Gamma-hydroxybutyrate (GHB) is a naturally occurring compound in the brain that is involved in key physiological processes such as sleep regulation and muscle tone. As a physiological neurotransmitter, GHB has been explored for its therapeutic potential on the central nervous system, particularly in the treatment of conditions such as alcohol withdrawal and sleep disorders.1
Unfortunately, despite its legitimate medical applications, GHB has gained attention for the wrong reasons, with people abusing it as a recreational drug due to its euphoric and sedative effects, leading to it being infamously called the “date rape drug” or “liquid ecstasy.”
Because it has a narrow therapeutic window, meaning the line between the dose that produces the desired effects and the dose that leads to overdose is very thin,2 Misuse can have serious and possibly fatal consequences, as recent studies in Australia have shown.
New Australian study reveals growing trend in GHB poisoning
A study published in April 2024 in the journal Emergency Medicine Australia3 The researchers analyzed data collected from 2012 to 2021 across four major Sydney hospitals to assess trends in reports of GHB exposure. They found that from 2015 to 2020, emergency department visits related to GHB poisoning rose from 228 to 729 cases per year, a 114% increase.
While men still account for the majority of cases, the number of women affected by GHB poisoning has increased significantly, from 27.9% in 2012 to 37.8% in 2021. The study also highlighted that the 25-34 year old group consistently accounted for the largest proportion of GHB-related presentations, with a significant decrease in affected people aged 16-24 over the study period.
Of particular concern is the increasing severity of GHB poisoning. Researchers noted a significant increase in cases classified as very urgent (triage category 1), suggesting that GHB-related emergencies are becoming more severe and potentially life-threatening.
Most of these incidents occurred between midnight and 4 a.m., which is typical of nightlife hours. The authors noted that these findings mirror trends seen in other parts of Australia and internationally. They concluded:4
“The increasing number and severity of GHB overdoses across NSW may be linked to an increase in the incidence of GHB and methamphetamine use combined and demographic shifts, with more overdoses occurring among females.
There is an urgent need to understand the psychosocial and underlying factors behind these increases in order to better target harm reduction and overdose prevention strategies.”
In contrast, US data from the 2015–2020 National Survey on Drug Use and Health shows that only 0.05% of adults reported using GHB in the past year. However, this survey also highlighted that past-year methamphetamine, ketamine, and ecstasy use were strong predictors of GHB use, suggesting a link between GHB and other substances, consistent with the findings of the Australian study.5
Symptoms of a GHB overdose typically begin with drowsiness and lethargy, and may progress to coma and respiratory depression. Muscle tremors and seizures may also occur. Fortunately, recovery is often rapid and does not require specific treatments, with most patients regaining consciousness within a few hours. However, it is important to monitor the person’s airway and provide breathing support if necessary.6
More information about the use of GHB
A previous study published in March 2024 in the journal Drug and Alcohol Review7 The study further explored the growing trend of GHB poisoning and provided additional insights into the broader context of drug use in Australia. This study focused on the frequency and effects of GHB exposure with other substances, particularly methamphetamine. The authors noted:8
“Concurrent exposure to multiple drugs has been reported in cases of GHB poisoning and may significantly influence the clinical presentation. Concomitant use of GHB with other CNS depressants (e.g., alcohol, benzodiazepines) increases the risk of severe respiratory depression and coma, while use of GHB with psychostimulants (e.g., methylamphetamine) increases the risk of cardiovascular complications and seizures.”
According to their findings, co-use of GHB and methamphetamine was alarmingly common, with methamphetamine detected in 82.2% of confirmed GHB cases. The authors also highlighted that many individuals who used GHB with other drugs did not report all of the substances used, either due to stigma or because they considered GHB to be the primary cause of their symptoms.
Furthermore, the study examined emerging patterns of GHB use outside of traditional nightlife. It suggested that GHB is increasingly being used as a coping mechanism for stress, rather than just for recreational purposes. This shift in use patterns may explain the increasing number of female users and the varied viewing times observed in other studies.
These findings underscore the importance of comprehensive toxicology screening and demonstrate that GHB is not inherently bad. In fact, misuse and lack of understanding of its effects can pose significant risks.
GHB controversy
in Guest article by a Midwestern physician.He delved into the history of GHB. Developed in 1874, it was introduced as an intravenous anesthetic in 1964. It slows the heart rate without affecting blood pressure, irritating veins, or suppressing breathing. It also helps relax muscles, induces sleep without lowering oxygen levels, and protects tissues from damage.
Despite these benefits and the science supporting its use, GHB suffered a major setback in the 1990s. As it gained popularity, especially among bodybuilders, the FDA and the Centers for Disease Control and Prevention began to highlight its risks, often exaggerating them.
The FDA later banned the drug and labeled it a dangerous drug linked to sexual assault, overshadowing its true benefits. Interestingly, the pharmaceutical version, known as sodium oxybate (Xyrem), remains legal.
