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GBL/ GHB withdrawal HELP

belfort

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Nov 2, 2005
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2,300
50-60 ml a day!?!?damn, thats literally drinking 3-4 mls every hour..what was your dosing schedule like?were you able to go to work and perform, live a somewhat normal life?notice any health problems at all??thats my biggest question about gbl abuse, i read much about it but dont notice that anyone actually suffers health problems as a result..
 

tyler5

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Mar 6, 2005
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Northeastern Europe
Hey guys, ive been using GHB for about 2 weeks at 20mL/day. how much is that when converted to benzos?
I want to use benzos for the G w/d.
 

LilNerd

Greenlighter
Joined
Aug 17, 2015
Messages
6
Im from the netherlands.. atm i use 20ml per 2 hours (GHB) been clinic a lot, know every rehab method cu netherlands is specialized in GHB
. I get Medical GHB at clinic, something like Xyrem but a better version.
 

Boris_

Greenlighter
Joined
Dec 22, 2014
Messages
13
1 year after my addiction i smartend up an bought 500ml of the stuff :) managed to have it for 2 months, used it max 4 times a day, pulled off with very minimal wds, no problems, anyway, gave like 60ml of the stuff to a junky, as you imagine he used all off it 24/7, min 2ml, then 4 or 5ml per dose, crazy i know, lasted him like a week and he told me he expirienced the most brutal withdrawal in his life, i mean, he had like delirium and was out off it for couple of days, 60ml :) so, be careful guys
 

Gtarded

Greenlighter
Joined
Jul 28, 2016
Messages
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Ive never posted before but am desperate at the moment. Ive been using again for little over three weeks now and im doing 40mls a day like alot of others. Now its not affecting me just making me feel toxic. I need to get off it now. Im in a probation program that i take a ua at least once a week sometimes twice. Soooo i cant drink take benzos or any other narcotic. If i go to the hospital they will want to see papers. So my predicament is this i have 150 ml of gbl to taper. Last night i went 8 hrs without taking a dose and was hallucinating. Its way worse than heroin. My heart rate get to 130 bpm. Please help me what can i do. I dont have access to the other prescription meds u talk about. PLEASE HELP ASAP
 

Captain.Heroin

Sr. Moderator: H&R, Words
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Ive never posted before but am desperate at the moment. Ive been using again for little over three weeks now and im doing 40mls a day like alot of others. Now its not affecting me just making me feel toxic. I need to get off it now. Im in a probation program that i take a ua at least once a week sometimes twice. Soooo i cant drink take benzos or any other narcotic. If i go to the hospital they will want to see papers. So my predicament is this i have 150 ml of gbl to taper. Last night i went 8 hrs without taking a dose and was hallucinating. Its way worse than heroin. My heart rate get to 130 bpm. Please help me what can i do. I dont have access to the other prescription meds u talk about. PLEASE HELP ASAP
you need to taper. Are you familiar with tapering?
 

Gtarded

Greenlighter
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Jul 28, 2016
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I can get more but need to know how to taper the amount of time at a certain dose.
 

Captain.Heroin

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Take less and less often.

Since I never got addicted to GHB, I wouldn't know how quickly to proceed.

Anyone with GHB tapering experience want to help out here?
 

Gtarded

Greenlighter
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Jul 28, 2016
Messages
4
Yea im having a hard time just taking 2.5. I think im getting acidosis. Im going to the ER in the morning and just biting the bullet. Everytime i drink some my body goes akaline and i can feel the acid build up. Its not enjoyable at all. I look horrible. Just in a two day period i look bad.. Lol I did do some ICE yesterday. I ate a .30 which is first time in years and not fun at all. The mix is really bad. Im scared though. This is gonna be intense. Im a 20 yr heroin addict and being dope sick aint got shit on this. So med help is necessary. Im truely scared of this. But love gbl and ghb. Will definitely have to change my habbits. Anyone dealing with toxic PH from b or l delute ur dose with 12ozs of water as a delivery or gell cap its not so harsg.
 

