GHB Dosage Guide

## Recognizing GHB Overdose The hallmark of GHB overdose is sudden, deep unconsciousness. Unlike alcohol, GHB can take someone from talking to collapsed within minutes. The classic presentation -- abrupt coma followed by spontaneous awakening hours later -- is distinctive enough that experienced emergency physicians can identify GHB involvement from the pattern alone. Warning signs: - **Sudden loss of consciousness** with no preceding drowsy phase - **Slow or stopped breathing** (fewer than 10 breaths per minute is an emergency) - **Vomiting while unconscious** (the most acutely dangerous sign -- aspiration risk) - **Blue-tinged lips or fingertips** (cyanosis) - **Muscle spasms or jerking** (myoclonic activity) - **Deep snoring or gurgling** (may indicate airway obstruction -- bystanders have mistaken dying people for someone "sleeping it off") ## What to Do **Call emergency services immediately.** Do not wait to see if they wake up. You cannot tell from the outside whether someone is in a survivable G-out or a fatal one. While waiting: - Place them in the **recovery position** (on their side) to reduce aspiration risk - **Monitor breathing** -- if it stops, begin rescue breathing or CPR - Do **not** induce vomiting or give anything by mouth - Do **not** rely on folk remedies like citrus in the mouth -- no pharmacological basis, and it creates aspiration hazard ## Medical Treatment There is no antidote for GHB. Hospital management is supportive: airway protection, monitoring, and time. Most overdoses resolve within 2-6 hours. Good Samaritan laws exist in most jurisdictions -- calling for help will not get anyone arrested. ## "G-ing Out" Is Not Routine Community language sometimes treats losing consciousness on GHB as a minor inconvenience. It is not. Every episode carries risk of respiratory arrest and aspiration death. The fact that someone has G'd out before and been fine does not mean the next time will be fine. Treat every instance as an emergency.