GHB-GBL – Overview
GHB (gamma-hydroxybutyrate) is a synthetic molecule used in medicine to treat narcolepsy and as an anaesthetic, which acts on GABA receptors such as alcohol or benzodiazepines. When it is diverted from its medical use to be used for recreational purposes, its expected effects are inebriation, loss of inhibition, increase in libido, sedation, and euphoria. It generally takes the form of a colourless and odourless liquid, and less frequently a white powder. It has been listed as a narcotic in France since 1999. GBL (gamma-butyrolactone, commonly known as “G”) is a liquid industrial solvent, a chemical precursor of GHB, which, once ingested, is rapidly metabolised into GHB in the body after absorption. This substance has identical effects to that of using GHB, although quicker and for a shorter period (one to two hours instead of three to four hours). Before use, GBL is diluted in a soft drink or water. Due to its frequent use in industry, GBL was not subject to any specific regulations until 2011, facilitating accessibility to and the diversion of the substance, so much so that throughout the 2000s, it progressively replaced the use of GHB. In 2011, the transfer and sale of GBL was banned for the general public. Since the 1990s, GHB has been a substance associated with cases of sexual assault, often being secretly added to glasses for the chemical submission of the victim in order to assault them. At the end of the 2000s, there was an intensification in the use of GHB/GBL in private spaces, linked to the development of chemsex, which is the practice of using psychoactive substances in the context of home sex parties. Initially limited to these settings, the use of poppers and GHB/GBL has gradually spread to other users frequenting party venues. There are also other hallucinogenic substances, such as LSD, hallucinogenic mushrooms, poppers, ketamine, and nitrous oxide: for these substances, please see the dedicated pages. Production/Supply In France, hallucinogenic substances are not subject to organised or large-scale trafficking like other illicit substances. Seizures In France, the number of seizures and arrests for the simple use and trafficking, or use-resale, of hallucinogenic substances is very low due to the lack of structured trafficking. Therefore, the quantities seized, which see a fair share of random variation from one year to the next, are not truly representative of the presence of substances across the country. Moreover, these hallucinogenic substances are not detected by kits used during roadside checks. At European level, GHB seizures are not subject to systematic monitoring. Nevertheless, large seizures of GHB and GBL have been reported by 18 countries, constituting 48 tonnes or rather 500 litres. Due to the extensive use of GBL for industrial purposes, the data is difficult to interpret. European Drug Report: Trends and Developments. EMCDDA, 2023 Supply GHB, colourless and odourless, and GBL, colourless, are easily transportable into party venues by users. Most often, the substance is transported through public spaces in a bottle of water, a pipette, syringe or, less frequently, in a vial for poppers. According to observations from the OFDT’s monitoring scheme for Emerging Trends and New Drugs (TREND), coordinating bodies in Paris and Lyon in 2016 and 2017 observed that GHB/GBL is shared between users bringing their own substance, and very rarely resold within the venue. However, when this is the case, it is often sold per unit dose for 10 euros and packaged in a pipette. The contents of these pipettes is poured into glasses as the evening progresses. Psychoactive substances, users and markets in France in 2022, Tendances n°160, 2023, 8 p. Use in the adolescent population According to the National Adolescent Health and Substance Use Survey in Middle and High Schools (ENCLASS survey), among high school students, the lifetime use level of GHB remained stable between 2018 and 2022. 1.5% stated to have tried GHB in 2022 and 1.1% in 2018. Drug use in adolescence: trends reported in 2022. Briefing paper, 2024, 17 p. in the adult population Considering how rare the use of this substance is among this entire population; its use is no longer measured by general population surveys in France. GHB and GBL are available at European level, but these substances are poorly monitored, which limits the comprehension of their use and incidence on public health. National estimates of the prevalence of use of GHB in adult and school populations are low. GHB was the fifth most frequently recorded drug by Euro-DEN Plus research hospitals in 2019, present in 10.6% of cases of acute drug toxicity and in 27% of intensive care admissions. European Drug Report: Trends and Developments. EMCDDA, 2023 Impacts The negative effects mentioned by users are often “bad trips”, and “nightmare-like” discomfort, accompanied by anxiety, which generally occur when taken in a suboptimal context (individual is tired, for example). Lasting effects, often for several days (“glued” or “high” users), but also proven risks of accidents or reckless actions linked to delusions experienced, are also mentioned. In high doses, GHB and GBL have amnesic and hypnotic properties. GBL requires an extremely precise dose (to the millilitre) due to the fact that there is only a small difference between the dose resulting in desired effects and acute intoxication which can lead to seizures, loss of consciousness (known as a “G-hole” by familiar users of this substance) and a respiratory depression, with a risk of death. There are variations between the effects of GHB/GBL depending on the individual. Usually, hallucinogens result in neither dependence nor tolerance, particularly due to the fact that they are used in relatively widely spaced sequences. However, according to scientific literature, the long-term use of GHB and GBL can lead to dependence, with a particularly strong tolerance effect. There is little information available on the health impact of the long-term use of GHB/GBL. Although the main long-term risk is addiction, other long-term effects have been recorded, notably neurotoxic damage such as severe memory problems, deteriorating mental, physical, and sexual health, cardiovascular diseases, and respiratory disorders. Seeking treatment In 2021, almost 150 people visited a specialised drug treatment