It's refreshing to hear doctors that clearly have real world experience with the substance, and up to date & honest information that isn't just to scare people. Not to imply most doctors do the opposite, rather I've just noticed a pattern from the other videos I've watched on the subject regardless of whether it's a medical professional or a low effort text-to-speech overview. it seems a lot of similar videos are thrown together for the sake of covering the topic with information pulled from a few minutes of research, as I think GHB is still often overlooked as "the date rape drug" as if that is the only, let alone most common circumstance that it's used. Something I haven't been able to find detailed information on is the potential physical and psychological side effects of use that doesn't cross the threshold in to 24/7 dependence. For example, abdominal and intestinal issues, muscle twitches and nerve issues, and whether any of these can linger after someone has ceased use. Cheers guys, subsribed.
I listened to this before and after learning the full mechanisms of action as well as reading the entire breadth of knowledge we have through peer review literature. It’s mind blowing to see the actual lack of knowledge being implemented It’s very important to know which actual “ghb” substance is being used. Actual ghb use is extremely rare, you are more likely to emcounte Titration step down method should be the staple. The clinical data is clear cut and dry that a cold turkey approach with benzo deployment is subpar to clinically outright ineffective from actual withdrawal.
Thank you for your insightful comment and for engaging with our podcast. You raise an important point about the complexity of GHB withdrawal and the need for precise treatment protocols. Understanding the exact substance used and employing a titration step-down method, as you mentioned, is indeed critical. Clinical data supports this approach over a cold turkey method with benzodiazepines alone, highlighting the importance of tailored withdrawal management plans. Your perspective is valuable, and we appreciate your commitment to deepening the conversation around addiction treatment.
'Excitotoxicity' is a condition that can be caused by large amounts of glutamate in the brain. Glutamate binds to its receptors (AMPA, NMDA and kainate) and in excess can cause a large influx of calcium ions into neurons. This calcium influx can cause a process called 'apoptosis', also known as programmed cell death. Essentially, the neurons commit suicide. It follows from the mechanism of action of GHB that in withdrawal, excitotoxicity plays a role. Considering this, anyone in a GHB addiction should seek medical assistance if possible and request gabapentin or pregabalin, two drugs which block calcium channels and reduce glutamate production in the brain. These drugs could prevent the neurotoxicity caused by GHB withdrawal.
Quit various times, baclofen by far is the only thing that really works by far, 50mg for the first three days then 30mg for the following 7 days. I can’t stress enough how important baclofen is
Thank you for sharing your experience! Baclofen can indeed be very helpful during GHB withdrawal. It’s crucial to tailor treatment to individual needs, so always consult with a healthcare professional for personalised advice. Stay safe and take care!
I was prescribed Xyrem 4.5g 2x a night for a decade. I switched insurance and I was unable to refill my rx. I had severe Anxiety/ panic attacks, insomnia. I can’t workout some days. I get profuse sweating, shaking, and muscle weakness. I can’t imagine people taking 40 grams of ghb daily. I’m miserable coming of 9 grams nightly.
Thank you for sharing your experience. Coming off 9 grams of Xyrem (sodium oxybate) nightly after a decade is incredibly challenging, and it's no surprise you're facing severe withdrawal symptoms like anxiety, panic attacks, insomnia, and physical symptoms like sweating, shaking, and muscle weakness. These symptoms are common in GHB withdrawal and can be very distressing. It's hard to imagine the struggles of those consuming even higher amounts daily, but your experience highlights the significant challenges of GHB withdrawal at any level. It's crucial to approach this with support from a healthcare provider who can help manage these symptoms, possibly by tapering the dose gradually or using medications to alleviate withdrawal symptoms. Your journey is difficult, but with the right support, it can become more manageable. Stay strong and consider reaching out to a specialist in addiction medicine if you haven't already. You're not alone in this, and there are people ready to help you through this challenging time.
Hi. Dr. Naren. Thank you for this episode. I would love to reach out to regarding two community ghb cases in the primary care setting and the unique challenges of the US Healthcare system. I’ve reached out to every researcher in the field that I can and would greatly appreciate your perspective.
I experienced extreme withdrawals when i quit ghb. Now i try to get that same high but with alcohol. Is there a supplement that I can take that is similar to ghb?
If you’re taking something like this more than once or twice a week it’s abuse. I can’t handle more than a couple glasses of win a week. So the need to be fucked up all the time is the issue. Moderation these things are fine. I find lifting weights being an athlete precludes nicotine & alcohol due to side effects interrupting gains. Being athletic gets me high.
