GHB

What is GHB?

Ingesting the drug does not cause depression in the user, rather, depressant-type drugs slow the central nervous system, resulting in the delay of messages between the brain and the rest of the body. Whilst Gamma-hydroxybutyrate is a naturally occurring chemical in the human body, the illegal variant of the drug most frequently used socially is a synthesised drug manufactured in illicit and backyard labs. (1)

In small doses, taking GHB results in the user feeling euphoric, relaxed, less socially inhibited, and more promiscuous. However, GHB is also well known as the “date rape drug”; GHB is frequently identified by law enforcement authorities as being involved in cases of drink spiking and subsequent sexual assaults. (1)

The long-term side effects of GHB are relatively unknown, other than that there is a risk of tolerance and dependence due to its effect on the reward pathways (i.e., a user requires more and more of the drug to achieve a satisfactory high). (2)

Download the GHB Drug Fact Sheet

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Common Street Names

Blue Nitro, Fantasy, Grievous Bodily Harm, GBH, G, Gina, Liquid Ecstasy, Liquid E, Date Rape Drug, Geeb, Georgia Home Boy, Goop, Liquid X, Scoop (3)

Availability

When analysing usage of GHB, it’s important to reference the two precursors that are often included in or substituted for GHB. Gamma-butyrolactone (GBL) and 1,4-butanediol (1,4-BD) are reported to be equally as dangerous as GHB, if not more so. Both substances metabolise to GHB after ingestion and produce identical effects. The amplified danger with 1,4-BD is concerned with the fact that it takes longer to take affect than GHB. In this situation, it is common for users to think the initial dose did not work, so they take more. This can result in overdose. GBL works faster than GHB and is commonly stronger.

Of the respondents who took part in the 2020 IDRS Interviews, one in ten reported recent GHB use within the previous 6 months. Users reported the fast action, low cost, ease of use, and ease of secretion as key factors in their choice to use the drug.

Over the last decade the number of GHB detections at the border increased 8,900 per cent, from 1 in 2009–10 to 90 in 2018/19. Over the same period, GBL detections increased from 44 to 445 (a 911 per cent rise). (4)

In 2020, the main approach for arranging the purchase of any illicit or non-prescribed drugs by participants of the Drugs Reporting System (EDRS) in the previous 12 months was via social networking applications (such as Facebook, WhatsApp, Snapchat, Grindr, Tinder) (75%), followed by face-to-face (67%). (5)

How GHB is used and how to identify it

Users of GHB can be classed as Occasional, Binge, or Regular Users. With these different classifications comes different use patterns, different administration methods, and the use of different variants of the drug:

• In most cases, GHB is sold as a clear or blue odourless liquid in small vials (often in small plastic fish-shaped soy sauce containers) and is normally taken orally in this form. (6)
• GHB can also be found in white powder form. It may be packaged in small plastic sachets, balloons, or household aluminium foil if sourced. The powder may be dissolved in a carrier substance and injected, snorted, or administered anally. (7)
• Generally, the onset of the effects of taking GHB are felt by the user within 15 minutes of ingestion, and last for approximately 3 hours. These timings vary.

What are the symptoms of somebody who is under the influence?

The following symptoms are known behaviours associated with systematic drug use. They should not be used as definitive confirmation that a person is drug affected or struggling with substance abuse.

The physical and mental effects of GHB vary greatly from person to person, as do the onset and duration of the effects after ingestion. Users may exhibit the following behaviours whilst affected by a modest dosage of GHB:

• Increased energy, talkativeness and overt displays of exhilaration and euphoria
• Increased sex drive and lower inhibitions
• Drowsiness and heightened feelings of relaxation(1)

Where a high dosage of GHB has been ingested the following dangerous physical effects may be encountered:

• Nausea and vomiting
• Hot and cold flushes, and heavy sweating which may lead to dehydration.
• Tremors, dizziness, confusion, and loss of coordination
• Rapid mood swings (from exhilaration and euphoria to agitation, irritability, and violent outbursts)
• Tunnel vision, hallucinations, blackouts, and memory lapses
• Seizures, difficulty or cessation of breathing, coma, and death (1)

What are the symptoms of withdrawal?

When it comes to withdrawal, or the effects of ceasing or lowering dosage, the mental and physical experience associated with abstinence may last up to 2 weeks or more. As with many drugs, these symptoms vary in intensity and longevity based upon the history of usage (i.e. higher dose or longer term users experience more intense side-effects, and for longer).

