GHB/GBL + Opioids
GHB/GBL + Opioids: the short answerTwo of the strongest breathing suppressants combined: this mix can stop breathing fast and without warning. Call emergency services, give naloxone for the opioid, and keep the airway open.
Why it’s dangerous
GHB works through GABA-B/GHB receptors and opioids through mu-opioid receptors — different switches, same result: both shut down the brainstem's drive to breathe, and the suppression adds up. GHB also causes deep, abrupt unconsciousness on its own, so the opioid overdose may arrive while the person is already 'G-ing out' and unable to seek help.
What happens
- Rapid progression from drowsy to deeply unconscious
- Slow or stopped breathing
- Vomiting with high aspiration risk
- Long unresponsive periods that naloxone only partly fixes
Warning signs
- Unrousable, limp body
- Fewer than ~8 breaths a minute or long pauses
- Blue/grey lips and fingertips
- Gurgling or choking sounds
What to do
- Call emergency services immediately
- Give naloxone and repeat every 2-3 minutes — it reverses the opioid, not the GHB
- Recovery position; clear the airway; rescue breaths if trained
- Never combine these; if you use either, never use alone and have naloxone within reach