GHB Dosage Guide

## Recognizing GHB Overdose GHB overdose is a medical emergency. The primary danger is respiratory depression and loss of consciousness, particularly when combined with other depressants. GHB-related deaths most commonly involve co-ingestion of alcohol. The transition from pleasurable effects to unconsciousness can be rapid and unpredictable. Signs of GHB overdose include: sudden loss of consciousness, vomiting while unconscious (aspiration risk), very slow or irregular breathing, inability to be roused by stimulation, seizures, blue-tinged skin (cyanosis), and muscle spasms or myoclonic jerks. A distinctive sign of GHB overdose is deep unconsciousness with a relatively stable pulse; however, this can deteriorate rapidly. ## Emergency Response Call emergency services (911) immediately. While waiting: - Place the person in the **recovery position** (on their side) to prevent aspiration if they vomit - **Monitor breathing** continuously - If breathing stops, begin **rescue breathing or CPR** - Do **not** attempt to induce vomiting - Do **not** give the person anything by mouth - Do **not** rely on folk remedies such as putting lemon or citrus in the person's mouth, despite persistent community claims about their effectiveness -- there is no pharmacological basis for this and it poses an aspiration risk in an unconscious person ## Medical Treatment There is no specific antidote for GHB, though the experimental drug physostigmine has shown some efficacy in clinical settings. Treatment is primarily supportive, focused on airway protection and monitoring. Most GHB overdoses resolve within 2-6 hours as the body metabolizes the drug, but the critical period requires medical supervision. Good Samaritan laws apply. ## Community Risk Awareness Experienced users emphasize that the risk of overdose with GHB is not limited to inexperienced users or reckless behavior. The steep dose-response curve, inconsistent solution concentrations, and variable individual sensitivity mean that even careful, experienced users can unexpectedly lose consciousness. Community members who have witnessed others "G-ing out" in public settings describe it as deeply alarming and emphasize that it reflects the inherent danger of the substance's pharmacology rather than user error alone. This reality underscores the importance of always having a sober, informed companion present when GHB is being used.