GHB: Harm Minimisation Strategies

General safety tips

Understand your substance

• Know the effects and risks: effects can range from feeling relaxed and euphoric, to being very sleepy and losing consciousness. These effects often happen within the same dose range, due to GHB’s high potency.
• Risks of GHB use include trouble breathing, unconsciousness, coma, and even death, particularly when mixed with other depressants like alcohol or benzodiazepines.

Testing and potency

• Test your GHB: the strength can vary significantly, so test a small amount (less than 0.5ml) and wait at least 60 minutes before deciding whether to take more. This will help you understand its strength.
• Types of GHB: substances sold as GHB in Australila are actually more likely to be GBL (Gamma Butyrolactone) or 1,4-B (1,4-Butanediol). These are prodrugs, which means your body converts them into GHB after you’ve taken them.
  GBL is more potent than GHB and its effects come on faster. GHB usually tastes salty, while GBL and 1,4-B have a strong, bitter and chemical taste.

Measuring, tracking and handling

• Use a syringe or pipette to measure your doses accurately. Avoid syringes larger than 3ml to prevent overdosing.
• GHB doses build up in your system, so every additional dose will be stronger than the last. It’s a good idea to take a smaller amount of GHB each time you redose.
• Use the same tool each time to ensure consistent dosing. Measure your own doses so that you know how much you’re taking.
• Record how much GHB you took and what time you took it - on your phone, hand, or somewhere visible, so that you can keep track of your doses and reduce the chance of accidentally redosing too soon.
• Eating slows GHB absorption, so you might not feel it straight away, even though it’s in your system. Wait at least 2 hours after eating before dosing.
• Avoid using GHB for more than two days in a row. Tolerance builds quickly and can lead to withdrawal symptoms.
• GHB is corrosive and can break down measuring equipment and plastic bottles.
• Add food colouring to your GHB so that it’s not mistaken for water.

Carry Naloxone

• Although it’s for opioid overdoses, carrying Naloxone when you’re mixing substances is a good idea.

Set and setting

Your mindset (set) and environment (setting) can strongly influence how GHB affects you—and how safe the experience is. Because GHB is a depressant with a narrow safety window, being mindful of these factors is essential.

Set = your body and mind

This includes:

• Current mood and mental health
• Life stressors or emotional load
• How safe and supported you feel
• Your physical state (sleep, food, hydration, illness)
• How familiar you are with GHB and its effects
• Any prescribed medications or other substances you've taken

GHB can amplify feelings of relaxation, euphoria, or disinhibition—but it can also cause nausea, unconsciousness, or confusion. If you’re unwell, anxious, or sleep-deprived, the risk of blackout or overdose is higher. A stable mood and well-rested body help reduce harm.

Setting = your surroundings

Think about:

• Where you are: is it a familiar or unfamiliar space?
• Lighting, sound, temperature, and smells
• Who you're with and whether you trust them
• The time of day, if you're indoors or outdoors, the weather

Use GHB in a safe, calm environment with trusted friends who know what you’ve taken and when. Avoid using alone, as GHB can cause sudden unconsciousness. Let someone know when you dose and record it on your phone to avoid accidentally redosing too soon.

Mixing and masking

Knowing what happens when you mix certain substances is important, to help minimise harm when you’re using GHB. Some combinations cause unpredictable effects, while others can mask how intoxicated you really are—making it easier to misjudge your limits.

• Mixing: avoid mixing with alcohol, benzodiazepines, or opioids. This is extremely dangerous and can lead to life-threatening respiratory depression.
• Masking: stimulants like cocaine or amphetamines can mask GHB’s effects - making you feel more alert while GHB is still slowing your system down. This can hide signs of overdose, making it easier to redose too soon or take more than your body can handle—especially when one drug wears off before the other

Risky mixes with GHB

• GHB and alcohol: this mix is extremely dangerous. Alcohol is metabolised before GHB, which can delay or mask the effects of GHB, making it easier to redose too soon and potentially overdose. Both substances are depressants, and together increase the risk of vomiting, blackouts, and overdose. Even small amounts of alcohol can significantly amplify GHB’s effects.
• GHB and depressants (like benzodiazepines or opioids): greatly increases the risk of unconsciousness, slowed breathing, and death. These combinations are a major cause of GHB-related overdoses.
• GHB and stimulants (like cocaine or amphetamines): this mix may mask the sedative effects of GHB, making it easier to redose too soon. This increases the risk of sudden overdose or collapse when the stimulant wears off.
• Dosage control: GHB has a very narrow safety window. The difference between a recreational dose and an overdose can be less than 0.5 mL. Always measure carefully and allow time between doses.
• Health conditions and medications: Avoid GHB if you have liver or kidney issues, or stomach ulcers. Some medications may interact unpredictably with GHB - speak to a healthcare professional if unsure.

Ways to use GHB

Oral

• Effects start within 10–20 minutes and can last up to 4–5 hours depending on dose, body weight, and other individual factors.
• Dilute GHB in water or a non-alcoholic drink to reduce irritation or burns to your mouth, throat, and stomach lining.
• Always measure doses accurately using a 1–3 mL syringe barrel (no needle). The difference between a light dose and an overdose can be less than 0.5 mL.

Plugging or shelving (inserting into your bottom)

• Faster onset and often stronger effects.
• Use clean hands or gloves, sterile water (if mixing), and lubrication to prevent infection and skin tearing.
• Measure with a syringe barrel and insert gently.

GHB overdose

GHB has a very narrow dose range, meaning there’s a fine line between a dose that feels good and one that leads to overdose. A GHB overdose is also known as a “blowout” or “G drop”, where someone falls asleep suddenly, becomes floppy or unresponsive, or blacks out.

Signs of a GHB overdose:

• shallow or difficulty breathing
• unresponsiveness
• clammy skin
• blue lips or nails
• vomiting
• inability to wake up
• seizures

What to do if you’re with someone who has overdosed

• Call emergency services (000) immediately: tell them clearly what substance was taken, how much they have taken if known, and what symptoms are showing. Signs of a GHB overdose need immediate medical attention.
• Stay with the person: monitor their breathing and check for responsiveness.
• Put them in the recovery position: if they are unconscious but breathing, turn them on their side to keep their airway open.
• Don't give them caffeine or other stimulants: stimulants won’t stop a GHB overdose, and may make it harder for emergency services to assess the person’s condition