Official Names: Gamma-hydroxyybutyrate (GAMM-uh hy-DROK-see-BYOO-tuh-rate), gamma-hydroxyybutyric acid (GAMM-uh hy-DROK-see-byoo-TEER-ic AH-sid), sodium oxybate, Xyrem (Zy-rum)
Street Names: Cherry meth, easy lay, G, Georgia home boy, grievous bodily harm, G-riffick, liquid ecstasy (not the same as the drug ecstasy), liquid E, liquid X, salty dog, salty water, scoop, soap, zonked
Drug Classification: Schedule I, depressant
What Kind of Drug Is It?
GHB is an acronym for gamma-hydroxyybutyrate, also known as gamma-hydroxyybutyric acid. GHB acts as a depressant, which is a substance that slows down the activity of an organism or one of its parts. It slows both breathing and heart rates in the people who take it. GHB is produced in the body from a similar compound, gamma-butyrolactone (GBL). The reaction also occurs in the laboratory when GBL is treated with a basic substance such as sodium hydroxide. GBH and GBL have similar physical, chemical, biological, and pharmaceutical properties. As a result, references to GHB and GBL are sometimes used interchangeably.
GBH occurs naturally in very small amounts in the human body. However, it can also be synthesized in a laboratory to be used illicitly, or illegally. This makes it one of the many so-called "designer drugs" of the 1990s. (A separate entry on designer drugs is available in this encyclopedia.) GHB is especially hazardous to humans because of its ability to cause addiction in users and because of its potential deadly effects.
Although GHB was developed for use as an anesthetic in the 1960s, its makers "later withdrew it from consideration for approval by the U.S. Food and Drug Administration because of severe side effects reported by patients," explained M. Foster Olive in Designer Drugs. Decades later, GHB gained popularity among three different groups of users: 1) bodybuilders looking for greater muscle mass; 2) partiers at nightclubs and raves seeking a new kind of high; and 3) sexual predators searching for their next victim.
GHB is an odorless, colorless substance. Its slightly salty taste is said to disappear when mixed with alcohol or soft drinks. (A separate entry on alcohol is available in this encyclopedia.) The effects of GHB make it a perfect "knock out" drug for surgeries. It acts very quickly, bringing on a deep sleep and erasing all memory of what occurred while the user was under its influence. In fact, it was developed with this purpose in mind. In the 1960s, GHB showed promise as a new type of anesthetic for use in medical settings. However, its effects were unpredictable, and the substance had the potential to depress breathing and heart rates to dangerously low levels. This made it too risky to use on patients being readied for surgery.
In the 1980s, GHB was sold legally in health food stores and gyms as a dietary supplement designed to stimulate growth hormones. At that time, no one knew that even small doses of the substance could cause dangerous and addictive effects. Mass marketing campaigns hailed it as a safe and effective way to increase muscle mass and maintain weight. GHB became a huge seller among bodybuilders and dieters.
But over the course of the decade, reports of life-threatening reactions to GHB began to surface. GHB produced a wide range of effects, depending on the dosage. These effects included: intoxication (the loss of physical or mental control due to the use of any drug), relaxation, vomiting, seizures, coma, and even death. H. Joseph Pittman explained in Nursing that "even small increases in the amount of GHB ingested can lead to significant intensification of effects."
After investigating sixty reports of life-threatening reactions to GHB, the Food and Drug Administration (FDA) declared in 1990 that GHB was unsafe and illegal for use by the general public. Its only accepted use would be for drug research carried out under strict, agency-controlled conditions.
Getting around the Ban
After GHB became more difficult to buy, two other substances quickly took its place. These substances are gamma-butyrolactone (GAMM-uh byoo-tear-oh-LAK-tone; GBL) and 1,4-butanediol (BD). (A separate entry on GBL is available in this encyclopedia.) Both GBL and BD actually turn into GHB as they are broken down in the body, producing the same effects as a dose of GHB. Manufacturers of GBL and BD supplements claimed that their products could enhance users' muscle mass, sexual performance, mood, and sleep.
Like all dietary supplements, GBL and BD were regarded by law as foods rather than drugs. For years, this legal loophole kept the FDA from being able to ban them. But reports of fifty adverse reactions and one death linked to GBL led the FDA to reclassify GBL as an unapproved drug. As a result, GBL- and BD-containing supplements were removed from store shelves and are no longer legally available for purchase. However, GBL has many industrial uses, which have kept it on the market as a cleaning agent. But it is illegal to market it for human consumption. BD is now considered a Class I Health Hazard, meaning that it is a life-threatening substance.