The most commonly observed symptoms of GHB withdrawal are:

• Confusion, agitation, anxiety, and panic attacks
• Sleeplessness and tiredness
• Tremors, muscle cramps, and seizures
• Hallucinations and psychosis
• Hot and cold flushes, and heavy sweating
• Nausea and vomiting
• Dehydration (a side effect of profuse sweating, and vomiting)
• Elevated heart rate and high blood pressure (6)

Business Risks

Whilst under the influence of Cocaine, many of the symptoms associated with the drugs consumption are likely to cause hazardous behaviours in the user. These actions may not only affect the user personally, but also; the safety of co-workers, a greater risk of damage to plant and equipment, and in the event of an accident, ongoing commercial impacts such as increased insurance premiums, costs associated with injury management, and the potential for costly legal action.

Quick facts about usage

• Since 2015, over 3 tonnes of GHB have been seized globally. The Americas, Oceania and Europe accounted for 98 per cent of these seizures with the largest by weight quantities attributed to seizures in the US, Australia, and Norway, respectively. (4)
• GHB and its precursors are regularly reported to be used in drink spiking events as the substance is difficult to detect prior to ingestion (clear liquid whose aroma and taste are mostly masked by the carrier liquid). The drugs dis-inhibiting and amnesiac effects put victims at risk of overdose, sexual assault, or theft. (2)
• An analysis of 74 GHB related deaths between 2000 and 2019 found that 80% of the deaths occurred in the home as a result of accidental overdose, and a further 12% were as a result of trauma (motor vehicle accidents were by far the largest portion of these events). (8)
• From the same report, the mean age of the GHB-related deaths was 31.5 years old and more than 70 per cent per cent of cases were male. More than 20 per cent of deaths were aged over 40, and ages ranged into the sixties” with more than half of these people being employed.(8)
• GHB use is associated with significant risk to users due to the high rate of negative reactions reported by users. In an early study, 99% of users reported at least one negative side effect, with the mean number being 6.5 negative side-effects. These side-effects ranged from extended periods of vomiting, to unconsciousness, and problems regulating body temperature. (9)

What does a GHB Overdose look like?

When a person uses high or increasing quantities of the drug more frequently, the physical and mental effects of that usage is amplified. When the concentration within a user’s system reaches such a level that the body cannot eliminate the drug fast enough, an overdose occurs. (10)

In addition, as GHB is often interchanged with GBL or 1,4-BD without the user’s knowledge, the likelihood of an overdose occurring are significantly higher due to the differing onset of action characteristics of both substitutable drugs.

Signs of a potential GHB overdose are:

• Dizziness, disorientation, and falling in and out of consciousness.
• Agitation, irritability, and violent outbursts
• Loss of memory
• Nausea and vomiting
• Uncontrollable tremors, muscle cramping, and seizures
• Breathing difficulties (11)

What to do in the event of an overdose

If someone looks like they are in trouble and there is a suspicion that they may have been using drugs, it’s very important that they get medical help quickly. A quick response can save their life.

• Call an ambulance by dialling triple zero (000). Ambulance officers are not required to involve the police unless they feel in danger.
• Stay with the person until the ambulance arrives. Find out if anyone at the scene knows CPR in case the person stops breathing.
• Ensure the person has enough air by keeping crowds back and opening windows or taking them outside. Loosen tight clothing.
• If the person is unconscious or wants to lie down, put them in the recovery position. This involves gently rolling them onto their side and slightly tilting their head back. This stops them choking if they vomit and allows them to breath easily.
• Provide ambulance officers with as much information as you can, such as how much of the drug was used, how long ago and any pre-existing medical conditions. If they have taken a drug that came in a packet, give the packet to the ambulance officers.
• If you can’t get a response from someone, don’t assume they’re asleep. Not all overdoses happen quickly and sometimes it can take hours for someone to die. Doing something early could save a life.
• Update your Incident and/or Injury Register with all required details(12)

Detection Window

A Drug Detection Window is the period of time after a drugs ingestion by a user during which a drug or its metabolites remain present in the user’s system and can be detected through various drug testing protocols.