AdvanceBase

Greenlighter
Joined
Mar 10, 2016
Messages
2
if your own body's alkalinity is fucked up, i'd consider sourcing the g differently, switching to ghb if youre using gbl, or tweak your method of synthesization. concerning the withdrawal/rebound, i find them pretty mild, but very troubling. i take g to help with anxiety, motivation, and overall happiness. but as most of us come to realize is the g stops providing this. if you can get a couple days off, just sit in your room and be miserable for two days, funny tv shows and movies tend to help a tiny bit (as with any withdrawal). tapering is very hard to do because a huge part of this is waiting 4 hours (prefereably 6 hours) between each dose, makes it so you can taper of relatively quickly. if you're not giving the g time to leave your system youre going to be tapering for a very long time, weeks, months. after a while taking g to feel better stops working, so why do it this way is my opinion. the sleep part is one of the stickiest parts to deal with and i havent nailed it down yet. sometimes, taking seroquel, trazadone, and vistaril together helps immensely, mostly it doesn't though. as far as daytime use, take 400 mg of lyrica, wait an hour or two and you wont even feel like taking g, you just wont. i havent been able to procure a big enough supply to use it for a while instead of g, but i'm doing that next week hopefully. out here fighting the fight people. best i can do right now is wait four and half hours between doeses, when i'm NOT at work, lol. so that only gives me two days a week to stop a bit
 

Captain.Heroin

Sr. Moderator: H&R, Words
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Life has no meaning, yet I keep searching...
if your own body's alkalinity is fucked up, i'd consider sourcing the g differently, switching to ghb if youre using gbl, or tweak your method of synthesization. concerning the withdrawal/rebound, i find them pretty mild, but very troubling. i take g to help with anxiety, motivation, and overall happiness. but as most of us come to realize is the g stops providing this. if you can get a couple days off, just sit in your room and be miserable for two days, funny tv shows and movies tend to help a tiny bit (as with any withdrawal). tapering is very hard to do because a huge part of this is waiting 4 hours (prefereably 6 hours) between each dose, makes it so you can taper of relatively quickly. if you're not giving the g time to leave your system youre going to be tapering for a very long time, weeks, months. after a while taking g to feel better stops working, so why do it this way is my opinion. the sleep part is one of the stickiest parts to deal with and i havent nailed it down yet. sometimes, taking seroquel, trazadone, and vistaril together helps immensely, mostly it doesn't though. as far as daytime use, take 400 mg of lyrica, wait an hour or two and you wont even feel like taking g, you just wont. i havent been able to procure a big enough supply to use it for a while instead of g, but i'm doing that next week hopefully. out here fighting the fight people. best i can do right now is wait four and half hours between doeses, when i'm NOT at work, lol. so that only gives me two days a week to stop a bit
It sounds like you're not ready to quit yet. Do you want to?
 

DrDarkside

Greenlighter
Joined
Sep 13, 2016
Messages
13
Be very careful coming off the GBL, its dangerous stuff. I had 2 seizures after discontinuing GBL use on seperate occasions. I have also wound up in hospital because of it, but both times I was in hospital, they never really knew what to do with me and would give me a vitamin B drip and that was it!

If you run out of G and/or your taper goes down too quickly, the likleyhood of you having a seizure becomes very likley. Baclofen would be very useful in aiding you through the wd. Benzos will also aid you - especially through the anxiety/panic attack moments.


Here is some information:

Guidance for managment of GBL and 1,4-BD withdrawal and detox

Warning- The information below is guidance about trialled treatment regimes applied in clinical settings in UK. This is not guidance about home detoxes. Anyone reading this who is dependent on GBL or related substances should get in contact with medical services due to the withdrawal symptom risks.


Due to the dangers of GBL withdrawal, it is recommended that patients that have developed physical dependence undergo detoxification as an inpatient, although a small number have been done as an outpatient with close supervision by the responsible consultant psychiatrist in addictions. Physical dependence can often be identified by "round the clock use".


Withdrawal effects are similar to chronic alcohol dependence and benzodiazepine dependence. Symptoms include anxiety, insomnia, tremor, confusion, nausea, vomiting, hypertension and tachycardia. Symptoms can start very quickly, one or two hours after the last dose and may rapidly progress to a state of uncontrolled delirium and agitation. Rhabdomyolysis and seizures have occurred. In such cases, transfer to a medical unit is indicated, and occasionally treatment in ICU may be required.