In 2000, GHB became a Schedule I substance under the guidelines set forth in the Controlled Substances Act (CSA) of 1970. This designation means that GHB is extremely dangerous and has a high potential for abuse and addiction.
Despite these actions, GBL, BD, and GHB continue to be manufactured and sold illegally. GBL is sold on the Internet in 55-gallon drums. Some Web sites provide the tools and the directions to convert it to GHB. The drug is typically made in illegal kitchen or basement labs and then sold locally on the street. Newsweek reported that in September of 2002 alone, "115 people in 84 cities" had been arrested "for peddling GHB on the Internet."
GHB Use Linked to Club Scene and Violent Crimes
GHB is one of several drugs that began dominating the club scene in the 1990s. Other common club drugs include ecstasy (MDMA), ketamine, 2C-B (Nexus), and Rohypnol. (Separate entries on these drugs are also available in this encyclopedia.) Along with Rohypnol (known most commonly as "roofies"), GHB quickly gained a reputation as a "date-rape" drug. Both drugs make potential crime victims unable to resist their attackers. In addition, the memory lapse caused by date-rape drugs makes it hard for victims of violent crimes to identify the offender later.
Because its taste can be hidden, and it is colorless and odorless, GHB can be slipped into a drink without someone's knowledge. "GHB can mentally and physically paralyze an individual, and these effects are intensified when the drug is combined with alcohol," wrote Jennifer Lloyd in a GHB fact sheet published by the Office of National Drug Control Policy (ONDCP). In high enough doses, GHB can cause a user to pass out. Various companies have created coasters and test kits designed to help people check their drinks for the presence of drugs before they consume them. The effectiveness of such testing devices is highly debated, however.
As of 2005, significant strides had been made in detecting GHB in trace, or very small, amounts of blood, urine, and other bodily fluids. In cases where an unused portion of the drug cannot be recovered, gas chromatography-mass spectrometry (a high-technology instrument that separates a chemical mixture and identifies its composition) can be used to detect GHB and related compounds. All evidence in a case of suspected GHB poisoning must be collected and processed quickly. According to Matthias E. Liechti and Hugo Kupferschmidt in Swiss Medical Weekly, "GHB levels decrease rapidly over several hours." The drug is "undetectable in blood within 4-8 hours of administration and in urine after a maximum of 12 hours."
What Is It Made Of?
GHB is a natural substance produced in small amounts in the human body. It may act as a neurotransmitter in the brain. The chemical formula for GHB is C4H8O3. It is illegally manufactured and sold in its crystalline compound (or salt) form, which is called sodium oxybate. Sodium oxybate's chemical formula is C4H7NaO3. GHB can be produced by combining drain cleaner with GBL.
How Is It Taken?
GHB usually comes in a colorless and odorless liquid form, but it is also available as a white soap-like powder. Either way, it is taken orally, usually in small amounts mixed with a liquid such as a soft drink, a sports drink, or an alcoholic beverage to mask its salty taste. The distinctive saltiness is more obvious when mixed with plain water. GHB is sometimes disguised by adding food coloring or flavorings, or by storing it in mouthwash bottles or eye drop dispensers. It may be sold in small vials, capfuls, or "swigs" at club parties. According to the DEA's "Drugs and Chemicals of Concern" report, "the presence of GHB in the liquid can be detected by shaking the liquid. If it becomes cloudy, GHB may be present." On average, a teaspoon of the liquid contains 1 gram (0.035 ounces) to 5 grams (0.175 ounces) of GHB and costs anywhere from $5 to $25 per dose.
Are There Any Medical Reasons for Taking This Substance?
Although GHB was initially developed as an anesthetic, it was never ultimately used in the United States for that purpose. Outside of the United States, however, GHB is still occasionally used for anesthesia, resuscitation, and addiction therapy.
When President Clinton signed the Hillary J. Farias and Samantha Reid Date Rape Drug Prohibition Act into law in 2000, he ordered the DEA to categorize GHB as a Schedule I dangerous drug with no medical benefits. Subsequently, two almost paradoxical uses have been found for these substances. In 2002, Orphan Medical, now a part of Jazz Pharmaceutical, obtained approval to market GHB for treatment of narcolepsy, a condition of excessive daytime sleepiness, and cataplexy, attacks of muscle weakness. The drug is marketed under the brand name Xyrem;®, and is strictly controlled. More recently, GBH has been studied for treatment of alcoholism and control of alcohol withdrawal, and has been approved for these uses in some European nations, but not in the United States.
