Harm Reduction: How to detox GHB/GBL in 10 days
GHB/GBL is organically a very safe drug. It has not been shown to cause liver, kidney, cardiovascular or nervous system damage. But as we saw in the previous post in this series, it has a high potential to intoxicate and a few milliliters is the difference between a recreational dose and a dose that produces deep sleep.
GHB/GBL addiction and withdrawal
And there is yet another drawback. GHB/GBL is highly addictive. Some people need to administer it on a daily basis in several doses a day to avoid withdrawal symptoms.
Some authors consider that daily consumption of GHB for a week is enough to generate dependence. Others (less exaggerated) estimate that withdrawal symptoms may occur when GHB is used more than four times daily for two to four weeks at doses of over 18g per day. Mild symptoms are common, severe symptoms are uncommon (around 10%) but can be life-threatening or difficult to manage.
These are some pharmacological treatment available for GHB detoxification:
• Tapering with GHB
• Tapering with benzodiazepines
• Phenobarbital
• Baclofen
• Gabapentin
So the bad news is that GHB/GBL is addictive and can lead to withdrawal in people who use it regularly. The good news is that tapering with GHB/GBL is, according to available studies, the simplest method, with the fewest adverse effects and the lowest risk of withdrawal symptoms.
| Mild GHB Withdrawal Symptoms | Severe GHB Withdrawal Symptoms |
|---|---|
| Insomnia | Delirium |
| Tremors | Psychosis, Hallucinations |
| Anxiety | Hypertensive Crisis, Suicidal Behavior |
| Rhabdomyolysis | |
| Seizures | |
| Agitation |
Dr. X's GBL Detoxification Method
This method is based on available clinical trials on GHB detoxification. It is not a strict clinical guideline. Whenever possible, GHB detoxification should be done with the agreement and supervision of a qualified and experienced (or at least interested) healthcare professional. In the real world this is not always possible.
In this method we will use only volume units (ml) to simplify the calculations. It is possible to calculate the corresponding mg (weight) of GHB/GBL from the information provided in the first post of this series. GHB/GBL harm reduction guide (1) and How to avoid GHB-intoxication and what to do (and not to do) in case
Detoxification on an outpatient basis or without medical supervision is particularly inadvisable in some situations:
• High daily consumption of GHB/GBL (>30 ml of pure GHB/GBL daily).
• Inability to remain abstinent for more than two hours.
• Coexistence of severe organic diseases (kidney, heart, liver...) or severe psychiatric disorder (schizophrenia, compulsive obesity disorder, severe depression...).
• Frequent nocturnal use (two or more nocturnal awakenings on a regular basis).
• History of severe withdrawal symptoms with GBL/GHB
• Coexistence of other concurrent severe addictive disorders (especially alcohol, benzodiazepine and/or opiate abuse).
The method requires only three essential components:
• A quantity of GHB/GBL to cover 5 days daily requirements. from the same source.The source of supply should be the same throughout the period, to avoid the risk of changes in product concentration when changing supplier. Ideally, use one of those cleaning products available on the Internet with 99.9% GBL that are supposed to be used for cleaning cars and restoring furniture
• 1, 2 and 5 ml syringes (or any other instrument that can accurately measure the volume).
• A little bit of patience and self-discipline
The technique is to reduce the dose gradually and gradually. Decreasing doses of GHB/GBL are administered over the 10-day period every 3 hours (some studies extend the schedule to 14 days).
Consists of three phases:
Calculation
Calculate the daily dose (measured in millilitres) of the product being used. Measure with a syringe the dose to be administered, as well as the time of administration over a 24-hour period (including night-time intakes if applicable). Repeat the process for 2 or 3 days until you have a clear idea of the daily volume being used.
Stabilization
Once the total volume has been calculated, we will proceed to distribute it evenly throughout the day. For a regular user, the ideal is to distribute the total amount in three-hour periods in equal quantities.
If the person uses GHB/GBL during the night, try to respect this administration pattern. If the person does not usually wake up at night to take GHB/GBL, it is sufficient to divide the total daily dose over a period of 18 hours (6 intakes).
It is possible to adjust some of the intakes, if the morning doses are too strong or the afternoon-evening doses are insufficient. The important thing is to achieve a regular pattern of administration of fixed amounts of GHB/GBL that allows the day and night to pass without significant withdrawal symptoms or overly potent effects.
The body needs to acclimate to this consistent method of delivery before advancing to the next phase.