GHB/GBL withdrawal: treatment and management issues

Benzodiazepines (selective GABAA agonists) are useful in ameliorating some of the signs and symptoms of GHB/GBL withdrawal. Loading doses of benzodiazepines do not decrease the likelihood of withdrawal delirium, but are important for controlling agitation. Most patients in GHB/GBL withdrawal have an extremely high tolerance to the sedating effects of benzodiazepines and require large frequent doses greater than those required for the treatment of severe alcohol withdrawal.

Use of high-dose benzodiazepines requires prolonged intensive monitoring and is associated with complications. A lack of activation of GABAA receptors by GHB may explain why benzodiazepines may beunsatisfactory. Withdrawal from GHB/GBL has been shown to be a GABAB-mediated effect. This suggests that baclofen (GABABB agonist) would be effective at replicating many effects of GHB, and thus be a useful adjunctive treatment for GHB/GBL withdrawal.


Inpatient management of GBL withdrawal

A local protocol and drug treatment regimens has been developed for NHS Lothian from evidence available in the literature, clinical experience gained locally and from peers in other units. (This protocol would also be applicable to the treatment of patients withdrawing from GHB or 1,4- BD).

Patients are prescribed oral high-dose chlordiazepoxide and baclofen regimens (Lorazepam injection, haloperidol and procyclidine by are also prescribed on an ‘as required’ basis.

Chlordiazepoxide (brand name Librium)

Day 1 Chlordiazepoxide 40mg 12 times a day
Day 2 Chlordiazepoxide 30mg 12 times a day
Day 3 Chlordiazepoxide 40mg 6 times a day
Day 4 Chlordiazepoxide 30mg 6 times a day
Day 5 Chlordiazepoxide 20mg 6 times a day
Day 6 Chlordiazepoxide 10mg 6 times a day

In addition, chlordiazepoxide 10mg to 40mg may be given on an ‘as required’ basis at 30-minute intervals up to a maximum dose of 120mg in 24 hours on Day 1; use will be reviewed daily

Baclofen (Brandnames Lioresal® (Non-proprietary include Spasmolen® Lyflex®)

Day 1 Baclofen 20mg 3 times a day
Day 2 Baclofen 20mg 5 times a day
Day 3 Baclofen 20mg 5 times a day
Day 4 Baclofen 20mg 5 times a day
Day 5 Baclofen 20mg 3 times a day
Day 6 Baclofen 10mg 3 times a day

In addition, baclofen 10mg may be given on an as required basis 2-hourly up to a maximum dose of 50mg in 24 hours on Day 1; use will be reviewed daily.

It is recommended that as required baclofen is given initially in preference to as required chlordiazepoxide and then chlordiazepoxide and baclofen alternately as required, as this may reduce the total benzodiazepine dose.


Outpatient management of GBL withdrawal

Withdrawal can be managed on an ambulatory basis, the key being early and aggressive management with ongoing monitoring for tachycardia, insomnia, anxiety, visual disturbances and any medical deterioration. It may be appropriate to manage patients with less severe GBL dependence on an outpatient basis as the clinician’s experience dictates.

Relapse prevention in formerly GBL-dependent patients

Baclofen as a GABABBagonist is already used (unlicensed) for relapse prevention in alcohol dependent patients. Given its mode of action it might be expected to provide similar benefits in those with GBL-dependence, particularly those who have already relapsed once.

Information on similar use elsewhere

South London and Maudsley NHS GBL/GHB Clinic

With about 3 presentations per week with overdose for GBL / GHB, the Clinic was set up to address the lack of available treatment options for the small but steady and growing demand from those suffering addiction and related issues. It provides dedicated successful in-patient and outpatient treatment and crucial pioneering aftercare support for clients, appreciating that ‘detox is just a part of the process,’ needing ongoing monitoring over weeks for insomnia, anxiety and high risk of relapse.

Withdrawal can be managed on an ambulatory basis, the key being early and aggressive management with ongoing monitoring for tachycardia, insomnia, anxiety and visual disturbances, and the high risk of relapse.

It is managed with a combination of Benzodiazepines staving withdrawal and the muscle relaxant Baclofen. Medication is usually required for 5-7 days. Complex withdrawal may require ICU admission and large doses of Chlordiazepoxide and Baclofen.


Since summer 2009, the clinic has treated 30 patients - both in-patient and outpatients - 90% having successfully completed withdrawal with no adverse affects, and sustained a period of abstinence.


