficult if testing is delayed.

• If you suspect you have been drugged, go to an emergency room immediately and request GHB-specific testing.
• Do not shower, change clothes, or eat or drink before the exam if sexual assault is suspected.
• Call the National Sexual Assault Hotline at 1-800-656-4673 for support and forensic exam guidance.

The DEA’s 2025 GHB Drug Fact Sheet states that GHB is among the most dangerous drugs of abuse due to its narrow therapeutic window and unpredictable dosing. The agency notes that most GHB-related deaths involve co-ingestion with alcohol or other depressants.

Signs of GHB Use

• Sudden, unexplainable drowsiness or confusion
• Euphoria and disinhibition followed by rapid sedation
• Nausea and vomiting
• Slow, shallow breathing
• Memory gaps or complete amnesia for events during intoxication
• Loss of muscle control and coordination
• Unconsciousness that cannot be reversed by stimulation

GHB Overdose

GHB overdose looks like deep unconsciousness. The person cannot be woken. Breathing becomes slow, irregular, or stops. Vomiting while unconscious creates aspiration risk. Seizures may occur. There is no antidote for GHB overdose. Treatment is supportive: airway management, oxygen, and monitoring in an intensive care setting.

If someone becomes unconscious after suspected GHB use, call 911 immediately. Place them on their side to prevent choking. Monitor their breathing. Do not leave them alone.

GHB Addiction and Withdrawal

Regular GHB use, especially daily use, produces severe physical dependence. GHB withdrawal is one of the most dangerous withdrawal syndromes and can be fatal. Symptoms include:

• Severe anxiety and agitation
• Tremors and muscle spasms
• Insomnia lasting days
• Hallucinations and delirium
• Seizures
• Psychosis

GHB withdrawal shares features with both alcohol and benzodiazepine withdrawal and requires medical supervision. Do not attempt to quit GHB abruptly if you use it daily.

Getting Help

If you are using GHB regularly, professional treatment provides safe withdrawal management and recovery support. Contact a treatment program with experience in sedative-hypnotic withdrawal or call SAMHSA at 1-800-662-4357 for referral assistance. GHB addiction is treatable, but the withdrawal requires medical care that cannot safely happen at home.