Because of the risks of diversion and misuse, sodium oxybate, the therapeutic version of GHB, is subject to special dispensing requirements, and cannot be obtained through community pharmacies. All physicians authorized to prescribe the drug must be registered. Patients too must be registered with the program, and prescriptions written on a special form. Before the drug can be dispensed, a physician consults with the patient to verify that the patient understand the appropriate way to take the drug. All supplies are provided by a central pharmacy, and are shipped by overnight delivery service.
Use in treatment of alcohol withdrawal syndrome has not been as well established, and dosage studies are still being conducted.
Preliminary studies suggest that GHB-based drugs may also be useful in treating Alzheimer's disease or Parkinson's disease, but it is still too early to tell. Two European studies found GHB effective in relieving alcohol craving and alcohol withdrawal symptoms. In one study, alcoholics took a moderated daily dose for three months. Participants reduced their drinking by half, and their days of abstinence tripled. Another study found that GHB relieved opiate withdrawal symptoms. This area of use is still uncertain, but a 2007 Italian study reported that GHB is somewhat more effective in treating alcoholism than is diazepam (brand name Valium). At the same time, animal studies are continuing.
Help for Narcoleptics
Although GHB is generally viewed as a dangerous drug, it seems to help people who have an unusual and hard-to-treat daytime sleep disorder called narcolepsy. On July 17, 2002, the FDA approved Xyrem (an oral solution of sodium oxybate, or GHB) "as a treatment to reduce the incidences of cataplexy in patients with narcolepsy," according to Jennifer Lloyd in a GHB fact sheet written for the White House Office of National Drug Control Policy. Cataplexy is a sudden episode of muscle weakness that can cause a person to collapse unexpectedly during waking hours. The way GHB works on narcoleptics is not completely known, but it may help keep them "awake during the day by giving them a better night's sleep," explained Jeff Levine in a WebMD article.
When used as a narcolepsy treatment, Xyrem is considered a Schedule III substance under the CSA of 1970. Schedule III substances have less potential for abuse and dependence than Schedule I and II substances. Even though Xyrem has an accepted medical use, selling it, distributing it, or using it for anything other than its prescribed use is against the law and subject to stiff Schedule I penalties.
One source of data about the misuse and abuse of GHB is the Drug Abuse Warning Network (DAWN), a division of the U.S. Department of Health and Human Services. DAWN monitors drug-related visits to hospital emergency departments (EDs). In the most recent year for which data are available (2011), GHB misuse or abuse was the proximate cause for 2,406 ED visits, of whom 1,408 were males and 998, females. The vast majority of patients (2,020) were white, and the remainder, of unknown or unreported race. By far the largest percentage of patients were in the age group 35 to 44 years, with the remainder in the age group 25 to 29 years.
A source of information about GHB use among teenagers is the Monitoring the Future (MTF) study, a well-known survey of drug use and attitudes toward drugs among middle school and high school students. MTF has included questions about GHB in its research since 2000. It discontinued those questions for eighth and tenth grade students in 2012, but continued to include the questions for twelfth graders. The study has found that the percentage of eighth grade students reporting that they had used GHB at least once in the year preceding the study has remained at about one percent from 2000 to 2011. It reached its peak in 2000 and fell to its lowest point (0.6 percent) in 2011. The pattern for tenth graders during the period 2000 to 2011 was similar to that for eighth graders, with a peak of 1.1 percent in 2000 and a low point of 0.5 percent in 2011. In the case of twelfth graders, 0.9 percent reporting using GHB at least once during the previous year, a number that was cut roughly in half (to 1.0 percent) a decade later.
Effects on the Body
The increase in GHB use can also be traced to its price. At $5 to $10 per capful, it has been viewed by teens as a cheap alternative to ecstasy or speed. Typical GHB users and sellers are between eighteen and thirty years old. "Pulse Check" statistics from 2004 indicate that GHB and GBL purchases most often occur in club settings frequented by young people, such as raves, nightclubs, bars, and parties, or through Internet Web sites.