Summary of evidence on clinical effectiveness issues- Chlordiazepoxide


Reference 1: McDonough M, Kennedy N, Glasper A, Bearn, J. Clinical features and management of gamma-hydroxybutyrate (GHB) withdrawal: a review Drug & Alcohol Dependence. 2004; 75(1):3-9


This reviews 38 cases of GHB or GHB precursor withdrawal. Symptoms were similar to alcohol withdrawal, about half progressed to delirium. High dose benzodiazepines were used to good effect. In benzodiazepine refractory cases withdrawal responded to other sedative agents mainly pentobarbital or chloral hydrate were used in more severe cases (3 patients). One death was reported; the cause of death was reported as a complication of GHB withdrawal.

A tapering benzodiazepine regimen (usually diazepam of parenteral lorazepam) was used in 91% of casesbut usually in combination with other drugs (82% of cases) mainly antipsychotics, anticonvulsants and non-benzodiazepine sedatives. There was insufficient cases for a meaningful comparison of combination drug treatment with benzodiazepine treatment alone. The mean dose of benzodiazepines (in diazepam
equivalents) used to manage the withdrawal period was 335mg ranging from 20mg to 2655mg.

Reference 2: Noorden M, van Dongen L, Zitman F, Vergouwen T. Gamma-hydroxybutyrate withdrawal syndrome: dangerous but not well-known. General Hospital Psychiatry 2009; 31: 394 – 396

Presents two cases and reviews literature. Treatment of GHB withdrawal has not been systematically investigated. Conclusions are made about treatment – high-dose benzodiazepines are the treatment of choice. Antipsychotics often ineffective, may cause side effects and lower seizure threshold, but may still be useful. Pentobarbital or baclofen addition was successful in benzodiazepine-refractory cases.

Reference 3: Craig K, Gomez H, McManus J, Bania T. Severe gamma-hydroxybutyrate withdrawal: a case report and literature review. The Journal of Emergency Medicine, 2000; 18 (1): 65–70

Presents a case of severe GHB dependency mimicking alcohol delirium tremens with autonomic dysfunction and requiring large amounts lorazepam (507mg) and diazepam (120mg) over 90 hours (3.75 days) to control agitation – equivalent to diazepam 2665mg. Also reviews other case reports.

Reference 4: Wojtowicz JM, Yarema MC, Wax PM. Withdrawal from gamma-hydroxybutyrate, 1,4- butanediol and gamma-butyrolactone: a case report and systematic review. CJEM; The Journal of the Canadian Association of Emergency Physicians. 2008; 10(1):69-74.

Reports a case of withdrawal from 1,4-Butanediol (1,4-BD, like GBL, is a pro-compound of GHB) with seizures and rhabdomyolysis. Also reviewed 27 studies with 57 episodes of withdrawal from GHB, 1,4-BD and GBL. Most common symptoms tremor, hallucinations, tachycardia and insomnia. Seizures and rhabdomyolysis in 7% of cases. One death reported. Treatment – benzodiazepines plus pentobarbital in benzodiazepine-refractory cases.

Reference 5: Catalano MC, Glass JM, Catalano G, Burrows SL, Lynn WA, Weitzner BS. Gamma Chlordiazepoxide Capsules / Tablets 10mg
butyrolactone (GBL) withdrawal syndromes. Psychosomatics 2001; 42(1):83-8.

Presents three cases showing between them agitation, autonomic disturbance, seizure activity and psychosis. Concludes that GBL withdrawal resembles GHB, alcohol and benzodiazepine withdrawal, and responds to benzodiazepines

Reference 6: Professor Fabrizio Schifano (Chair in Clinical Pharmacology and Therapeutics Associate Dean, Postgraduate Medical School Consultant Addiction Psychiatrist University of Hertfordshire. GHB Clinical Pharmacology and Management Issues. SCANbites (quarterly newsletter of the Specialist Clinical Addiction Network) Autumn 2010 Volume 7 Issue 2.


High-dose benzodiazepines most frequently used, but very high doses needed – possibly due to lack of activation of GABAA receptors by GHB. The GABAB-agonist baclofen improves clinical outcome, when added to benzodiazepines. Baclofen has a favourable side effect profile compared with GHB at the doses required to relieve severe withdrawal symptoms.


Are there any safety issues regarding this medicine in comparison to existing medicines?