The “period of time” can vary depending on several factors including but not limited to:

• Amount and frequency of use
• Metabolic Rate
• Body Mass
• Age
• Gender
• Overall Health
• Drug Tolerance Level
• Urine Ph Level
• Type of specimen, testing method, and Cut-off Level(13)

Drug	Urine	Sweat	Oral	Blood
Amphetamine	1-3 days	1-4 days	12 hours	2 days
Methamphetamine	1-3 days	1-4 days	1 day	2 days
MDMA	1-3 days	1-4 days	1 day	1 day
THC	1-30 days	1-4 days	12-24 hours	2-3 days
Cocaine	1-3 days	1-4 days	1 day	2 days
Heroin	1-3 days	1-4 days	1 day	2 days

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Help with developing a Workplace Alcohol and Drug Policy

Alcohol and drugs—including medicines prescribed by a doctor or available from a pharmacy—can affect a person’s ability to work safely. Whilst all workers have a personal responsibility to ensure their own health and safety is not compromised in the workplace, or may unduly affect their co-workers, there is also an onus on employers to reduce the risk associated with drug and alcohol impairment where an employee fails in their own duty of care. Among other measures, Employers should develop a Workplace Alcohol and Drug Policy to set forth the principles under which a safe and drug-free working environment is governed. Following are the state-based organisations who can help employers with developing a Workplace Alcohol and Drug Policy.

New South Wales – Download PDF

Queensland – Download PDF

Victoria – Download PDF

Australian Capital Territory – Go to website

South Australia – Download Doc

Northern Territory – Go to website</a

Western Australia – Go to website

Tasmania – Download Doc

Disclaimer

The information on this website is presented by APAC Diagnostic and is intended as an educational and research tool to aid businesses in creating safe and drug free workplaces.

Whilst all due care has been undertaken to ensure the accuracy and currency of the material contained on this website, the information is made available on the understanding that APAC Diagnostic is not providing professional or medical advice on any particular matter.

APAC Diagnostic does not accept any legal liability or responsibility for any injury, loss or damage incurred by use of or reliance on the information provided on this website.

About APAC Diagnostic

APAC Diagnostic sponsors the No Drugs at Work campaign and also offers fully customisable drug testing solutions for your workplace. These include, but are not limited to: Onsite testing, alcohol testing, and drug testing. Our devices are designed to be user friendly and non-invasive.

APAC Diagnostic works with a broad spectrum of businesses in both the private and government sectors. Should you require a quotation on larger commercial quantities of our products or a tailored service solution, please contact our team on +61 2 9986 2252 or via email and we will be pleased to help you in working to create a safe and drug free workplace.

