In the THUMP Guide to Drugs column, Anna Codrea-Rado interviews experts to find out what clubbers need to know about their substances.
Of all the club drugs, GHB is the one that carries the most stigma. The liquid substance is also used a date rape drug, and so talking about taking it recreationally is tricky to navigate. Sometimes known as "liquid ecstasy," or just "G," it's a central-nervous system depressant that produces an intoxicating euphoria. Unlike MDMA and acid, however, the exhilarating effects don't last anywhere near as long and don't result in savage comedowns.
One of the biggest dangers with GHB is dosing; take a few drops too many, and the user passes out cold. While seasoned users are aware of its risks, many ravers don't fully understand how it works and how to mitigate its dangers.
As part of my THUMP Guide to Drugs column, I spoke with Joseph Palamar, Associate Professor of Population Health at New York University Langone Medical Center. Palamar's research focuses on the behavioral aspects of GHB, particularly within the gay community, and here he explains the particular risks of the drug and why people need to be aware of its effects.
THUMP: What is GHB?
Joseph Palamar: It stands for Gamma Hydroxybutyrate. It's a strong depressant—it's often compared to alcohol, but it's much stronger.
Does it have any legitimate clinical uses?
GHB is a Schedule One drug, but it is approved here in the US for some medical uses. There's a brand of GHB called Xyrem and it's prescribed to people with narcolepsy. GHB has also been used in medical trials conducted in Italy to treat alcoholism.
What effects does GHB have on the person taking it?
I think one of the most perfect explanations I've gotten upon interviewing GHB users was that it feels like a combination of ecstasy and alcohol together. You feel extremely euphoric because it causes a dopamine rush. You feel drunk and euphoric at the same time on GHB, depending on the dose.
Typically the results don't last for very long. They usually kick in pretty quickly, within maybe 20 minutes or a half hour, and the effects will wear off within maybe an hour or so, depending on the dose you take, your tolerance, and factors such as whether you've eaten and how much you've slept.
As with any club drug, there are problems around dosing. But it seems to be a particular issue with GHB. Why is that?
Say you're taking shots of tequila. That's regulated. You know how much alcohol is supposed to be in a shot. But if someone gives you a "cap" of GHB, just a couple of extra drops could make a huge difference. Even if you're familiar with that particular batch, a few extra drops can make all the difference. If you didn't get enough sleep that night, it might hit you harder. If you're on other drugs, it might hit you harder, or it might not hit you as hard. You should never combine GHB with alcohol, because it has what we call a "synergistic effect," which effectively means the sum of the two highs is greater than each individual high.
People don't know how to dose this, plus it's an illegal drug that people tend to take in a dark night club.You're going to pour it out of a water bottle into a cap. You're doing it quickly, you're looking out, making sure the bouncers—or other people—don't see you. It's just a risky situation. It's really hard to calibrate your doses in a dark nightclub. And if you're already inebriated, you're already not thinking straight. You might accidentally dose twice.
What's fun about taking GHB? Why is it a club drug?
A lot of people don't understand this, and it's one of the most stigmatized club drugs out there, because people think that if you use GHB you're going to overdose. So why do people take it? It's a very strong high, and it's very straightforward—the high kicks in pretty quickly, and then it goes away pretty quickly. There's also not really a hangover. You could have a headache or an irritated stomach, but unlike drugs like ecstasy, there's no bad hangover. And if you take it to sleep, you sleep for a couple of hours but feel like you slept for 8 hours.
It's also one of the most sexual drugs out there. People think methamphetamine is the most sexual drug, and in some respects it is, but GHB has almost an animalistic feeling when it comes to sex. "You just wanna devour the other person," is the way one person described it during one of my research interviews.
Why is it popular among the gay nightlife scene?
A lot of gay men I think are a lot more willing to engage in chemsex, which is intentionally using drugs to enhance sex. That's not as big in the heterosexual community.
GHB is also sometimes known as the date rape drug. Can you explain what that is about?
You'll have a stranger pour a bit of GHB in typically a woman's drink in a bar or at a club, and hope that she becomes so inebriated that she could be taken advantage of. Even though GHB has sexual effects, when we're talking about date rape it's a situation where the perpetrator knocks a person unconscious and then sexually assaults them. Or when she's close to unconscious and she just can't remember everything.
If you're passing out from GHB, that's going to affect your memory. You might not recall very much; you might not recall anything at all. And if it's mixed with alcohol, that synergy again can be pretty dangerous, because you'll be more likely to pass out if you combine the two. GHB can knock you out cold, for maybe a good hour—or longer—and often times it's like a coma.
How dangerous is GHB compared to other club drugs like MDMA, coke, or alcohol?
It's actually more complicated than you think. A lot of GHB users would argue that GHB is the safest drug, which is interesting. So how would it be one of the most dangerous drugs? Because you could pass out very easily. And if you're in a crowded nightclub and pass out, you could smash your head and severely injure yourself.
If you take too much or combine GHB with a drug like alcohol, the effects increase greatly and you're at a higher risk for more severe consequences, including death.
[Some] people become very used to taking GHB, but as I wrote in one of my papers, people are very hesitant to start, then they use a few times. They tend to become more confident and use in a riskier manner. And this is when all the bad stuff starts happening.
How can people minimize the risks as much as possible if they decide to take it?
Like with any drug, if you insist on taking a drug, you should try to stick to small doses, especially a drug you're not very familiar with, or a batch you're not familiar with. People are recommending that with ecstasy now—like if you're unfamiliar with a pill, take a small piece and see how you react. Same thing would go with GHB. But, I don't think anyone should take large doses of GHB no matter what. And no matter what, just don't combine it with alcohol. It's just not worth it.
At some parties people write "G'" on their hands with a marker. This will let people know if they're on GHB and how to handle them. I don't think this is necessary for a lot of other drugs, but it might work well with regard to GHB.
You should make sure you feel okay before taking it; you shouldn't be up for two days and then take a cap of GHB, because you might pass out like a ton of bricks. And it happens quickly. As I explained to someone else who asked me about GHB last year, the more euphoric you feel, the closer you are to passing out. So, if you feel so euphoric that you can't even stand it, you're probably gonna pass out any minute. Like, you typically know when you're gonna pass out.
If you think you are going to pass out, what should you do?
Depending on the situation, someone needs to know that you're about to pass out. Whether it's friends or staff at the party, someone needs to know. There's actually a little bit of debate whether or not an ambulance should be called. I'm not a medical doctor, but I'm sure any medical specialist you would talk would say that no matter what, an ambulance should be called.
But the best advice I give is don't let yourself get to that state. I've known hundreds of GHB users, and I think that the "smarter ones" were the ones who said, "Never use it at a nightclub." They use it at home or at a private party with friends; they don't use at a nightclub filled with thousands of people.
Anna Codrea-Rado is THUMP's News Editor. Follow her on Twitter.