GHB binds to the GABA-B receptor in the brain. GABA is the main inhibitory neurotransmitter. It reduces neural activity, producing relaxation etc. GHB use will cause downregulation of GABA-B receptors from a single use - the brain produces less and less GABA-B receptors plus upregulation of glutamate receptors (more glutamate receptors). Glutamate is the main excitatory neurotransmitter, essentially it increases neural activity. In addition there is a GHB receptor. GHB is present naturally in the brain, where it binds to GHB receptors and produces and excitatory response (increasing stimulation). When you come down from a dose of GHB, or stop dosing during an addiction, the combination of downregulated GABA-B plus upregulated glutamate receptors (plus the continued stimulation of GHB receptors as one comes down from a dose) produces excessive neural stimulation, hence the sudden waking effect from night-time GHB use. In addiction, this produces the withdrawal effects. Benzodiazepines are unsatisfactory on their own as they target the wrong receptor (GABA-A), they need to be taken alongside BACLOFEN a GABA-B agonist. Baclofen should be used immediately alongside Diazepam
Hi doctors, Just wondering how long can someone go on using GHB before you get extreme brain damage or organ failure? Let’s say they use it every day and every night how long can they go on in life before their body just gives up? Or can they go on for years?
Hello and thanks for listening to the episode. It's impossible to give a prescriptive or definitive answer to your question. The real answer is any dose of GHB can cause damage and that there are both acute and chronic effects and harms of GHB on the brain and the body so there is no safe time period to use GHB.
@@thileepannaren8503 Thank you so much for replying. I have a family member suffering from chronic addiction in the drug seen. These episodes are so very helpful for me as they help me understand what is actually taking place in their mind and the timeline on how the brain and body reacts to these drugs from first administered to the comedown or withdrawal if you like.
Regarding the question about the use of gabapentin in GHB withdrawal, gabapentin can be a useful adjunct in managing withdrawal symptoms. Gabapentin, primarily used for its anticonvulsant and analgesic properties, can help alleviate some of the neurological and musculoskeletal symptoms associated with GHB withdrawal, such as anxiety, insomnia, and muscle pain.
It's refreshing to hear doctors that clearly have real world experience with the substance, and up to date & honest information that isn't just to scare people. Not to imply most doctors do the opposite, rather I've just noticed a pattern from the other videos I've watched on the subject regardless of whether it's a medical professional or a low effort text-to-speech overview. it seems a lot of similar videos are thrown together for the sake of covering the topic with information pulled from a few minutes of research, as I think GHB is still often overlooked as "the date rape drug" as if that is the only, let alone most common circumstance that it's used. Something I haven't been able to find detailed information on is the potential physical and psychological side effects of use that doesn't cross the threshold in to 24/7 dependence. For example, abdominal and intestinal issues, muscle twitches and nerve issues, and whether any of these can linger after someone has ceased use. Cheers guys, subsribed.
I listened to this before and after learning the full mechanisms of action as well as reading the entire breadth of knowledge we have through peer review literature. It’s mind blowing to see the actual lack of knowledge being implemented
It’s very important to know which actual “ghb” substance is being used. Actual ghb use is extremely rare, you are more likely to emcounte
Titration step down method should be the staple. The clinical data is clear cut and dry that a cold turkey approach with benzo deployment is subpar to clinically outright ineffective from actual withdrawal.
Thank you for your insightful comment and for engaging with our podcast. You raise an important point about the complexity of GHB withdrawal and the need for precise treatment protocols. Understanding the exact substance used and employing a titration step-down method, as you mentioned, is indeed critical. Clinical data supports this approach over a cold turkey method with benzodiazepines alone, highlighting the importance of tailored withdrawal management plans. Your perspective is valuable, and we appreciate your commitment to deepening the conversation around addiction treatment.
'Excitotoxicity' is a condition that can be caused by large amounts of glutamate in the brain. Glutamate binds to its receptors (AMPA, NMDA and kainate) and in excess can cause a large influx of calcium ions into neurons. This calcium influx can cause a process called 'apoptosis', also known as programmed cell death. Essentially, the neurons commit suicide.
It follows from the mechanism of action of GHB that in withdrawal, excitotoxicity plays a role. Considering this, anyone in a GHB addiction should seek medical assistance if possible and request gabapentin or pregabalin, two drugs which block calcium channels and reduce glutamate production in the brain. These drugs could prevent the neurotoxicity caused by GHB withdrawal.
The worst withdraw ever😢....
I lost my girl to ghb ova dose at Easter ,,,so devastated and I miss her dearly and I never got to say goodbye
Sorry for your loss, that’s unimaginably sad.
That’s so terrible & so easily avoided. I’m sorry for your loss.
Quit various times, baclofen by far is the only thing that really works by far, 50mg for the first three days then 30mg for the following 7 days. I can’t stress enough how important baclofen is
Thank you for sharing your experience! Baclofen can indeed be very helpful during GHB withdrawal. It’s crucial to tailor treatment to individual needs, so always consult with a healthcare professional for personalised advice. Stay safe and take care!
