What is GHB, and why is it so dangerous?

In short

• GHB (and GBL, which the body converts into GHB) is a depressant with a famously narrow safety margin. According to the NHS’s chemsex support service, the gap between a dose that gets someone high and one that makes them lose consciousness is less than a millilitre.
• Stopping regular GHB use on your own can be dangerous. Left untreated, withdrawal causes delirium in more than 50% of cases, and severe symptoms can be life-threatening for up to 15 days.
• At Renewed Life Center in Lakeside, Cape Town, medical detox runs under 24-hour nursing supervision, with medication prescribed only where a doctor decides it’s needed. Admission can be immediate, typically within three days of first contact.

Worried about your own G or GHB use, or someone else’s? Book a free, confidential call. Twenty to forty minutes, we reply the same day, and a partner or friend can make the call.

GHB shows up in two settings that do not look alike from the outside. On a dance floor, it is a capful dropped before the music peaks. At a chemsex party, it is timed alongside other drugs across a session that can run all night. In both, the same problem sits underneath: the dose that works and the dose that puts someone under are close enough that one extra capful, or one drink on top, is the difference.

This page is for anyone who uses G occasionally and wants to understand the risk properly, for anyone who has started needing it more often than planned, and for anyone reading this about someone else, at a party or afterwards.

What is GHB, and how is it different from GBL?

GHB, gamma-hydroxybutyric acid, is a depressant used recreationally for a relaxed, euphoric, disinhibited effect, usually called G or Gina. GBL, gamma-butyrolactone, is an industrial solvent that the body converts into GHB almost as soon as it is swallowed, which is why the NHS’s chemsex support service treats the two names as one drug and one risk. Both are usually sold as a clear, salty-tasting liquid, dosed by the capful, which is part of why the dose is so easy to misjudge.

Why is the gap between a working dose and an overdose so small?

GHB’s effect climbs so steeply on a small change in dose that the gap between a working dose and an overdose all but disappears. According to the clinical reference StatPearls, around 10 mg per kilogram of body weight brings on amnesia and variable sedation, 20 to 30 mg/kg leads to cycles of REM-like sleep, and 50 mg/kg causes a dangerously slow heart rate, breathing that shuts down, and coma. The UK’s FRANK drug advice service puts it more plainly: it is very easy to overdose on GHB and GBL, because the gap between the dose that gives the effect someone wants and the dose that causes a severe overdose is so small.

In practice, that margin gets eaten up fast. A drink on top lowers it further. And because G takes a while to come on, redosing before the first capful has peaked, to “catch up” with everyone else, is one of the most common ways people end up taking far more than they intended in a single session.

Why does mixing GHB with alcohol turn dangerous so fast?

Because alcohol and GHB are both depressants that slow breathing and the central nervous system in the same direction, so together they add up rather than cancel out. Alcohol was the other substance involved in 76% of GHB-related emergency department visits, according to StatPearls. The NHS’s chemsex service advises against mixing G with alcohol at all: it raises the risk of going under, and it also delays how quickly G takes effect, which is exactly the situation that leads to redosing too soon.

Why does GHB turn up at chemsex parties and clubs?

GHB turns up at chemsex parties and clubs because it does two jobs at once: it lowers inhibition, and it extends a session that would otherwise wind down. Chemsex, using drugs like GHB, crystal meth or mephedrone to enhance and prolong sex, usually runs over many hours, sometimes with little or no sleep between doses. Clubs run a faster version of the same pattern: a capful poured by someone else, seconds before the next one, with nobody keeping a running total.

For most people, G is doing a job, not just supplying a high. It quiets the anxiety that makes a packed room, or a stranger’s flat, feel unbearable. A stimulant comedown from earlier in the night gets smoothed over. A session runs longer than the body would otherwise allow on its own. That is also why simply deciding to stop rarely works on its own: the anxiety, or the comedown, or the tiredness it was managing is still there once the drug is not.

Where anxiety or panic sits underneath the G use, that gets treated at the same time, through our dual diagnosis work, rather than referred somewhere else.

If G has quietly become part of every session, or every weekend, that is worth talking through properly. Book a free, confidential call. We reply the same day.

GHB as a “date rape drug”: what are the signs a drink has been spiked?