  • Need to consider possibility of other illicit drugs or alcohol, and prescribe accordingly in view of high doses of chlordiazepoxide used.


  • Common adverse effects of chlordiazepoxide include drowsiness, sedation, unsteadiness and ataxia; these effects are dose-related. If chlordiazepoxide is combined with centrally-acting drugs the sedative effects are likely to be intensified.

Summary of evidence on clinical effectiveness issues- Baclofen


Reference 1: LeTourneau J, Hagg D, Smith S. Baclofen and Gamma-Hydroxybutyrate Withdrawal Neurocrit Care 2008; 8(3): 430–433


Presents a case report of a 61 year old woman admitted to ICU for severe withdrawal symptoms from chronic gamma-hydroxybutyrate (GHB) use. This manifested as delirium, tremor and seizures, despite only small decreased in GHB dose and treatment with benzodiazepines. The addition of baclofen (a GABABB agonist) allowed rapid reduction in the GHB dose without seizure or delirium and resulted in long-term improvement of tremor.

Patient received tapering doses of GHB, baclofen initiated at 5mg three times a day and increased to 10mg three times a day.

Reference 2: Professor Fabrizio Schifano (Chair in Clinical Pharmacology and Therapeutics Associate Dean, Postgraduate Medical School Consultant Addiction Psychiatrist University of Hertfordshire. GHB Clinical Pharmacology and Management Issues. SCANbites (quarterly newsletter of the Specialist Clinical Addiction Network) Autumn 2010 Volume 7 Issue 2.


High-dose benzodiazepines most frequently used, but very high doses needed – possibly due to lack of activation of GABAA receptors by GHB. The GABAB-agonist baclofen improves clinical outcome, when added to benzodiazepines. Baclofen has a favourable side effect profile compared with GHB at the doses required to relieve severe withdrawal symptoms.


Are there any safety issues regarding this medicine in comparison to existing medicines?

  • Possible additive sedative effects, require monitoring
  • The CSM has advised that serious side effects (risk of hyperactive state, muscle spasm, may precipitate autonomic dysfunction including hyperthermia, psychiatric reactions and convulsions) can occur on abrupt withdrawal of baclofen
  • Baclofen must be used with caution in patients with neuropathies, such as cerebellar ataxia; and patients with a history of seizures.
  • There is the possibility of enhanced hypotensive effects of many drugs used for hypertension.
  • The BNF advises that the muscle relaxant effect of baclofen is enhanced by tricyclic antidepressants

Source: NHS Lothian
 

Sobrietysucks

Bluelighter
Joined
Sep 4, 2016
Messages
400
50-60 ml a day!?!?damn, thats literally drinking 3-4 mls every hour..what was your dosing schedule like?were you able to go to work and perform, live a somewhat normal life?notice any health problems at all??thats my biggest question about gbl abuse, i read much about it but dont notice that anyone actually suffers health problems as a result..
Someone give this poor fella an answer! i read this thread from start to finish. One thing I noticed is how you keep asking how people function at work on gbl 24/7? yet not a single person replies. Lol.
 

Captain.Heroin

Sr. Moderator: H&R, Words
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Messages
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Life has no meaning, yet I keep searching...
Someone give this poor fella an answer! i read this thread from start to finish. One thing I noticed is how you keep asking how people function at work on gbl 24/7? yet not a single person replies. Lol.
I never had a job while using GHB (only enjoyed it for one week).
 

WhiteDream

Greenlighter
Joined
Jun 1, 2012
Messages
31
Bumping because the other major thread died.

Been dosing 1.2ml-ish every 2-3h for 3-4 weeks now. When I stop, I get cold hands and feet and lethargy. Alchohol and phenibut relieves these symptoms.

However Im having a hard time stopping. I want to ask - how much time will pass before I experience some serious W/D?

What do I have to watch out for ?

So far It's my only motivation to shower, tidy up, run, fitness, socialize etc.
 

WhiteDream

Greenlighter
Joined
Jun 1, 2012
Messages
31
Ok I've since relapsed 2 times, once last week and then continued to daily dose til today, where I dosed phenibut and have thus NO urge to dose GBL. However, just like last time, when phenibut wears off, it'll be boredom, lethargy, maybe GBL WD's and just general shittiness. However, I have since written 20-day challenge on my wall. In 20 days I have to be clean of GBL.

Today is day 1 completed.
 
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