The Case that Captured the Nation's Attention
Carlson High School ninth-graders Samantha Reid and Melanie Sindone were best friends. They lived in a downriver city just south of Detroit, Michigan. On a Saturday night in January 1999, the girls joined up with two boys from school, Daniel Brayman and Nicholas Holtschlag. Both were seniors. (A third girl, Sindone's stepsister, went along as well.) The five teens reportedly cruised around in Holtschlag's van for a while. For lack of anything better to do, the seniors ended up driving the girls to the apartment of an older friend, twenty-five-year-old Erick Limmer, on Grosse Ile in Michigan. Another teen, Joshua Cole, was already there with Limmer.
Cigarettes, joints, and alcohol were all part of the mix that night, but the drug that led to tragedy was GHB. Apparently, the party on Grosse Ile was less exciting than everyone had hoped. The girls seemed very quiet, and the boys were looking for a way to liven things up. Three of the young men (excluding Limmer who was not in the room at the time) decided to slip some GHB into the girls' drinks. Reid was drinking a Mountain Dew and Sindone was having a screwdriver (orange juice and vodka). Limmer had purchased the GHB earlier. He was with Cole at the time of the sale and had told Cole not to touch it.
The girls did not know that the drinks had been spiked with a drug that could kill them. According to Detroit News writer Jodi S. Cohen, Sindone "remembers what it felt like as her body slowly went numb while she watched her friend slump down into a couch." Within minutes of consuming their GHB-laced drinks, the drug caused both girls to vomit and pass out.
Limmer was reportedly upset about the vomit stains on his rug and furniture. The girls were moved to the bathroom floor, where they continued to choke on and off. Sindone's stepsister did not become ill. Two of the boys headed out to a nearby store to pick up some carpet cleaning equipment. Hours went by, but the girls did not sleep off the effects of the GHB.
Emergency Care Too Late
It was not until 4:30 a.m. that the boys finally took Reid and Sindone to the hospital. The girls were both intubated and restrained. Sindone survived, but her best friend did not. Reid died of the complications that occurred after vomit entered her lungs.
At the time of Reid's death in early 1999, little was known about GHB. "When Grosse Ile detectives confronted Joshua Cole,...it became clear that he...didn't know he was experimenting with an unpredictable, potentially deadly substance," wrote Cohen. Michigan police officials had not been trained to recognize the symptoms of GHB poisoning, and hospital emergency room staffs had no way to test for it. In response to a lack of awareness about the drug, Reid's mother, Judi Clark, founded the Samantha Reid Foundation to help educate communities about the dangers of GHB. As noted in the Detroit News, Clark became determined to "warn the world about GHB." In remembering Reid, Clark read from one of her daughter's poems: "For I shall not go quietly into the night; / I shall succeed and no battle will be won until I have had my fight. / Harsh hammers and evil enemies look out, / I am on my way."
A little more than a year after the incident, the four men stood trial for the death of Samantha Reid. The three teens--Cole, Brayman, and Holtschlag--were convicted of involuntary manslaughter and poisoning. Limmer was found guilty of being an accessory to manslaughter and poisoning. In March of 2000, the three younger men were sentenced to up to fifteen years in prison. Limmer received a lighter sentence of up to five years. Defense attorneys argued that the penalties were too stiff and appealed the decision.
Three years later, the Michigan State Court of Appeals threw out the manslaughter charges. According to the New York Times, "prosecutors vowed to appeal the ruling." In 2004, the case went before the Michigan Supreme Court and the manslaughter convictions were reinstated. As of mid-2005, three of the men were in their twenties, one in his thirties, and they remained in prison.
Law Stiffens in 2000
The key to surviving a GHB-related overdose is getting prompt medical treatment. Without help, victims of GHB poisoning may suffer brain damage due to an insufficient supply of oxygen, or they may stop breathing. The effects of the drug wear off relatively quickly, so with proper care the chances for recovery are good. "In the absence of complications," noted Pittman, many patients hospitalized for a GHB overdose "can be discharged within a few hours." Doctors suspect that if Reid had been taken to an emergency room as soon as she became ill, she might have survived.
The case was watched closely by authorities. In response to public outcry over Samantha Reid's death, Congress banned GHB in 2000. President Bill Clinton signed the Hillory J. Farias and Samantha Reid Date-Rape Drug Prohibition Act into law on February 18, 2000. The law also commemorates Farias, a seventeen-year-old high-school senior from La Porte, Texas, who died from a GHB overdose after someone slipped it into her soft drink.