A drink spiked with GHB usually looks and tastes normal, because GHB has little to no colour or taste and dissolves completely. The signs to watch for are in the person, not the glass: sudden, disproportionate drunkenness that does not match what they have had, confusion, dizziness, nausea, loss of coordination, and blacking out, coming on faster and harder than the drink itself would explain.

If you see this in someone, treat it exactly as a GHB overdose: do not leave them, get them somewhere safe, and follow the steps further down this page.

What are the signs of GHB addiction?

The clearest signs of GHB addiction are needing more for the same effect, redosing through the night to avoid the comedown, and a weekend or a session that no longer feels possible without it. According to the UK’s FRANK drug advice service, people who take GHB or GBL regularly can develop a dependence, with reported withdrawal symptoms including confusion, shaking, an epileptic seizure and coma.

That call is better made with someone who works with addiction every day than guessed at from a list. At Renewed Life Center in Lakeside, Cape Town, Dr Ruby Weber heads the psychological side of treatment, with more than two decades in the addictions field working with both chemical and process addictions, for international and South African clients.

Talk it through before it gets worse. Book a free, confidential call, twenty to forty minutes, no obligation.

Why does GHB withdrawal need medical care, not willpower?

GHB withdrawal needs medical care, not willpower, because it can turn dangerous within a day. According to StatPearls, early symptoms of anxiety, tremor, a fast heart rate and insomnia can progress within 24 hours to severe agitation with autonomic instability, and severe withdrawal symptoms are life-threatening and can last up to 15 days. Left untreated, GHB withdrawal causes delirium in more than 50% of cases, according to a 2021 review in the Journal of Neurosciences in Rural Practice. StatPearls is direct about what severe withdrawal needs: benzodiazepine treatment and management in an intensive care setting.

That is the case for treating GHB withdrawal as a medical event from the start, not something to push through at home. At Renewed Life Center, detox begins with a risk assessment before withdrawal starts, then monitoring, symptom management and stabilisation of sleep and routine, with medication used only where a doctor decides it is clinically indicated and nurses on duty around the clock.

Stopping alone is where GHB withdrawal goes wrong most often. Read about medical detox in Cape Town, or book a free, confidential call first.

Is GHB legal in South Africa?

No: in South Africa, GHB (gamma-hydroxybutyrate) is listed as a Schedule 7 substance under the medicines control schedules published by SAHPRA, the South African Health Products Regulatory Authority, the same schedule as heroin. Elsewhere the picture differs: in the UK, GHB is a Class B drug, meaning it is illegal to have for yourself, give away or sell without a prescription.

What should you do if someone passes out after taking GHB?

If this happened at a party or a chemsex session and you are worried about what comes after, for yourself or the person you were with, that conversation is easier with someone who has had it before.

Why do people choose Renewed Life Center for GHB and chemsex-related addiction?

People choose Renewed Life Center for GHB and chemsex-related addiction because the detox and the reasons behind the use get treated in the same place, by people you can name. Dr Ruby Weber, who leads that side of the programme, has worked in the addictions field for more than two decades, across both chemical and process addictions. Dr John Wulz, our resident GP, examines every arrival, and nurses are on duty 24 hours a day for anyone who needs medical detox. Where anxiety, low mood or the comedown from other drugs sits underneath the GHB use, that gets treated on the same plan, through our dual diagnosis work, without a separate referral.

The house is in Lakeside, in Cape Town’s Southern Suburbs, well away from the clubs and sessions tied to using. Payment is direct, so the clinical picture sets the length of stay, not a scheme’s limit, and airport transfers are included both ways for people flying in. Family therapy runs alongside treatment, in person or by video, and there is a longer guide on how to talk to a loved one about rehab if this is about someone you love.

How do you start?

You start with twenty to forty minutes on WhatsApp, video or phone, free and confidential. A clinical assessment follows within three days, and admission can be immediate, typically within three days of first contact.

Write to us about the GHB or G use, or book a free, confidential call straight away.

Questions people ask

This article is general information, not medical advice.

Sources

1. StatPearls, GHB Toxicity, NCBI Bookshelf
2. Wolf et al., GHB withdrawal, Journal of Neurosciences in Rural Practice, 2021
3. NHS, Let’s Talk About It, chemsex support: GHB/GBL (G)
4. FRANK, GHB and GBL
5. chemsex.co.uk, GHB emergency guidance
6. SAHPRA, Consolidated Schedules, 1 August 2025
7. South African Border Management Authority, national emergency numbers
8. City of Cape Town, emergency contact numbers