GHB Withdrawal Symptoms, Effects, and Timeline

GHB Withdrawal Symptoms, Effects, and Timeline

Gamma hydroxybutyrate (GHB) is a central nervous system depressant that is used illicitly at bars, nightclubs, concerts, and parties. Bodybuilders also report illegally using GHB to increase muscle and reduce body fat.2 In addition, perpetrators of sexual assault may use GHB, as the drug reduces a person’s ability to resist and may cause victims to lose consciousness.3,4

Users may develop tolerance to GHB and require higher doses to achieve the same effect.1,4 Regular use of GHB for as little as 2 months may result in physiological dependence and give rise to a withdrawal syndrome if stopped.3 Some of the symptoms of GHB withdrawal may include vomiting, confusion, delirium, hallucinations, and insomnia.1

Stopping use without medical assistance can be dangerous.1 GHB users who are not dependent on the drug may be able to cease use with education and outpatient therapy.6 However, for regular users, withdrawal can be severe and may last 2 weeks. A person who is dependent on GHB and wants to quit should consider an inpatient treatment center.1

How Long Does Withdrawal Last?

The severity of GHB withdrawal symptoms and the timeline of effects depend on the level of GHB use prior to quitting. Those who were heavy GHB users—for example, taking a dose of GHB every 2-3 hours for a few months or more—are at risk of more serious effects. As far as the timeline, people may begin to have signs of withdrawal from GHB within 1 to 6 hours after their last dose.1,6 But the symptoms typically appear approximately 1 day after last use. 1

Nervousness and vomiting may occur early on, and over the course of the next 5 days, symptoms may include anxiety, delirium, confusion, insomnia, and hallucinations.1 Withdrawal may last up to 2 weeks.6 Some symptoms, including anxiety, depression, insomnia, and cognitive deficits, may continue for months after initial detox.6

Symptoms of GHB Withdrawal

Not all users of GHB users experience the same GHB withdrawal effects. Common symptoms of GHB withdrawal include: 1,4,6

  • Anxiety.
  • Delirium.
  • Confusion.
  • Insomnia.
  • Hallucinations.
  • Tremors.
  • Tachycardia (rapid heart rate).
  • Nausea.
  • Vomiting.
  • Sweating.
  • Paranoia.
  • Muscle cramps.

Not all users of GHB users experience the same GHB withdrawal effects. The following factors affect the severity of GHB withdrawal: 6

  • Using alcohol with GHB
  • Any concurrent psychiatric illness(es)
  • Daily doses of GHB prior to stopping use

Withdrawal from GHB can also lead to memory loss, which can complicate treatment because the person forgets the consequences of their addiction.3

Dangers of Withdrawal

Unsupervised withdrawal from GHB can be dangerous and may even lead to death.4,9 Some users have also experienced psychosis and severe agitation.3 

Some people use GHB or other substances such as benzodiazepines or alcohol to feel better.3 Taking additional drugs places the person at risk for overdose and may ultimately increase withdrawal severity.3,6  lt can also lead to the development of other addictions.

Some symptoms of GHB withdrawal may persist for several months and place the person at high risk of relapse. These symptoms include:6

  • Anxiety.
  • Depression.
  • Insomnia.
  • Problems with thinking and memory.
  1. Busardo, F. P. & Jones, A. W. (2015). GHB pharmacology and toxicology: Acute intoxication, concentrations in blood and urine in forensic cases and treatment of the withdrawal syndrome. Current Neuropharmacology, 13(1), 47-70.
  2. National Institute on Drug Abuse. (2014). Club drugs (GHB, ketamine, and rohypnol).
  3. Substance Abuse and Mental Health Services Administration. (2002). GHB: A club drug to watch.
  4. Government of Canada. (2015). GHB.
  5. University of Maryland Center for Substance Abuse Research. (2013). GHB.
  6. Miotto, K. & Roth, B. (2001). GHB withdrawal syndrome. Austin: Texas Commission on Alcohol and Drug Abuse.
  7. Kamal, R. M., van Noorden, M. S., Franzek, E., Dijkstra. B. A., Loonen. A. J., and DeJong, C. A. (2016). The neurobiological mechanisms of gamma-hydroxybutyrate dependence and withdrawal and their clinical relevance: A review. Neuropsychobiology, 73(2), 65-80.
  8. Freese, T. E., Miotto, K., & Reback, C. J. (2002). The effects and consequences of selected club drugs. Journal of Substance Abuse Treatment, 23, 151-156.
  9. Towsend, C. (2015). The Scary Reason GHB Is Making a Comeback. The Daily Beast.