At the time he signed the act into law, Clinton stated: "Making GHB a Schedule I controlled substance appropriately reflects the Congress' judgment that GHB has a high potential for abuse by sexual predators." He added, however, that the act would "not impede ongoing research into the potential legitimate use of this drug to treat the special needs of those suffering from narcolepsy."
Effects on the Body
The effects of GHB on the human body are dose related. As Olive pointed out, "The difference between getting high and ending up in a coma can be only a few drops." The makers of illegal drugs like GHB often know little about the strength and quality of the ingredients they are mixing. GHB and other synthetic drugs are typically brewed in a kitchen sink from an Internet recipe. One batch is never the same as the next. Furthermore, as Elizabeth Russell Connelly noted in Psychological Disorders Related to Designer Drugs, "the toxic chemicals used in the synthesis of GHB may cause chemical burns to the esophagus, mouth, and throat."
Fast-Acting and Potentially Deadly
At low doses, GHB is said to produce a high similar to the early stages of drunkenness. Users report feelings of well-being, relaxation, and increased sociability. They may also experience an increase in sex drive and a heightening of the senses, which makes sights, sounds, and tactile feelings more intense.
Usually, people under the influence of higher doses of GHB become less aware of their surroundings and begin to feel out of control. Confusion, aggressive behavior, and impaired judgment often result. GHB is a fast-acting drug. Its effects can be seen within fifteen to twenty minutes and last for about three to six hours. The drug can cause respiratory depression, slowed heart action, and extreme grogginess. Nausea and vomiting, tremors, and a lowered body temperature may also occur. Patients who have overdosed may need to be restrained because of seizure-like activity and combativeness. If breathing rates go down to a dangerously low level, or if there is a chance that patients will choke on their vomit, intubation may be necessary.
In cases of overdose, GHB can bring on seizures, periods of unconsciousness, coma, and death. Most users who live through an overdose suffer severe memory loss and may not even realize what has happened to them.
The Risk of Addiction
Some people take GHB as a recreational drug--a drug used solely to get high, not to treat a medical condition. Those who take GHB recreationally run the risk of experiencing a number of problems. Because the drug is so unpredictable, users risk a deadly overdose every time they take it. The danger of a fatal overdose is increased when GHB is combined with alcohol.
Some GHB users become hooked on the drug to such an extent that they need a dose every few hours. Frequent users who stop taking the drug may experience a set of severe withdrawal symptoms known as GHB withdrawal syndrome. These symptoms include: 1) extreme anxiety; 2) confused thinking; 3) hallucinations--visions or other perceptions of things that are not really present; 4) paranoia--abnormal feelings of suspicion and fear; 5) insomnia--a sleep disorder; 6) tremors; 7) convulsions; 8) dangerously high blood pressure; and 9) possible death.
Reactions with Other Drugs or Substances
GHB is a depressant and can be fatal when taken alone. It is capable of shutting down the breathing center of the brain. Other depressants such as alcohol slow respiration as well. Club drug users often consume more than one drug at a time, and alcohol is almost always part of the mix. Alcohol and other nervous system depressants such as benzodiazepines, painkillers, allergy medications, or sleeping pills are known to enhance the effects of GHB. (A separate entry on benzodiazepine is available in this encyclopedia.) Mixing GHB with any of these drugs increases the risk of serious breathing problems that can lead to death.
Treatment for Habitual Users
Users of GHB develop a tolerance to the drug over time. If they increase their dosage, they face a greater risk of death from an overdose. As of 2005, there was no antidote for GHB poisoning.
Long-term GHB users who stop taking the drug can become extremely ill. The withdrawal process typically lasts from three to twelve days, but symptoms may continue for as long as fifteen days. Habitual GHB users are likely to benefit from drug dependency treatment programs, including counseling.
Use of GHB can impair judgment and cause memory loss, increasing the possibility of risk-taking behavior among users. Recreational users report that the drug decreases their inhibitions. People with lowered inhibitions are more likely to engage in unsafe sex, putting themselves at risk for contracting HIV (the human immunodeficiency virus), which can lead to AIDS (acquired immunodeficiency syndrome). GHB also impairs the user's ability to drive, causing the same reckless driving patterns seen in alcohol-related traffic crashes. The long-term health threats associated with GHB abuse were not known as of 2005.