It is important not to introduce additional prescription drugs or increase the dosage of drugs that are taken regularly. If the person uses, for example, fixed doses of benzodiazepines to sleep on a regular basis, these should not be changed.
Tapering
There are several different regimens. The most common is a tapering of 0.1-0.3 ml (around 100-300 mg of GHB in each dose). To simplify the calculations we will reduce 10% of the total daily dose each day.
If you've read this far, you're probably finding it all a bit of a mess. Don't panic. The following example makes it clearer:
Unsealing the Addiction: Bernie and His wonderful GBL Recovery Story
Bernie has been taking an unspecified amount of G on a daily basis for more than five years. He buys GBL online in a European shop. On occasion he has had a delayed order and has gone two or three days without taking G. On those days he has had intense sweating, anxiety and insomnia with no other symptoms.
For whatever reason, Bernie decides one day that he wants to stop taking G. He enters the Dread forum and decides to put the DoctorX method into practice.
Phase 1.
Bernie has never kept track of the amount of G he takes daily. He takes "a little bit" when he feels like it about 7-15 times a day. Some nights he wakes up around 3-4am and takes a little more.
Bernie finds it a nuisance to measure the millilitres with a syringe. But he does it. That's how he knows he's taking 18-22 ml of GBL a day.
Phase 2.
Bernie decides to divide his GHB intake into 6 intakes of 3 ml every 3 hours. He keeps 3 ml "in reserve" for the night if he needs it.
Occasionally he feels he is "running short" (especially in the afternoon-evening, the morning doses are a bit strong). So he keeps 1-2 ml extra in case he feels uncomfortable one evening.
At first it is difficult for him to keep the timer on all day and the alarm going off every 3 hours. But after a week he manages to get used to this pattern and distribute 18-21 ml in 24 hours.
| Time | Dosage |
|---|---|
| 08:00 am | 3 ml |
| 11:00 am | 3 ml |
| 14:00 pm | 3 ml |
| 17:00 pm | 3 ml |
| 20:00 pm | 3 ml |
| 23:00 pm | 3 ml |
| Night | 3 ml (in case he awakes in the middle of the night with abstinence symptoms) |
Phase 3.
After a week, Bernie decides to reduce gradually his GBL intake. To make things easier, he will continue to take 21 ml per day (3 ml during the day every 3 hours and another 3 at night if needed and using his usual bottle. But he will mix the GBL with water every day according to the following scheme. He calculates to decrease 10% of the total dose each day (0.2 ml).
| Day | GBL milliliters (whole day) | Water milliliters | Total |
|---|---|---|---|
| 1 | 19 | 2 | 21 |
| 2 | 17 | 4 | 21 |
| 3 | 15 | 6 | 21 |
| 4 | 13 | 8 | 21 |
| 5 | 11 | 10 | 21 |
| 6 | 9 | 12 | 21 |
| 7 | 7 | 14 | 21 |
| 8 | 5 | 16 | 21 |
| 9 | 3 | 18 | 21 |
| 10 | 1 | 20 | 21 |
"Over the next few days Bernie ponders whether DoctorX is a real doctor or a phony. He doesn't quite believe that this works, although the obsession with milligrams and milliliters is, in the end, what creates the most anxiety for him. He actually needs 14 days instead of the expected 10 and has to cheat on occasion. The following week he has more difficulty sleeping than usual. But finally Bernie manages to forget about GHB and the discomfort of using it with almost no pleasurable effects, a habit he had acquired over the last few years. So Bernie makes a small donation in XMR to DoctorX's wallet as a happy ending to this story.
Additional notes
Some people find it difficult to maintain the 3-hour period. This is especially true in the first three days. In available clinical trials, a dose of 5-10 mg diazepam has been shown to control these effects.
If withdrawal symptoms are significant, a less abrupt taper should be made and the number of days should be increased. In published clinical trials the occurrence of severe or dangerous withdrawal symptoms is infrequent (less than 0.5%).
In the method we propose, the dose is decreased per day (maintaining the same amount throughout the day in the tapering period). Some clinical trials decrease GHB more slowly and gradually in each dose (not exceeding a maximum of 0.3 g of GHB per dose/day). It is likely that many people with mild to moderate GHB/GBL dependence do not need to taper each dose.
Credits
Full credit goes towards DoctorX on Dread! (sourced from /post/df03f044944ee85b07c6) - http://www.doctorcaudevilla.com/doctorx
