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GHB Facts

Depressant; Γ-Hydroxy acid; GHB receptor agonist

Description

GHB (gamma-hydroxybutyric acid) — G, liquid G, liquid ecstasy — is a CNS depressant of the hydroxy acid class. GHB suppresses brain activity through GABA-B activation, producing the sedation, relaxation, and euphoria characteristic of depressants.

Subjective effects include euphoria, disinhibition, muscle relaxation, anxiolysis, and amnesia. The experience resembles compressed alcohol intoxication — a warm, sociable loosening that tips quickly into heavy sedation as the dose rises.

GHB produces rapid physical dependence, and only a roughly five-fold span in blood concentration separates euphoria from lethal respiratory depression.[1] Small dose increases cause disproportionately large jumps in blood levels because the body's processing capacity saturates;[2] no antidote exists,[3] and withdrawal progresses faster and more dangerously than with alcohol or benzodiazepines.[4][5]

Dose and durationby route · individual sensitivity varies

Oral(g)
Threshold< 0.5 gLight0.5 – 1.5 gCommon1.5 – 2.5 gStrong2.5 – 4 gHeavy4+ g

Starts in 5 – 30 minLasts 1.5 – 2.5 hoursAfter-effects 2 – 4 hours

Body and dependence

Acute toxicity
Critical
Chronic toxicity
Moderate
Physical dependence
High
Psychological dependence
Moderate
Withdrawal
Severe · fatal · medical supervision
Compulsive redosing
High

Tolerance

Builds
Rapid
Fully resets after
10.5 days
Carries over to
baclofen; phenibut; GBL; 1,4-butanediol

Effectslikely at a common dose

Perception
Sleep-transition hallucinations; Vestibular distortion; +9 possible, including Spatial disorientation, Visual acuity suppression, Double vision
Body
Bodily heaviness; Body high; Dizziness; Motor control impairment; Muscle relaxation; Physical fatigue; Respiratory depression; Sedation; Tactile euphoria; +17 possible, including Nausea, Vomiting, Nystagmus (eye wobbles)
Thinking
Cognitive impairment; Compulsive redosing urge; Decision impairment; Focus suppression; Information processing suppression; Memory suppression; +17 possible, including Analysis suppression, Confusion, Delusions of sobriety
Feeling
Anxiety suppression; Euphoria; +8 possible, including Anxiety, Dysphoria, Emotional lability
Self
Disinhibition; Sociability enhancement; Social connection; +9 possible, including Communication suppression, Craving, Depersonalization
Time
none likely · 3 possible, including Temporal disorientation
Awareness
none likely · 1 possible

Who shouldn't take it

Absolute
Respiratory compromise; Succinic semialdehyde dehydrogenase deficiency; Pregnancy; Concurrent CNS depressant use; Concurrent GBL or 1,4-butanediol use
Relative
Patients on valproate; Concurrent HIV protease inhibitor use

Combinations64 recorded

Lethal (7)
Baclofen; Buprenorphine; GHB, GBL; Ketamine, DXM, PCP; Kratom; Opioids; Tramadol
Dangerous (36)
Alpha-2 adrenergic receptor antagonist; Antihistamines; Antipsychotics; Benzodiazepines; Benzodiazepines, Barbiturates; Cannabis, THC; Clonidine, Guanfacine; MDMA, Amphetamines; Synthetic cannabinoids; Amphetamines; Anticholinergics; Atypical antipsychotics; Buprenorphine, Kratom; Buspirone; Caffeine; Cannabis; Dopamine agonists; DXM; Gabapentin, Pregabalin; Ibogaine; Lithium; Local anesthetics; MAOIs; MDMA, MDA; and 12 more, see full page
Caution (14)
See full page: psychedex.org/substances/ghb
Not graded (7)
Not listed never means safe.

Seek help immediately if

  • Extreme drowsiness — can't stay awake or be roused
  • Confusion, slurred speech, severe loss of coordination
  • Slow, shallow, or irregular breathing
  • Unconsciousness / unresponsive; limp, floppy body
  • Blue lips or fingertips
  • Vomiting while sedated (choking / aspiration risk)
  • Cold, clammy skin; weak pulse

What to do

  1. Try to wake them — shout, firm sternal rub
  2. If unresponsive or breathing is impaired, call emergency services
  3. Place them in the recovery position — critical, they can choke on vomit
  4. Monitor breathing continuously; be ready to give rescue breaths / CPR
  5. Never leave them alone to "sleep it off"
  6. Do not give other drugs, stimulants, or more depressants

Most depressant overdoses resolve with airway protection, breathing support, and monitoring. The danger is respiratory depression and choking on vomit — sharply worse when combined with opioids or alcohol. GHB/GBL overdoses often involve sudden deep unconsciousness and may self-resolve, but airway protection is essential.

988 Suicide & Crisis LifelineFireside Project: 62-FIRESIDE

Version r1 · Not medical advice

References

  1. [1]
    ^Busardò FP, Jones AW (2015) GHB pharmacology and toxicology: acute intoxication, concentrations in blood and urine in forensic cases and treatment of the withdrawal syndrome — Current Neuropharmacology doi:10.2174/1570159x13666141210215423
  2. [2]
    ^Palatini P, Tedeschi L, Frison G, et al. (1993) Dose-dependent absorption and elimination of gamma-hydroxybutyric acid in healthy volunteers — European Journal of Clinical Pharmacology PMID:8299669
  3. [3]
    ^Felmlee MA, Morse BL, Morris ME (2021) γ-Hydroxybutyric Acid: Pharmacokinetics, Pharmacodynamics, and Toxicology — The AAPS Journal doi:10.1208/s12248-020-00543-z
  4. [4]
    ^Moitroux A, Kestens C (2023) Withdrawal syndrome following chronic use of gamma-hydroxybutyric acid (GHB) — Revue medicale de Liege PMID:37560960
  5. [5]
    ^Wood AML, Schellekens AFA, Dijkstra BAG, Wolf CJH, Beurmanjer H (2025) Development of the Gamma-Hydroxybutyrate Withdrawal Symptom Questionnaire — European Addiction Research doi:10.1159/000545700
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