GHB

• Gamma-hydroxybutyrate (GHB) is classed as a depressant drug that contains sedative and, at sufficient doses, anaesthetic properties.
• GHB was first manufactured in 1960, and has been used in several countries as a general anaesthetic, and for treatment of the sleep disorders insomnia and narcolepsy. More recently, GHB has been trialled as a treatment for alcohol and opiate (e.g. heroin) withdrawal.
• GHB commonly comes as a colourless, odourless, bitter or salty-tasting liquid, usually sold in small bottles or vials. It also comes as a crystal powder. It is mostly taken orally, but, there have been reports of people injecting the drug.
• GHB has also been identified as a 'date-rape drug' due to effects of amnesia, impairing movement and speech, and because it can be added to drinks without visible trace.

Street names

Fantasy, grievous bodily harm (GBH), liquid ecstasy and liquid E.

Effects

The effects of any drug can vary from person to person. The effects of GHB appear to vary greatly according to the amount used—a small increase in amount can result in a dramatic increase in effect. One of the most dangerous aspects of using GHB is the small difference between an amount that produces the desired effect and the amount that results in overdose. A further risk is that there is often no way to be sure that the drug is manufactured correctly. Improperly made GHB may result in an extremely toxic mixture of GHB and the chemical sodium hydroxide.

Generally, the effects of GHB are experienced within 15 minutes of use, and last for approximately 3 hours. Effects of lower amounts may include:

• a sense of well-being
• relaxation
• drowsiness
• induced sleep
• nausea
• increased confidence, reduced inhibitions
• dizziness
• headache
• increased sociability
• enhanced sense of touch.

An increase in the amount or strength of GHB used may result in the initial feelings of euphoria being replaced by effects including:

• confusion
• agitation
• extreme drowsiness/grogginess
• hallucinations
• difficulty focussing eyes
• vomiting
• stiffening of muscles
• disorientation
• convulsions/seizures
• unconsciousness/abrupt short-term coma
• respiratory collapse
• amnesia (afterwards)
• impaired movement and speech.

 The health and social consequences of long-term GHB use are not known.

Overdose

There appears to be a very fine line between the amount of GHB required to achieve the desired affect and that which leads to coma. As there is usually no way of knowing the strength of GHB, the risk of overdosing is high. An added risk of overdose is that GHB can cause both unconsciousness and vomiting, which increases the risk of choking on vomit.

Combining GHB with other drugs will also increase the dangers. For example, using GHB with another central nervous system depressants, such as alcohol, benzodiazepines (such as Valium) or opiates (such as heroin ) will intensify the effects and increase the risk of overdosing. Deaths have been associated with the use of GHB in the United States. However, there is debate over whether death can result from using GHB alone or using GHB with other drugs, particularly alcohol.

Dependence

Although this is not widely known, some reports suggest that some people can become both physically and psychologically dependent (addicted) on GHB. Physical dependence occurs when a person's body becomes used to functioning with the drug present. If the person suddenly stops their drug use, withdrawal symptoms are experienced. A sign of psychological dependence is when the use of a drug becomes increasingly important in a person's life—the drug use may take priority over other activities and responsibilities. A p erson who becomes dependent on a drug may find it difficult to cut down or stop using it.

Pregnancy and breastfeeding

Little is known about GHB use during pregnancy. As is the case with many other licit and illegal drugs, GHB use during pregnancy is not recommended. Drug use during pregnancy can increase the incidence of premature labour, resulting in low birth weight babies. If the mother continues to use GHB while breastfeeding, it is possible that the drug will be present in the mother's milk and possibly can cause adverse affects on the baby.

Where to get help

If a person is concerned about their GHB use, they need to be encouraged to get help from their local Aboriginal Health Service, their doctor or from a drug and alcohol service. Family and friends who are concerned about someone they care about can also get information and support from these places:

• Direct Line; Phone: 1800 888 236
• Family Drug Help; Phone: 1300 660 068
• Youth Substance Abuse Service (YSAS); Phone: 1800 014 446; Website: www.ysas.org.au
  Drug and alcohol services for people aged between 12 and 21 who are experiencing significant problems related to their drug use
• Alcoholism and Drug Treatment Centre - Moreland Hall; Phone: 9386 2876.

This fact sheet has been adapted from more detailed information provided by the DrugInfo Clearinghouse.