WARNINGOVERDOSE, COMBINATIONS, & WITHDRAWAL CAN BE FATAL
High doses alone or ordinary doses in combination with other depressants can fatally stop breathing. After regular use, stopping suddenly can cause seizures, delirium, or death.
GHB
GHB is a depressant that occurs naturally in the human body. First synthesized in the 1920s, it has seen varied use as an anesthetic, a bodybuilding supplement, and eventually a recreational club drug by the late 1990s. It is known for producing euphoric, disinhibiting, and sedative effects. GHB carries notable risks due to inconsistent concentrations in commonly sold liquid form and dangerous interactions with other depressants.
Dosage & Duration
Dosage
Doses are population estimates that vary widely between individuals.
Doses of 3 grams or more commonly produce heavy sedation, while amounts exceeding 3.5 grams carry a significant risk of sudden loss of consciousness. Because the margin between desired effects and dangerous overdose is narrow, precise measurement with calibrated equipment is critical. If onset is slower than expected, allow a minimum of two hours before considering any additional dose.
Duration
Subjective Effects
Effects vary widely by individual, dose, and context.
Physical
The physical effects of GHB can be broken down into several components which progressively intensify proportional to dosage.
Cognitive
The cognitive effects of GHB can be broken down into several components which progressively intensify proportional to dosage.
Pharmacology
Pharmacodynamics
GHB acts as an agonist at excitatory GHB receptors and as a weak agonist at inhibitory GABA-B receptors. The GHB receptor, which is densely expressed in cortical and hippocampal regions, represents the higher-affinity binding site. At elevated brain concentrations, GABA-B receptor activation becomes pharmacologically predominant and is primarily responsible for the substance's sedative properties. GHB also exerts a biphasic effect on dopamine release: at low concentrations it stimulates dopamine release via the GHB receptor, while at higher concentrations it inhibits dopamine release through GABA-B receptor activation, with dopamine release subsequently increasing again as GHB concentrations decline below the GABA-B activation threshold. Activation of the GHB receptor has additionally been associated with glutamate release in certain brain areas.
Pharmacokinetics
The vast majority of an administered GHB dose (95–98%) undergoes extensive hepatic metabolism, with only 1–5% excreted unchanged in urine. The primary metabolic pathway involves conversion to succinic semialdehyde (SSA) by GHB dehydrogenase or GHB transhydrogenase. SSA is subsequently oxidized by succinic semialdehyde dehydrogenase (SSADH) to succinic acid, which enters the Krebs cycle and is ultimately converted to carbon dioxide and water.
Interactions
An unlisted combination is an unknown one, not a safe one. Check a dedicated combination chart before mixing.
Tolerance
Tolerance timelines are rules of thumb, not exact schedules, and vary widely between individuals and use patterns.
Other GABAergic depressants
Harm Potential
Addiction & Dependence
Psychological
ModerateGHB is classified as habit-forming with recognized addiction potential. Repeated use can disrupt brain circuits controlling rewards, memory and cognition, leading to compulsive drug-taking patterns.
Physical
HighChronic high-dose consumption leads to severe physical dependence. Withdrawal symptoms include insomnia, anxiety, tremor, sweating, and muscle cramps, typically resolving within three to twenty-one days. The withdrawal syndrome can be severe, producing acute delirium that may require hospitalization in an intensive care unit. Medical supervision is strongly recommended for discontinuation.
Toxicity
Chronic administration in animal studies has been associated with impairments in spatial memory, working memory, and learning; relevance to human recreational use at typical doses is not fully established.
Psychosis Risk
Acute psychotic symptoms are not typically associated with GHB intoxication itself, but withdrawal can produce acute delirium requiring intensive care management. Benzodiazepines are the mainstay of treatment, often at higher doses than required for delirium from other causes.
Seizure Risk
Convulsions can occur at very high doses and are more likely when GHB is combined with stimulants. Severe physical withdrawal from chronic high-dose use can produce epileptic seizures. At very high doses, uncontrollable muscle twitching may occur which can progress to epileptic activity.