GHB was once legal in the United States. It was sold at health food stores across the country. Numerous cases of illness related to GHB use led the U.S. government to declare it unsafe and illegal, except for approved medical use, in 1990. Nevertheless, use of the drug increased dramatically throughout the decade. Then, in 2000--following reports of thousands of GHB overdoses--a significant drop in GHB use appeared in national statistics. This decrease coincided with President Clinton's signing of the Hillory J. Farias and Samantha Reid Date-Rape Drug Prohibition Act of 2000.
GHB now occupies a unique place among controlled drugs since it appears in two different schedules. The pharmaceutical product is a schedule III drug, and although physicians prescribing it and the central pharmacy dispensing it must be registered with the Drug Enforcement Administration, it occupies a lower level than the schedule II drugs such as morphine. In contrast, all other sources of GHB are now Schedule I controlled substances, indicating both a high risk of abuse, and an absence of any medicinal value. The penalty for manufacturing or distributing GHB includes large fines and a prison term of twenty years or more. Possession of GHB carries a penalty of at least a $1,000 fine and up to one year in prison. Repeat offenders typically receive harsher penalties.
GHB is also officially classified as a date-rape drug. The Drug-Induced Rape Prevention and Punishment Act of 1996 makes it a crime to give an unsuspecting person a drug with the intent of committing violence, including rape. It also imposes penalties of large fines and up to twenty years in prison for importing or distributing more than one gram of these drugs, including GHB.
According to Jodi L. Avergun, chief of the Narcotic and Dangerous Drug Section of the U.S. Justice Department's Criminal Division, drugs are estimated to be used in as many as 15 to 20 percent of sexual assaults. "With approximately 95,000 sexual assaults on women" in the United States each year, she stated, "it is fair to assume that GHB has been used in thousands of crimes of violence." Avergun testified before the United States Sentencing Commission in 2004, seeking stiffer sentences for GHB sales and use.
In some European countries, GHB remains legal for use as an anesthetic and a treatment for alcohol withdrawal.
- a substance used to deaden pain
- wild overnight dance parties that typically involve huge crowds of people, loud techno music, and illegal drug use
- a state of unconsciousness from which a person cannot be aroused by noise or other stimuli
- adverse reactions
- side effects, or negative health consequences, reported after taking a certain substance
- a substance that helps spread nerve impulses from one nerve cell to another
- a rare sleep disorder characterized by daytime tiredness and sudden attacks of sleep
- to insert a plastic tube into the lungs through the nose and throat, thus opening the airway of a person unable to breathe independently
- unintentional killing of a human being
- made in a laboratory
- pronounced TAK-tuhl; relating to the sense of touch
- respiratory depression
- a slowed breathing rate; severe cases can cause a person to slip into a coma or even stop breathing entirely
- a type of drug used to treat anxiety
- a condition in which higher and higher doses of a drug are needed to produce the original effect or high experienced
- a remedy to reverse the effects of a poison
- recreational users
- people who use drugs solely to achieve a high, not to treat a medical condition
- inner thoughts that keep people from engaging in certain activities
Fast GHB Facts
According to the U.S. Department of Justice:
- Typical GHB users and sellers are between eighteen and thirty years old.
- Approximately three out of every five people involved in GHB-related emergency department visits are between eighteen and twenty-five years old.
- When diluted, a gallon of GBL can produce 4,000 to 5,000 doses of GHB.
- A 55-gallon drum of GBL can yield 240,000 capfuls of GHB.
- Every dose of GHB can be thought of as containing the possibility of another date rape.
Avoid Being a Victim
As of 2002, GHB was being used more often than Rohypnol in drug-related sexual assaults. But women are not the only victims of GHB poisoning. Men have been knocked out by GHB as well, usually before being robbed. Here are some ways to avoid becoming a victim of GHB poisoning:
- Don't accept a drink from someone you don't know.
- Drink only from cans or bottles that you've opened yourself.
- Never take a drink from a punch bowl. It's very easy for a drug to be slipped into a communal drinking source.
- Don't leave your drink unattended. If you haven't kept an eye on your glass because you've been dancing or you took a trip to the restroom, dump the drink.
- Make a pact with friends to watch out for one another. If you begin to feel ill after taking a drink, let someone you trust know about it immediately.
- The Drug Enforcement Administration (DEA) notes that GHB use often causes "slurred speech, disorientation, and drunken behavior without the odor of alcohol." If you notice these symptoms in yourself or your friends, call 911 right away and try to save a sample of the drink that caused these behaviors.