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What is GHB and why is it seen as so dangerous?

“I was at a festival recently and when I went into the toilets there were a whole pile of soy fish containers on the floor. When I asked someone about it, they told me they were used to hold GHB. What is GHB and why is it so dangerous?” 

GHB is a naturally-occurring neurotransmitter, as well as an illegal drug. GHB molecules exist in all of us and they are involved in the everyday functioning of the brain. It was first synthesized in the early 1960s and has been used in the treatment of schizophrenia, as an anaesthetic and even an aid to childbirth.

GHB (or ‘G’ as it is usually called) comes in the form of a salty clear liquid but was made illegal in Australia in 1996 and, as a result, another substance was substituted – GBL or gamma butyrolactone. GBL is often used in products such as paint thinner, varnish and wood-stripping products. When it is taken on its own, it metabolises into GHB, creating the same effects (although it can take a little longer to ‘come on’, often leading to users thinking they haven’t taken enough and then taking more and subsequently overdosing). For a time it was marketed as ‘liquid ecstasy’ or ‘liquid E’, in an effort to counteract the negative publicity the drug was receiving, but it is important to remember that it is not related to ecstasy or MDMA in any way.

The reason it is regarded as such a dangerous drug is that it is a powerful depressant and highly ‘dose-dependent’, i.e., the difference between a ‘pleasurable’ effect and finding yourself in hospital on life-support is minimal. Take too much and the user loses consciousness and their respiratory system may start to shut down. Why so many people overdose on it is because the ‘high’ they get from this drug is intense and when that feeling starts to subside (usually after about 40 to 90 mins), not surprisingly, they want to feel like that again. Mistakenly believing that the drug has worn off, they take another dose, not realising that they still have a reasonable amount in their system and subsequently overdose.

There have been a number of GHB-related deaths over the years, most of which (but certainly not all) have been due to the person using the drug in combination with alcohol. When mixed with other drugs that slow the central nervous system, such as alcohol and sleeping pills, the depressant effects of GHB are increased. This continues to be an issue and is the greatest concern of paramedics and emergency department workers who have to deal with this issue.

The use of GHB has caused lots of problems for the nightlife industry. It was rare for an ambulance to be called to a nightclub or a music festival to deal with a drug-related incident before GHB came onto the scene. On-site medical teams are unable to manage GHB overdoses as they often have to be intubated, as a result, they are usually transported to hospital quickly. This attracts unwanted attention, both from law enforcement and the general public. Therefore, a great deal of effort is taken to prevent the liquid getting into events. To avoid detection, soy-fish containers are often used to carry measured amounts of GHB into nightclubs, dance events and music festivals. They are particularly popular due to their size and the plastic they are made from, making them difficult to detect if users are searched or patted-down by security or law enforcement.

First published: March 2019

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