Quick Facts
Risk LevelExtreme Risk
CategoryDepressant Stack
Duration2–8 hours
Peak WindowT+0:20 to T+1:30
Synergy
Dangerous Combination
Alcohol + GHB is classified as dangerous. Both are CNS depressants acting on GABA. The combination is one of the most dangerous drug interactions — effects are synergistic, not additive. Even small amounts of alcohol with GHB can cause rapid unconsciousness, respiratory depression, and death.
Extreme Risk
Depressant Stack
2–8 hours
T+0:20 to T+1:30
GHB and alcohol is one of the clearest hard-no combinations in harm reduction. GHB has a notoriously narrow window between euphoric, disinhibited effects and sudden heavy sedation, and alcohol pushes that window even closer to unconsciousness. People sometimes combine them because both are used in nightlife and sexual settings, and because low-dose GHB can feel euphoric, social, and sensual. But alcohol removes much of the margin for error. A dose that feels manageable on its own can become a medical emergency when drinks are involved.
In the early phase, the combo can feel loose, warm, and socially frictionless. Conversation flows, inhibition drops, and the body may feel soft, relaxed, and pleasantly heavy. That pleasant onset is part of the trap.
When the combo turns, it often turns fast. Speech gets mushy, balance vanishes, the eyes get heavy, and consciousness can seem to drop in steps rather than gradually. People go from "having a good time" to being nearly impossible to wake with very little warning. Unlike a challenging psychedelic where the distress is obvious, this combination can look deceptively calm right up until someone is in danger.
GHB primarily acts at GHB receptors and as a GABA-B agonist at recreational doses, producing sedation, euphoria, muscle relaxation, and dose-sensitive loss of consciousness. Alcohol enhances GABA-A signaling and broadly depresses the central nervous system. Together they create a compounded sedative load with particularly dangerous effects on consciousness, coordination, vomiting risk, and breathing. Because GHB dosing is often measured in milliliters of liquid or grams of powder with small errors mattering a great deal, alcohol turns an already precision-sensitive drug into an even riskier proposition.
Low-dose GHB can feel sociable and sensual. Alcohol can make that onset feel even easier. But the desirable window is short and unstable. The same user may feel euphoric for a while, then become nauseated, confused, deeply sedated, or unresponsive.
The most dangerous outcomes are not subtle: collapse, vomiting while unconscious, aspiration, slowed breathing, and the need for emergency support. This is why many harm-reduction organizations treat the combination as categorically unsafe rather than merely "higher risk."
| Substance | Solo Dose | Combo Dose | Route |
|---|---|---|---|
| Alcohol | 2–5 drinks | 0 drinks | Oral |
| GHB | 1–2.5 g | 0 g | Oral |
Do not combine GHB with alcohol. This is the guidance.
If a person has been drinking, the safer GHB dose is zero. If a person has taken GHB, the safer alcohol dose is zero.
Trying to compensate by using a "small amount" of both is unreliable because GHB potency, measurement accuracy, and timing vary so much.
T+0:00 — Alcohol or GHB taken.
T+0:15–0:45 — Combined onset. Sedation can build much faster than expected.
T+0:30–1:30 — Highest collapse risk. This is the window where people often become suddenly nonresponsive.
T+1:30–4:00 — Residual sedation, vomiting risk, and poor airway protection remain major concerns.
Afterward — Confusion and memory gaps are common even if the person avoids a worst-case outcome.
There is no recreational setting that makes this combo a good idea. If it has already happened, the priority is monitoring: keep the person away from stairs, pools, streets, and locked bathrooms; place them on their side if drowsy; and do not assume that snoring or "sleeping deeply" is benign.
Treat unresponsiveness seriously. GHB sleep is not always harmless sleep.
Do not leave the person alone.
If breathing is slow, irregular, or the person cannot be roused, call emergency services.
Avoid re-dosing entirely. People sometimes think the first dose "wore off" when it has actually only entered a deeper sedative phase.
Use precise measurement tools whenever GHB is involved , because eyeballing is already dangerous before alcohol enters the picture.
GHB and alcohol is one of those combos where the advice is boring because it has to be: just don't.
People underestimate how fast G can turn. Add booze and the margin for error is basically gone.
I've watched people go from chatty to face-down in what felt like ten minutes.
This is not a combo for experimentation. The good phase is short and the bad phase can be an ambulance.