I was prescribed Xyrem 4.5g 2x a night for a decade. I switched insurance and I was unable to refill my rx. I had severe Anxiety/ panic attacks, insomnia. I can’t workout some days. I get profuse sweating, shaking, and muscle weakness. I can’t imagine people taking 40 grams of ghb daily. I’m miserable coming of 9 grams nightly.
Thank you for sharing your experience. Coming off 9 grams of Xyrem (sodium oxybate) nightly after a decade is incredibly challenging, and it's no surprise you're facing severe withdrawal symptoms like anxiety, panic attacks, insomnia, and physical symptoms like sweating, shaking, and muscle weakness. These symptoms are common in GHB withdrawal and can be very distressing.
It's hard to imagine the struggles of those consuming even higher amounts daily, but your experience highlights the significant challenges of GHB withdrawal at any level. It's crucial to approach this with support from a healthcare provider who can help manage these symptoms, possibly by tapering the dose gradually or using medications to alleviate withdrawal symptoms. Your journey is difficult, but with the right support, it can become more manageable. Stay strong and consider reaching out to a specialist in addiction medicine if you haven't already. You're not alone in this, and there are people ready to help you through this challenging time.
Hi. Dr. Naren. Thank you for this episode. I would love to reach out to regarding two community ghb cases in the primary care setting and the unique challenges of the US Healthcare system. I’ve reached out to every researcher in the field that I can and would greatly appreciate your perspective.
I experienced extreme withdrawals when i quit ghb. Now i try to get that same high but with alcohol. Is there a supplement that I can take that is similar to ghb?
If you’re taking something like this more than once or twice a week it’s abuse. I can’t handle more than a couple glasses of win a week. So the need to be fucked up all the time is the issue. Moderation these things are fine. I find lifting weights being an athlete precludes nicotine & alcohol due to side effects interrupting gains. Being athletic gets me high.
Why chuckle @ 2.37 Anderson??
How about Xanax or valium to assist with reducing ghb tolerance?
Hi Sonia, thanks for the question. We have an episode on benzodiazepine withdrawal which can be found here ruclips.net/video/H70gYynKi5Q/видео.html
Your best bet is to take a tolerance break if your not dependent. A 2 week break and then using 1-2 doses a week max to minimise tolerance
@@tahad4298 thanks Taha D. yes my question was for dependence
GHB binds to the GABA-B receptor in the brain. GABA is the main inhibitory neurotransmitter. It reduces neural activity, producing relaxation etc.
GHB use will cause downregulation of GABA-B receptors from a single use - the brain produces less and less GABA-B receptors plus upregulation of glutamate receptors (more glutamate receptors). Glutamate is the main excitatory neurotransmitter, essentially it increases neural activity. In addition there is a GHB receptor. GHB is present naturally in the brain, where it binds to GHB receptors and produces and excitatory response (increasing stimulation). When you come down from a dose of GHB, or stop dosing during an addiction, the combination of downregulated GABA-B plus upregulated glutamate receptors (plus the continued stimulation of GHB receptors as one comes down from a dose) produces excessive neural stimulation, hence the sudden waking effect from night-time GHB use.
In addiction, this produces the withdrawal effects.
Benzodiazepines are unsatisfactory on their own as they target the wrong receptor (GABA-A), they need to be taken alongside BACLOFEN a GABA-B agonist. Baclofen should be used immediately alongside Diazepam
Hi doctors, Just wondering how long can someone go on using GHB before you get extreme brain damage or organ failure? Let’s say they use it every day and every night how long can they go on in life before their body just gives up? Or can they go on for years?
Hello and thanks for listening to the episode. It's impossible to give a prescriptive or definitive answer to your question. The real answer is any dose of GHB can cause damage and that there are both acute and chronic effects and harms of GHB on the brain and the body so there is no safe time period to use GHB.
@@thileepannaren8503 Thank you so much for replying. I have a family member suffering from chronic addiction in the drug seen. These episodes are so very helpful for me as they help me understand what is actually taking place in their mind and the timeline on how the brain and body reacts to these drugs from first administered to the comedown or withdrawal if you like.
Where is best place in Melbourne vic to get of ghb I Use 100ml a day and everywhere I go they are so dumb
@@SarahMartin-zx1iinot entirely sure but I'm in the same boat with bute and being tapered to 40mg fucking Val.
@@SarahMartin-zx1iiI've slept 1 hour in 3 days coz these spuds have no idea how fucked in the head I am coming off bute just gonna go back.
How about gabapentin?
Regarding the question about the use of gabapentin in GHB withdrawal, gabapentin can be a useful adjunct in managing withdrawal symptoms. Gabapentin, primarily used for its anticonvulsant and analgesic properties, can help alleviate some of the neurological and musculoskeletal symptoms associated with GHB withdrawal, such as anxiety, insomnia, and muscle pain.
why does delirium happen during withdrawal?