History & Culture
Early Research and Medical Development
The chemical family to which GHB belongs was first explored by Russian chemist Alexander Zaytsev, who published work on related compounds in 1874. The compound itself was first synthesized in the 1920s, though it would remain largely unexamined for several decades.…
Legality
By Country
References
Citations
- NIH PubChem GHB compound property record. pubchem.ncbi.nlm.nih.gov (n.d.). https://pubchem.ncbi.nlm.nih.gov/rest/pug/compound/name/gamma-hydroxybutyric%20acid/property/IUPACName,Title,CanonicalSMILES,IsomericSMILES,InChIKey,MolecularFormula/JSON1
- Home Office Circular 001/2022: Reclassification of GHB and related substances. gov.uk (n.d.). https://www.gov.uk/government/publications/circular-0012022-reclassification-of-ghb-and-related-substances/circular-0012022-reclassification-of-ghb-and-related-substances1
- Home Office list of most commonly encountered drugs currently controlled. gov.uk (n.d.). https://www.gov.uk/government/publications/controlled-drugs-list--2/list-of-most-commonly-encountered-drugs-currently-controlled-under-the-misuse-of-drugs-legislation1
- Misuse of Drugs Act 1971 (Modification) Order 2003 (S.I. 2003/1243). legislation.gov.uk (n.d.). https://www.legislation.gov.uk/uksi/2003/1243/made/data.xml1
- Home Office Circular 001/2015 on GHB rescheduling. gov.uk (n.d.). https://www.gov.uk/government/publications/circular-0012015-a-change-to-the-misuse-of-drugs-act-1971-control-of-ah-7921-lsd-related-compounds-tryptamines-and-rescheduling-of-ghb/circular-0012015-a-change-to-the-misuse-of-drugs-act-1971-control-of-ah-7921-lsd-related-compounds-tryptamines-and-rescheduling-of-ghb1
- Misuse of Drugs Act 1971, current revised Schedule 2. legislation.gov.uk (n.d.). https://www.legislation.gov.uk/ukpga/1971/38/schedule/21
- Misuse of Drugs Act 1971 (Amendment) Order 2022 (S.I. 2022/322). legislation.gov.uk (n.d.). https://www.legislation.gov.uk/uksi/2022/322/made/data.xml1
- Misuse of Drugs Regulations 2001, current revised Schedule 2. legislation.gov.uk (n.d.). https://www.legislation.gov.uk/uksi/2001/3998/schedule/21
- Misuse of Drugs Act 1971, section 2. legislation.gov.uk (n.d.). https://www.legislation.gov.uk/ukpga/1971/38/section/2?view=plain1
- Misuse of Drugs Act 1971, section 4. legislation.gov.uk (n.d.). https://www.legislation.gov.uk/ukpga/1971/38/section/4?view=plain1
- Misuse of Drugs Act 1971, section 5. legislation.gov.uk (n.d.). https://www.legislation.gov.uk/ukpga/1971/38/section/5?view=plain1
- Misuse of Drugs Act 1971, current revised Schedule 4. legislation.gov.uk (n.d.). https://www.legislation.gov.uk/ukpga/1971/38/schedule/4?view=plain1
- GOV.UK Drugs penalties. gov.uk (n.d.). https://www.gov.uk/penalties-drug-possession-dealing1
- NIH PubChem CID 10413 GHB property record. pubchem.ncbi.nlm.nih.gov (n.d.). https://pubchem.ncbi.nlm.nih.gov/rest/pug/compound/name/gamma-hydroxybutyric%20acid/property/IUPACName,Title,CanonicalSMILES,IsomericSMILES,MolecularFormula/JSON1
- NIH PubChem CID 10413 synonyms. pubchem.ncbi.nlm.nih.gov (n.d.). https://pubchem.ncbi.nlm.nih.gov/rest/pug/compound/cid/10413/synonyms/JSON1
- 21 CFR 1308.11 Schedule I, eCFR version 2026-08-26. ecfr.gov (n.d.). https://www.ecfr.gov/api/versioner/v1/full/2026-08-26/title-21.xml?part=1308§ion=1308.111
- DEA Diversion Control Division Orange Book, August 2026. deadiversion.usdoj.gov (n.d.). https://deadiversion.usdoj.gov/schedules/orangebook/orangebook.pdf1
- 21 CFR 1308.13 Schedule III, eCFR version 2026-08-26. ecfr.gov (n.d.). https://www.ecfr.gov/api/versioner/v1/full/2026-08-26/title-21.xml?part=1308§ion=1308.131
- FDA openFDA Drugs@FDA XYREM record. api.fda.gov (n.d.). https://api.fda.gov/drug/drugsfda.json?search=products.brand_name:Xyrem1
- Federal Register API record 00-5925, 65 FR 13235. federalregister.gov (n.d.). https://www.federalregister.gov/api/v1/documents/00-5925.json1
- DEA final rule full text, 65 FR 13235. federalregister.gov (n.d.). https://www.federalregister.gov/documents/full_text/text/2000/03/13/00-5925.txt1
- 21 U.S.C. § 829, current preliminary US Code. uscode.house.gov (n.d.). https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section829&num=0&edition=prelim1
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Automated synthesisInformation aggregated and synthesized using an autonomous workflow built by Josie Kins.
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