Alcohol is a social and legal psychoactive substance that adults who are at least 21 years of age can enjoy responsibly in moderation. The National Institute on Alcoholism and Alcohol Abuse (NIAAA) publishes that more than 85 percent of all Americans, aged 18 and older, have consumed at least one drink in their lives, according to data collected in 2015.
Alcohol is a central nervous system depressant, which means that it dampens the body's stress response by lowering anxiety and body temperature, and slowing down heart rate, respiration, and blood pressure. At low levels, alcohol can produce a mellow and pleasant "buzz," and in larger amounts, alcohol impedes rational thought processes, movement and coordination, and memory function while having sedative effects. Alcohol interacts with brain chemistry to change the way a person feels, thinks, and acts while under its influence. The National Council on Alcoholism and Drug Dependence (NCADD) publishes that it is the most frequently used addictive substance in America.
GHB, or gamma-hydroxybutyric acid, is an illegal drug that is often manufactured in illicit laboratories and passed around at clubs and raves. Often referred to as liquid ecstasy, Georgia homeboy, G, easy lay, grievous bodily harm, and goop, GHB is generally distributed as a clear and colorless liquid or a white powder that is dissolved in liquid.
GHB is known to lower inhibitions, make a person more passive and open to suggestion, and potentially heighten libido. These methods of action on the brain and body make GHB a candidate for use as a date rape drug, often without the victim knowing they are taking it.
GHB is also a depressant drug. It can lower anxiety and may lead to drowsiness and mental confusion. In large amounts, it may cause hallucinations, aggression, and overexcitement.
The drug is most often abused by young adults and teenagers. The Drug Enforcement Administration (DEA) publishes that around 1.5 percent of high school seniors reported GHB use in 2012.
The DEA also reports that GHB is commonly mixed into alcoholic beverages. The combination of GHB and alcohol can be dangerous, as both substances slow down some of the vital life-sustaining functions of the central nervous system, and both can have significant mind-altering affects.
Concerns of Mixing Alcohol with Other Drugs
- Crystal Meth
- Crack Cocaine
- Bath Salts
Heightened Risk of Overdose When Mixing Depressants
When GHB is added to alcohol, it may have a slightly salty taste, but it can be easy to miss. When the substances are combined, the sedative and depressant effects are amplified, and a person may be more apt to fall victim to a crime like sexual assault and to get into an accident. They may be more prone to fall down and become injured, and more likely to act in a manner that is out of character.
Both alcohol and GHB act on parts of the brain that help to control movement and coordination, memory and decision-making abilities, and mood regulation. Levels of neurotransmitters, such as dopamine and gamma-aminobutyric acid (GABA), are elevated with the presence of these substances. High levels of dopamine in the brain can contribute to feelings of pleasure and intoxication while elevated GABA levels serve to suppress the "fight-or-flight" reaction and slow down central nervous system functions. When GHB and alcohol are mixed, all of these side effects are heightened, and a person may become intoxicated faster and be more vulnerable to negative consequences as a result.
The Journal of Clinical Psychopharmacology reports that vomiting is one of the most common side effects of mixing alcohol with GHB. The mixture of these two depressants can also lead to sedation and amnesia (memory loss) and also result in a potentially life-threatening overdose.
The Centers for Disease Control and Prevention (CDC) warns that every day in the United States around six people die from alcohol poisoning. Drugs may often be involved in these fatalities as well. An overdose involving GHB and alcohol can cause a person to struggle to breathe, potentially resulting in respiratory failure, coma or death. Additional symptoms of overdose can include:
- Nausea and vomiting
- Lowered body temperature
- Weak pulse and irregular heart rate
- Extreme mental confusion and possible psychosis
- Loss of consciousness
Overdose is a medical emergency, and it is important for first responders to know that there are multiple substances involved. There is no specific reversal drug for a GHB overdose, and complications are amplified when the drug is mixed with alcohol.
Increased Rate of Addiction from the Combination of GHB and Alcohol Abuse
Both GHB and alcohol are addictive substances, and when they are used regularly over a period of time, the brain can become dependent on them. A person may then lose their ability to control how often and how much of each substance they ingest at one time. When GHB and alcohol are combined, physical dependence may crop up sooner than if one substance is taken on its own.
The brain can come to expect the chemical interference in its brain chemistry related to the drugs and will struggle to remain "balanced" without them. This means that difficult withdrawal side effects can occur when GHB and alcohol are not active in the bloodstream. GHB withdrawal can include symptoms like tremors, anxiety, raised blood pressure and heart rate, insomnia, and possible psychotic thoughts. Alcohol withdrawal can be intense as well and include side effects like headache, mental "fogginess," nausea and vomiting, tremors, anxiety, agitation, irritability, depression, insomnia, sweating, irregular heart rate and blood pressure, and possible hallucinations, mental confusion, and seizures.
When both GHB and alcohol are involved, the withdrawal syndrome is more significant and even possibly life-threatening in the case of delirium tremens (DTs). Difficult withdrawal symptoms, coupled with intense cravings, make it more likely that a person will continue to use these substances to avoid the negative ramifications that occur when they wear off, furthering the cycle of abuse. Mixing GHB and alcohol regularly can therefore increase the odds that a person will suffer from addiction.
Treatment Considerations for Alcohol and GHB Use and Abuse
Due to the significance of withdrawal involving the combination of alcohol and GHB, medical detox is typically the first step in a treatment program. A medical detox protocol is a highly structured program where a person can stay for an average of 5-7 days to allow the drugs to safely process out of the body while under the careful observation of trained professionals. Medications are often part of a medical detox program as the sudden cessation of alcohol, and potentially GHB, can be difficult and even fatal in extreme cases. Instead, medications like benzodiazepines (which are additional central nervous system depressant medications) can be used to slowly help the brain learn how to regulate its own chemistry safely instead of rebounding dramatically when substance use is stopped "cold turkey." Medications will need to be managed carefully by healthcare providers during medical detox when dependence involves multiple substances, such as alcohol and GHB.
After detox, a residential treatment program can provide the tools and skills needed to help a person develop healthy habits, combat cravings, recognize and cope with stressors and triggers, minimize relapse, and learn how to live a balanced life in recovery. Specialized addiction treatment programs catering to polysubstance abuse will often include the following:
- Behavioral therapy sessions
- Group, family, and individual counseling
- Life skills training
- Relapse prevention and educational programs
- Support group meetings
- Holistic methods, such as nutritional planning, fitness programs, yoga, massage therapy, mindfulness meditation, and more
- Medication management
- Aftercare and recovery support services
Comprehensive addiction treatment programs are personalized, based on each individual’s need, to enhance and sustain recovery.