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Not yet medically reviewed — information on this site is in preparation and has not been verified by a medical reviewer.
Drug index / Depressant / GHB
Depressant

GHB

4-hydroxybutanoic acid

GHB (gamma-hydroxybutyrate) is a central nervous system depressant used recreationally as a euphoriant and sedative, and medically (as sodium oxybate) for narcolepsy. Its defining danger is a very steep dose-response curve: the gap between a recreational dose and one causing unconsciousness or fatal respiratory depression is small, with no antidote.

Overview

GHB (gamma-hydroxybutyrate) is a central nervous system depressant. It occurs naturally in small amounts in the human brain and is also manufactured — medically as the prescription drug sodium oxybate (Xyrem), used to treat narcolepsy, and illicitly for recreational use. Recreationally it is known as "liquid ecstasy," "G," and other names, usually taken as a salty liquid, and is associated with nightclubs, the chemsex scene, and, notoriously, drug-facilitated assault (it has been used as a "date-rape drug" because it can cause sedation and amnesia). A closely related chemical, GBL, is converted to GHB in the body and carries the same risks.

Source: peer-reviewed pharmacology literature (NIH/PMC)

Chemistry & mechanism of action

GHB acts as a depressant primarily by stimulating GABA-B receptors, and also binds its own specific GHB receptors in the brain. The result is sedation, reduced inhibition, and euphoria at lower doses, shading into deep sedation, unconsciousness, and suppression of breathing as the dose rises. A central pharmacological problem is that GHB's effects do not increase smoothly with dose — it has a steep concentration-effect relationship, meaning a small increase in the amount taken can move a person abruptly from mild intoxication to overdose.

Source: peer-reviewed pharmacology literature (NIH/PMC)

Effects

At lower doses GHB produces euphoria, relaxation, lowered inhibition, increased sociability, and increased libido. Onset is usually rapid, around 15 to 30 minutes, with peak effects near an hour and a total duration of roughly three hours. As the dose increases, desired effects give way to nausea, vomiting, dizziness, drowsiness, and loss of consciousness. Because the active dose and the dangerous dose are close together, effects can escalate unexpectedly.

Source: peer-reviewed pharmacology literature (NIH/PMC)

Risks & harms

GHB's principal danger is respiratory depression: in overdose, breathing slows and can stop, which is the main cause of GHB-related death. Overdose can also cause deep unconsciousness (from which people may be difficult to rouse), seizures, dangerously low body temperature, vomiting with a risk of choking, and coma. There is no antidote — hospital treatment is supportive, focused on protecting the airway and breathing. The danger is multiplied dramatically by combining GHB with other depressants, especially alcohol, benzodiazepines, or opioids, which greatly increases the risk of fatal respiratory depression; a large share of GHB deaths involve such combinations. Regular use can lead to dependence, and abrupt withdrawal from heavy use can be medically serious and may require professional care. The steep dose-response curve means that even experienced users can overdose from a small miscalculation or a change in product concentration.

Source: peer-reviewed pharmacology and toxicology literature (NIH/PMC)

Subjective effects

euphoria, sedation; low doses → drowsiness, nausea, visual distortion

Harmful effects

overdose → unconsciousness, seizures, slowed HR, severe respiratory depression, low body temp, coma, death; NO antidote; alcohol intensifies; withdrawal syndrome

Medicinal use

Xyrem (sodium oxybate), FDA-approved 2002 for narcolepsy cataplexy

History

abuse popular in 1990s rave/club scene; notorious as a date-rape drug

Prevalence

NFLIS >5,800 reports since 1998; NSDUH ~161k past-year (2024)

Images

Visual references coming soon.

If it’s too intense

If an experience becomes overwhelming, the goal is to stay safe and let it pass — most difficult experiences ease as the drug wears off.

  • Get to a calm, safe space with someone you trust who is sober and can stay with you.
  • Cool down if you’re overheating — move somewhere cool, remove extra layers, rest. Overheating is especially a risk with stimulants and MDMA.
  • Sip water to thirst — but don’t over-hydrate. Drinking large amounts of plain water (especially after MDMA) can dangerously dilute your blood sodium (hyponatremia). Electrolytes help more than volume.
  • Slow your breathing — long, slow exhales help settle a racing heart and anxiety.
  • A sugary drink, fruit juice, or a snack can ease shakiness and the anxiety that comes with low blood sugar.
  • Do not take more, and do not add another substance to manage it. Redosing or adding something else (including a sedative like a benzodiazepine) can make things worse, not better.

With depressants, the danger is over-sedation: if someone is very drowsy, hard to wake, or breathing slowly, treat it as an emergency.

Call 911 (or Poison Control, 1-800-222-1222) right away for chest pain, a very high body temperature, a seizure, unconsciousness, or severe confusion. These are medical emergencies, not something to wait out.

Source: general harm-reduction guidance from SAMHSA, NIH/NIDA, and MedlinePlus, in our own words. Draft — not yet medically reviewed.

Forensic dossier

Draft · every field is source-cited or marked “Unknown — pending review”

Identity

IUPAC name
4-hydroxybutanoic acidPubChem PUG-REST · retrieved 2026-06-18
InChIKey
SJZRECIVHVDYJC-UHFFFAOYSA-NPubChem PUG-REST · retrieved 2026-06-18
Synonyms / aliases
g, liquid ecstasy, 4-Hydroxybutanoic acid, 4-Hydroxybutyric acid, gamma-Hydroxybutyric acid, 4-hydroxy-butyric acid, Anetamin, 4-hydroxy-butanoic acid, oxy-n-butyric acid, Butyric acid, 4-hydroxy-, 3-carboxypropoxy acid, 4-Hydroxyalkanoic acidPubChem PUG-REST + seed aliases · retrieved 2026-06-18

Composition

Composition
N/A — single compound (see Identity)

Physical / pill characteristics

Dosage form
Unknown — pending review (no Rx/OTC label; illicit — pill visuals = FIRST-PARTY submissions only, never generated or scraped)
Route
Unknown — pending review
Shape
Unknown — pending review
Color
Unknown — pending review
Imprint
Unknown — pending review
Score
Unknown — pending review

Scheduling & legal status

US schedule
Unknown — pending review
International
Unknown — pending review

Dosage

Pending medical reviewer

Sources

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