Gamma-hydroxybutyrate (GHB): what it is and why it matters

GHB is a central nervous system depressant known both as a prescription drug (sodium oxybate) and as an illicit street drug called GHB. Medically, sodium oxybate treats narcolepsy and cataplexy under strict supervision. Illicit GHB is used recreationally for its sedating and euphoric effects, but it carries a high risk of overdose and dependence.

How GHB works and common effects

GHB acts on GABA and other brain receptors to slow activity. At low doses people may feel relaxed, sociable, or sleepy. At higher doses it causes impaired coordination, confusion, vomiting, breathing problems, loss of consciousness, and sometimes seizures. Effects come on quickly—often within 15–30 minutes—and can last several hours.

Prescription sodium oxybate is formulated and dosed carefully, with medical oversight. Illicit GHB is unpredictable. It is often made in variable strength and mixed with other substances. That unpredictability is a main reason overdoses happen.

Risks, overdose signs, and what to do

Mixing GHB with alcohol, benzodiazepines, or opioids greatly increases the risk of life-threatening breathing suppression. Signs of overdose include very slow or stopped breathing, blue lips or fingernails, limp body, very low body temperature, vomiting while unconscious, or inability to wake someone. If you see these signs, call emergency services immediately and place the person on their side to reduce choking risk.

GHB can cause tolerance and physical dependence after repeated use. Withdrawal can be severe—insomnia, anxiety, tremors, high blood pressure, and delirium occur. Medical detox under supervision is the safest route for withdrawal management.

Testing and detection: standard drug screens often miss GHB because it’s cleared fast. For suspected recent exposure, hospital blood or urine tests can sometimes detect it, but timing matters a lot.

Legal status: many countries classify GHB as a controlled substance except for tightly regulated medical use of sodium oxybate. Penalties vary by jurisdiction. If you’re prescribed sodium oxybate, follow your provider’s instructions and never share medication.

Harm reduction basics: don’t mix GHB with other depressants; avoid using alone; start very low if you choose to use and wait long enough to feel effects before taking more; never accept drinks from strangers; seek medical help fast for any worrying symptoms. If dependence develops, talk to a health professional about detox and treatment options.

If you have specific questions about sodium oxybate for narcolepsy or need help with substance use, talk to your doctor or a trusted local health service. Emergency help saves lives—don’t hesitate if someone’s breathing slows or they become unresponsive.