Works Cited

1. Better Health Channel. GHB. Better Health Channel. [Online] Victoria State Government, October 19, 2018. [Cited: March 18, 2021.] https://www.betterhealth.vic.gov.au/health/healthyliving/GHB.
2. Your Room. GHB. Your Room. [Online] NSW State Government. [Cited: March 18, 2021.] https://yourroom.health.nsw.gov.au/a-z-of-drugs/Pages/GHB.aspx.
3. Addiction Centre. Drug Street Names. Addiction Centre. [Online] Addiction Centre, December 2, 2020. https://www.addictioncenter.com/drugs/drug-street-names/.
4. Australian Criminal Intelligence Commission. Illicit Drug Date Report 2018-19. Canberra : Australian Criminal Intelligence Commission, 2018-19.
5. ACIC 2020A. Illicit Drug Data Report 2018-19. Canberra : ACIC, 2019.
6. Department of Health. GHB. Drug Help. [Online] The Australian Government. [Cited: March 19, 2021.] https://campaigns.health.gov.au/drughelp/ghb.
7. Australian Journal of General Practice. The assessment and management of gamma hydroxybutyrate use in general practice. Australian Journal of General Practice. [Online] Australian Journal of General Practice, January-February 2020. [Cited: March 19, 2021.] https://www1.racgp.org.au/ajgp/2020/january-february/management-of-gamma-hydroxybutyrate.
8. University of New South Wales. Newsroom. University of New South Wales. [Online] University of New South Wales, February 21, 2020. [Cited: March 19, 2021.] https://newsroom.unsw.edu.au/news/health/new-report-shows-illicit-drug-ghb-deaths-could-be-prevented.
9. GHB use among Australians: Characteristics, use patterns and associated harm. Degenhardt, Louisa. Sydney : UNSW, 2002. 10.1016/S0376-8716(02)00017-0.
10. The Treehouse. List Of Commonly Abused Benzodiazepines. The Treehouse. [Online] The Treehouse, May 08, 2020. [Cited: February 02, 2021.] https://www.treehouserehab.org/list-of-benzos/.
11. Pennington Institute. GHB – Get the Facts. Pennington Institute. [Online] Pennington Institute, 2019. [Cited: March 23, 2021.] https://www.penington.org.au/resources/ghb/.
12. Alcohol and Drug Foundation. Overdose. Alcohol and Drug Foundation. [Online] February 16, 2017. https://adf.org.au/insights/overdose/.
13. Urine Drug Screening: Practical Gude for Clinicians. Karen E. Moeller, Pharmd, BCPP, Kelly C. Lee. Pharmd, BCPP and Julie C. Kissack. Pharmd, BCPP. 1, s.l. : Mayo Foundation for Medical Education and Research, 2008, Vol. 83. P66-76.
14. Better Health Channel. Benzodiazepines. Better Health. [Online] October 2020. https://www.betterhealth.vic.gov.au/health/healthyliving/tranquillisers.
15. Beyond Blue. Benzodiazepines. Beyond Blue. [Online] Beyond Blue. [Cited: January 21, 2021.] https://www.beyondblue.org.au/the-facts/anxiety/treatments-for-anxiety/medical-treatments-for-anxiety/benzodiazepines.
16. Nichols, Sam. The Rise, Fall, and Explosive Return of Benzos to Australia. Vice. [Online] Vice, July 28, 2020. [Cited: January 28, 2021.] https://www.vice.com/en/article/m7j5qp/the-rise-fall-benzos-valium-xanax-to-australia.
17. Peacock, A. Australian Drug Trends 2020: Key Findings from the National Ecstasy and Related Drugs Reporting System (EDRS) Interviews. Sydney : National Drug and Alcohol Research Centre, UNSW Sydney., 2020.
18. Bounds, Connor G. and Nelson, Vivian L. Benzodiazepines. NCBI. [Online] STATPEARLS, January 2020. [Cited: January 28, 2021.] https://www.ncbi.nlm.nih.gov/books/NBK470159/.
19. Amin, Nouran. Increasing Misuse of Prescription Drugs. Lab Roots. [Online] Lab Roots, December 18, 2018. [Cited: January 28, 2021.] https://www.labroots.com/trending/drug-discovery-and-development/13570/increasing-misuse-prescription-drugs.
20. AIHW. Alcohol, Tobacco, & Other Drugs in Australia. Canberra : AIHW, 2020.
21. Australian Institute of Health and Welfare. National Drug Strategy Household Survey 2016. Canberra : Australian Government, 2017. PHE 214.
22. Australian Bureau of Statistics. Causes of Death, Australia, 2016. Canberra : Australian Bureau of Statistics, 2018.
23. The Department of Health. Prevalence and patterns of psychostimulant use in Australia. The Department of Health. [Online] The Australian Government, April 2004. [Cited: February 22, 2021.] https://www1.health.gov.au/internet/publications/publishing.nsf/Content/drugtreat-pubs-modpsy-toc~drugtreat-pubs-modpsy-2~drugtreat-pubs-modpsy-2-2~drugtreat-pubs-modpsy-2-2-pr1.
24. National Institute on Drug Abuse. What are the long-term effects of cocaine use? Massachusetts : National Institute on Drug Abuse, 2016.
25. —. What are some ways that cocaine changes the brain? Massachusetts : National Institute on Drug Abuse, 2016.
26. New South Wales Police. Cocaine and the Law. NSW Police. [Online] [Cited: February 22, 2021.] https://www.police.nsw.gov.au/__data/assets/file/0013/2407/Cocaine.pdf.
27. Australian Institute of Health and Welfare. Illicit drug use. Canberra : The Australian Government, 2020.
28. Scott, Sophie, Timms, Penny and Lloyd, Mary. Cocaine use at new highs, increased vaping use in young people, report finds, but cigarette, alcohol consumption down. [Webpage Report] s.l. : ABC News, 2020.
29. National Drug and Alcohol Research Centre. Increase in cocaine prevalence, availability, and hospitalisations in Australia says new report. UNSW Sydney. [Online] National Drug and Alcohol Research Centre, February 25, 2021. [Cited: February 26, 2021.] https://ndarc.med.unsw.edu.au/news/increase-cocaine-prevalence-availability-and-hospitalisations-australia-says-new-report.
30. Australian Institute of Health and Welfare. Illicit Drug Use. Canberra : AIHW, 2020.
31. —. National Drug Strategy Household Survey 2019. Canberra : AIHW, 2020. 2205-507X.