Medical Disclaimer
This page provides first-aid guidance for drug-related emergencies. It is not a substitute for professional medical advice, diagnosis, or treatment. Always call emergency services in a life-threatening situation. The information here is compiled from public health sources and harm reduction organizations. It has not been reviewed by a licensed physician. Use at your own risk.
GHB/GBL Overdose: Unconsciousness, Airway, and Why Minutes Matter
The dose-response curve is steep. One milliliter too much and the person is unconscious.
Recognition
- •Sudden loss of consciousness — the person 'drops' without warning
- •Slow, irregular, or stopped breathing
- •Vomiting while unconscious — aspiration risk is very high
- •Cannot be woken even with sternal rub or pain stimulus
- •Blue lips or skin (cyanosis)
- •Heart rate may be very slow (bradycardia)
What to Do
Call emergency services immediately
GHB overdose can cause respiratory arrest within minutes. Do not wait. Tell the dispatcher: 'Someone is unconscious and barely breathing.' GHB is a central nervous system depressant — paramedics need to know what they are treating.
Check airway and breathing
Tilt the head back, lift the chin. Look, listen, and feel for breathing for 10 seconds. If breathing is absent or under 6 breaths per minute, begin rescue breathing immediately.
Place in recovery position
Roll onto the side. GHB frequently causes vomiting. The recovery position prevents aspiration (choking on vomit), which is the most common cause of GHB-related death.
Monitor continuously
GHB overdose depth fluctuates. The person may briefly regain consciousness and then lose it again. Do not assume they are 'okay now.' Do not leave them alone.
Do not give anything by mouth
No water, no food, no other substances. If the person is unconscious, anything in the mouth is an aspiration risk.
When to Call Emergency Services
- →The person cannot be woken with a sternal rub (firm knuckle pressure on the breastbone)
- →Breathing is under 8 breaths per minute or irregular
- →The person vomits while unconscious
- →You are unsure of the dose they took — GHB's safe-to-lethal window is extremely narrow
What NOT to Do
Myth: Give them stimulants to counteract the sedation
Truth: Mixing uppers and downers is how people die. The stimulant may wear off before the depressant, causing delayed respiratory arrest. Never give stimulants to an unconscious person.
Myth: They're just in a deep sleep — let them sleep it off
Truth: GHB-induced unconsciousness is not sleep. It is central nervous system depression that can progress to respiratory arrest. If you cannot wake them with a sternal rub, they are in danger.
Myth: A cold shower will wake them up
Truth: Never. Cold water on an unconscious person can trigger cardiac arrhythmia. Keep them warm and in the recovery position.
Prevention
- ✓Measure every dose precisely. GHB is dosed in milliliters. A difference of 1ml can be the difference between an enjoyable experience and an ambulance. Never eyeball GHB.
- ✓Never mix GHB with alcohol. Combined CNS depression is the leading cause of GHB fatalities. Even one drink significantly increases risk.
- ✓Wait at least 2 hours between doses. GHB has a steep cumulative effect. Redosing too soon is the most common overdose scenario.
- ✓Know your concentration. Street GHB varies wildly in potency. If you do not know the concentration of the liquid, assume it is strong and start with a low dose.
Testing & Resources
IMPORTANT: This guide is for informational purposes only and does not constitute medical advice. Drug use carries inherent risks. No substance use is completely safe. Always call emergency services (911 in the US/Canada, 999 in the UK, 000 in Australia, 112 in the EU) in a life-threatening situation. TestSubstances.com is not responsible for any actions taken based on this information. If you or someone you know is struggling with substance use, contact SAMHSA (1-800-662-4357) or your local health authority.