Gamma-Hydroxybutyrate (GHB): Uses, Risks & Regulations

What is Gamma-Hydroxybutyrate (GHB)? Gamma-Hydroxybutyrate (GHB) is a central nervous system (CNS) depressant with both legitimate medical applications and a history of illicit recreational use. It occurs naturally in small amounts in the human body as a neurotransmitter and metabolite of GABA (gamma-aminobutyric acid). In medicine, GHB is prescribed under strict regulation for the treatment of narcolepsy with cataplexy. Outside medical use, it is classified as an illegal drug in most jurisdictions due to its sedative, euphoric, and addictive properties. Medical & Legitimate Uses 1. Treatment of Narcolepsy Prescription form: Marketed under brand names such as sodium oxybate, GHB helps manage excessive daytime sleepiness and cataplexy (sudden muscle weakness). Administered under controlled conditions with limited distribution due to abuse potential. 2. Clinical & Research Context Investigated for potential roles in alcohol withdrawal treatment and certain sleep disorders. Any non-approved use outside regulated clinical settings is prohibited. Illicit Use & Misuse Risks Recreational Misuse Known as “liquid ecstasy” or “G,” GHB is used illicitly for its euphoric and sedative effects. Commonly misused in nightlife and party settings. Health Risks Short-term effects: Relaxation, drowsiness, reduced inhibitions, dizziness. Serious risks: Nausea, vomiting, seizures, respiratory depression, loss of consciousness, coma, and death in overdose cases. Addiction: Prolonged misuse can lead to dependence, with severe withdrawal symptoms (insomnia, anxiety, tremors, psychosis). Association with Drug-Facilitated Crimes Due to its colorless, odorless, and tasteless properties, GHB has been misused in cases of drug-facilitated sexual assault, making it a major public safety concern. Global Legal & Regulatory Status United States Classified as a Schedule I controlled substance when used illicitly. Prescription form (sodium oxybate) is listed under Schedule III, available only through a restricted distribution program. European Union Listed as a controlled substance under EU drug laws. Available only for medical purposes with strict authorization. Other Countries Most jurisdictions, including Australia, Canada, and Japan, regulate GHB as a prohibited or controlled drug with severe penalties for possession or trafficking. Safety Considerations Medical use only: GHB should only be used under the care of a licensed physician. Storage: Prescription GHB is dispensed in secure containers with clear labeling. Public awareness: Governments and health agencies issue warnings to highlight risks of misuse and overdose. Key Takeaways Gamma-Hydroxybutyrate (GHB) is a naturally occurring compound with limited medical use but a high risk of abuse. Health risks include overdose, respiratory depression, addiction, and withdrawal complications. Regulations worldwide strictly control GHB, differentiating between illicit use (illegal) and approved medical formulations (highly restricted). Public education and strict compliance are essential to reduce health hazards and criminal misuse.