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GHB Withdrawal & Detox

GHB withdrawal can be serious, so medical attention is necessary. Severe symptoms include respiratory depression, hallucinations, slow heartbeat, and coma.

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Regular use of GHB can lead to dependence. Severe withdrawal may occur even after only short-term use of the drug, particularly if high doses of GHB are taken.[1]

What Is GHB Withdrawal?

GHB is a recreational drug that is commonly abused in party atmospheres, such as at raves, concerts, or dance clubs. It’s abused for its euphoric effects, but it can foster dependency with consistent use. GHB withdrawal will then occur when the use of the drug is stopped.

While the body produces small amounts of GHB naturally, it’s not accustomed to the large amounts taken in when the drug is used recreationally.[2] But if GHB is used consistently, the body adjusts to its presence. When it is no longer present, withdrawal symptoms occur as the body struggles to regain a sense of balance without excess GHB present.

GHB withdrawal is often described as similar to alcohol withdrawal.[1]

What Are Common Symptoms of GHB Withdrawal?

Symptoms of GHB withdrawal include the following:[3]

  • Anxiety
  • Depression
  • Nervousness
  • Tremors
  • Gastrointestinal discomfort
  • Paranoia and hallucinations
  • Impaired respiration
  • Extreme fatigue
  • Slow heartbeat
  • Excessive sweating
  • Headache

Severe Symptoms

In rare cases, severe symptoms of GHB withdrawal include the following:[1]

  • Increased heart rate
  • High blood pressure
  • Difficulty breathing
  • Hallucinations
  • Delirium
  • Kidney failure
  • Coma

Factors That Determine the Intensity of Withdrawal Symptoms 

The main factors that influence symptoms of withdrawal from GHB include the following:[1,3-5]

  • Dose: Higher doses of GHB will lead to more significant withdrawal symptoms when use is stopped. 
  • Duration of use: People who have been taking GHB for a long time will generally experience more severe withdrawal symptoms than those who have only engaged in short-term use. 
  • Age: With age, metabolism slows, and it becomes more difficult to eliminate toxins like GHB from the system. 
  • Body size: Larger people generally have slower metabolisms, so it may take longer for GHB to be removed from their systems. 
  • Genetics and individual metabolism: Your genetics and basal metabolic rate will also influence your GHB withdrawal timeline and symptom severity. 
  • Medical conditions: Certain medical conditions that influence organs, like kidney or liver function, can influence how your body metabolizes GHB and other drugs. Generally, the presence of these conditions means your withdrawal timeline will be longer and symptoms will be more severe.

How Long GHB Withdrawal Lasts: Withdrawal Timeline

Withdrawal timelines will vary according to individual factors, but here’s what you can generally expect when withdrawing from GHB:

Days 1–2

Symptoms will usually include the following:[1]

  • Anxiety
  • Insomnia
  • Depression
  • Elevated heart rate
  • Muscle pain
  • Perspiration
  • Tremors
  • Feelings of sadness and regret

Days 2–5

Symptoms can intensify and include the following:[1]

  • More intense variations of the above symptoms
  • Mood swings
  • Feelings of panic
  • Paranoia
  • Gastrointestinal issues
  • Hallucinations or seizures (in severe cases)

Days 6 & Beyond

Most symptoms resolve within two to five days, but some may persist beyond that timeline. Here are some GHB withdrawal symptoms that may linger:[1]

  • Continued anxiety and depression
  • Low energy 
  • Cravings for more GHB
  • Irritability 
  • Problems with concentration with memory

Detoxing From GHB

While GHB withdrawal can be very uncomfortable and dangerous in some circumstances, medical detox can manage the process. This keeps you safe and comfortable as your body processes the drug.

Symptoms can be intense and painful, so it’s important that medical professionals provide supportive care. The goal is to lessen symptom intensity.[6] 

Medical professionals may provide intravenous fluids, high doses of benzodiazepines, other medications to alleviate certain symptoms of withdrawal, and other forms of supportive care, as needed.[1,7] In severe cases, breathing support may be given.

After withdrawal, it’s important to get comprehensive addiction treatment to ensure you don’t return to GHB abuse. The period following withdrawal is often the most vulnerable, and relapse is likely during this time.[8] With individualized treatment and a good support system in place, you can make it through this period without relapsing back to GHB misuse.

Updated December 1, 2023
  1. LeTourneau JL, Hagg DS, Smith SM. Baclofen and gamma-hydroxybutyrate withdrawal. Neurocrit Care. 2008;8(3):430-433. doi:10.1007/s12028-008-9062-2
  2. Kapoor P, Deshmukh R, Kukreja I. GHB acid: A rage or reprive. J Adv Pharm Technol Res. 2013;4(4):173-178. doi:10.4103/2231-4040.121410
  3. Tay E, Lo WKW, Murnion B. Current insights on the impact of gamma-hydroxybutyrate (GHB) abuse. Subst Abuse Rehabil. 2022;13:13-23. Published 2022 Feb 9. doi:10.2147/SAR.S315720
  4. Kinirons MT, O'Mahony MS. Drug metabolism and ageing. Br J Clin Pharmacol. 2004;57(5):540-544. doi:10.1111/j.1365-2125.2004.02096.x
  5. Brill MJ, Diepstraten J, van Rongen A, van Kralingen S, van den Anker JN, Knibbe CA. Impact of obesity on drug metabolism and elimination in adults and children. Clin Pharmacokinet. 2012;51(5):277-304. doi:10.2165/11599410-000000000-00000
  6. Wolf CJH, Beurmanjer H, Dijkstra BAG, et al. Characterization of the GHB withdrawal syndrome. J Clin Med. 2021;10(11):2333. Published 2021 May 26. doi:10.3390/jcm10112333
  7. Siefried KJ, Freeman G, Roberts DM, et al. Inpatient GHB withdrawal management in an inner-city hospital in Sydney, Australia: a retrospective medical record review. Psychopharmacology (Berl). 2023;240(1):127-135. doi:10.1007/s00213-022-06283-6
  8. Sinha R. New findings on biological factors predicting addiction relapse vulnerability. Curr Psychiatry Rep. 2011;13(5):398-405. doi:10.1007/s11920-011-0224-0
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