Rising GHB Overdose Rates in Australia and Strategies to Reduce Risks

Gamma hydroxybutyrate (GHB), a drug often used recreationally in Australia, is seeing increasing misuse across the country. Popularly known as "G," "juice," "Gina," or "fantasy," GHB is typically a colorless, odorless liquid that may taste bitter or salty. Despite its brief euphoric effects, GHB poses serious health risks, especially because the line between a recreational dose and an overdose is extremely narrow—sometimes less than 0.5ml can be deadly.

GHB is classified as a depressant, with higher doses resulting in slowed breathing and heart rate, potentially leading to unconsciousness or death. At low doses (around 1ml), users may experience feelings of euphoria, heightened libido, and lowered inhibitions. It is often used in party settings, including nightclubs, and as a facilitator for sexual activity.

Chemicals similar to GHB, such as gamma butyrolactone (GBL) and 1,4-butanediol (1,4-BD), are often used as substitutes, producing similar effects. Though only 0.2% of Australians reported using GHB in the past year—lower than cannabis (11.5%) or cocaine (4.5%)—certain groups exhibit higher usage rates. For instance, 12% of individuals who regularly take ecstasy or stimulants like methamphetamine, and 15% of those who inject drugs, have reported recent GHB use. Additionally, nearly 20% of gay and bisexual men have tried GHB at least once.

The danger of overdose, often called a "G-drop" or "blow-out," is significant. Because the therapeutic and toxic doses are so close, accidental overdoses are common. Symptoms include muscle twitching, seizures, respiratory depression, and unconsciousness. Unlike opioid overdoses, there is no reversal medication like naloxone for GHB overdose. Immediate medical intervention—calling emergency services and keeping the person's airway clear—is crucial.

Long-term harms of GHB are rising, with increases in ambulance attendances, emergency cases, and hospitalizations—Victoria, for example, experienced a 147% increase in ambulance calls related to GHB between 2012 and 2019. Daily users can develop dependence, and abrupt cessation may lead to severe withdrawal symptoms, highlighting the need for professional medical guidance.

GHB’s effects on libido and lowered social inhibitions also contribute to its use during sexual activity. However, it’s also linked to drug-facilitated sexual assault, including drink spiking cases. Detecting GHB in such incidents is challenging, and its prevalence in sexual violence cases remains uncertain.

To reduce harm, education on safe use practices is vital. Strategies include careful dose measurement, starting with low doses, spacing out usage, avoiding mixing GHB with other depressants like alcohol, and maintaining open communication about consent and boundaries in sexual encounters. Awareness campaigns and harm reduction information have been shown to influence safer behaviors among GHB users.

The rise in GHB use may be driven by factors like low cost and increased availability. New user groups, such as people who inject drugs and women, may lack knowledge of safe usage procedures and face higher risks. More research is needed to understand why GHB use is increasing and to develop effective support and treatment options.

Australian health authorities have published guidelines on GHB withdrawal management; however, there’s a shortage of tailored protocols for healthcare providers to assist in reducing GHB dependence. Resources like the National Alcohol and Other Drug Hotline offer free advice for individuals seeking help. Continued research and public education are essential to address ongoing challenges related to GHB misuse and overdoses.

Source: https://medicalxpress.com/news/2025-05-australians-overdosing-ghb-ways.html