Another formulation of GHB called low sodium oxybate, which contains 92% less sodium than sodium oxybate, is also approved in the United States for the treatment of narcolepsy and idiopathic hypersomnia. According to a study published in the journal Nature and Science of Sleep:9
“LXB (low sodium oxybate) is a promising long-term treatment for narcolepsy and idiopathic hypersomnia, showing efficacy in treating symptoms including EDS (excessive daytime sleepiness), muscle spasticity and sleep inertia, with a safety profile consistent with that of SXB (sodium oxybate) in narcolepsy.”
These drugs are very expensive. The price of sodium oxybate ranges from $60,000 to $100,000 per year, making it unaffordable for many patients despite its benefits in treating various conditions. I recommend reading the entire article to learn more about the history and effects of GHB.
Strategies to Improve Your Sleep Without Medication
If there’s one good thing that’s come out of banning GHB and making its prescription forms more expensive, it’s encouraging people to focus on addressing the root causes of poor sleep naturally, rather than relying solely on medication. Here are some strategies to help you fall asleep faster and enjoy good sleep:
Try Emotional Freedom Techniques (EFT) This technique is a form of acupressure, based on the same energy meridians used in traditional acupuncture for over 5,000 years to treat physical and emotional ailments, but without the intervention of needles. It can be very effective in reducing stress and promoting relaxation, which is why people often seek out substances like GHB. Watch the video below to learn the basic steps on how to practice emotional therapy to relax and relieve stress. |
Turn your bedroom into a sleep oasis — Your bed is where you can sleep and rest comfortably. There are only two other activities that won’t significantly interfere with your restful sleep – reading and intimate relationships with your partner. Anything else, such as working, using a computer or cell phone, or watching TV, will reduce the quality of your sleep.10 Minimize any disturbances from pets or outdoor activities. You might consider removing your pet from the bedroom or using a white noise machine to reduce the disturbance from outside noises. |
Create a calming bedtime routine — Humans are creatures of habit. When you create a calming routine before bed, you’re more likely to fall asleep easily. Activities like taking a warm bath, reading a good book, or doing relaxation exercises can help you fall asleep more easily. If you have trouble falling asleep at night, it’s better to leave the bedroom and read quietly than to try harder to fall asleep. I highly recommend using blue light blocking glasses if you do this to prevent the reading light from further suppressing melatonin production. |
Keep a consistent schedule – When you go to bed and wake up at the same times, your body gets used to a routine. This helps regulate your body clock, so you fall asleep and stay asleep throughout the night. Keep this routine up, even on the weekends. |
Get plenty of exposure to bright sunlight in the morning and afternoon — Exposure to bright light in the early morning stops the production of melatonin, a hormone that helps you sleep, and sends a signal to your body that it’s time to wake up. Outdoor sunlight is best, so you might want to take a quick walk outside. Not only will this increase in physical activity help you sleep longer, but walking outdoors — either first thing in the morning or in the afternoon when the sun is high — gives you more exposure to bright sunlight. |
At sunset, dim the lights (and/or use amber glasses) — In the evening (around 8 p.m.) you may want to dim the lights and turn off electronics. Your brain typically starts producing melatonin between 9 p.m. and 10 p.m., and these devices emit light that can stifle this process. After sunset, switch to a low-energy incandescent bulb with a yellow, orange, or red light if you need light. A salt lamp with a 5-watt bulb is the ideal solution that won’t interfere with melatonin production. If you’re using a computer or smartphone, install a blue light blocking program like Iris – an improved version of f.lux. However, the easiest solution is to use amber glasses that block blue light. I found the Uvex model (S1933X) on Amazon and it works great at eliminating almost all blue light. This way, you don’t have to worry about installing software on all your devices or buying special lighting bulbs for use in the evening. Once you have your glasses on, it doesn’t matter what light source you use in your home. |
Check your bedroom for electromagnetic fields (EMFs) — Electromagnetic fields This can disrupt the pineal gland and the production of melatonin and serotonin, and can have other negative effects. To do this, you need a gauss meter. You can find different models online, ranging from about $50 to $200. Some experts even recommend pulling the circuit breaker before you go to bed to cut off all power to your home. |
Exercise daily — Your body thrives on exercise and movement, which reduces your risk of cardiovascular disease and metabolic disorders. Exercise will help you fall asleep more easily and sleep more deeply. However, your body also releases cortisol during exercise, which can reduce melatonin secretion. Exercise at least three hours before bed, or earlier if you can. |
keep your room cool The ideal temperature for sleep is between 60 and 68 degrees Fahrenheit. If your room is cooler or warmer, you may have a more disturbed night’s sleep. During sleep, your core body temperature drops to its lowest level in a 24-hour period. The cooler your room is, the more conducive it is to your body’s natural temperature drop. |
sleeping naked sleeping naked This will help you stay cooler, and provide a number of other health benefits besides improving your chances of getting a good night’s sleep. |
Evaluate your mattress and pillow — You’ll sleep more comfortably when your mattress and pillows are comfortable and supportive. You may want to consider replacing your mattress after nine or ten years, which is the average life expectancy of a good quality mattress. |
