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Addiction and Withdrawal
GHB (Xyrem)
Citation:   Fitful Sleeper. "Addiction and Withdrawal: An Experience with GHB (Xyrem) (exp86922)". Sep 23, 2010.

  oral GHB (daily)
I took GHB in the form of Xyrem for 4 years for narcolepsy. I had been diagnosed with narcolepsy 6 years before beginning the Xyrem. At first, I thought GHB was a miracle drug. It helped with my daytime sleepiness and my other narcolepsy symptoms reduced. I started at a dose of 2.5 grams twice a night. This worked for about a year and then I had to increase my dose to 3 grams twice a night (or 6 grams a night). Once on the 6 grams a night, I quickly developed a tolerance and was not able to sleep more than 2 hours at a time so my dose was increased to 9 grams a night (4.5 grams twice a night). I continued at 9 grams a night for a few months, and then started adding a dose here and there on the weekend days to be able to take a nap. By the third year I was on the medication, it got to the point where I could not sleep at all without taking the Xyrem even though I would be very sleepy. I progressed from taking the prescribed 9 grams a night with a dose here and there on the weekends for a nap to taking super high doses at night (re-dosing with 4-5 grams every 2 hours - getting up to 16 or more grams a night).

In the mornings, I would wake up fine, but by 10:00-11:00 in the mornings, I would develop some mild tremors in my hands and have hot flashes. At first, I did not even realize that these were the withdrawal symptoms. I was told that GHB metabolizes out of the body so fast that one could not really become “addicted”. I even reported these signs to my doctor who attributed them to the “side effects” (which they are - sort of). As my dosing increased at night, the tremors during the day got bad enough that I began taking Atenolol (a beta blocker) to control the tremors. They were considered “benign tremors” and no one ever suspected that I could be addicted to a medication. With the increased dosing at night (and withdrawing during the day), my blood pressure also started creeping up. My normal blood pressure had always run very low – in the 90s/60s range. During the days when I was not taking the Xyrem, my blood pressure would creep up in the 140s/90s range. I called the pharmacy that distributes this medication and was told that the increase in blood pressure was likely due to the sodium level of the medication and to watch my sodium intake with food. This made perfect sense to me and served to help keep me in denial of possible addiction. (Of course, the pharmacy did not know that I was taking higher and higher doses per day, as I only got one shipment a month).

My daily “withdrawal” from the Xyrem was difficult. I got to the point that as soon as I got home from work, I would take a small dose of Xyrem (2.5-3 mg) to make all my symptoms go away. I would do small doses during the evenings and then the larger doses to get to sleep. I did this for months before getting up the nerve to try some small doses while at work to control the withdrawal symptoms. I found that these low doses actually gave me TONS of energy. I would talk faster and could concentrate more. This is when I admitted to myself that I had become addicted. Once I realized that small doses gave me great energy, the round-the-clock dosing started. I would take 1.5-2.5 grams at 2-3 hour intervals all day long and at night would begin increasing the doses until I would “pass out” for a couple of hours. I would have to take 4-5 gram bolus doses (sometimes a little more) to be able to sleep for just an hour or two at a time.

Of course, at this point, I started running out of medication before my next shipment would come in and I ended up having to go to a doctor (that did not know my medical history or know I took Xyrem) to get medications to help me sleep when I did not have my Xyrem. The GHB changed my sleep patterns so much, that when not on it, it would take 600 mg of Trazodone, 50 mg of Benadryl, 1-2 mg of Xanax just to get me to sleep.
I would finish my 3 prescribed Xyrem bottles in 1-2 weeks (vs one month) and then would basically withdrawal for 1-3 weeks. I guess my average dose would be in the neighborhood of 30 or more grams spread throughout the day (20-40g per day). This pattern went on for the fourth year of my addiction.

I tried to quit a few times. Each time I would run out of medication, I would tell myself I was not going to order it again. I would be “clean” for 2-3 weeks (depending on how fast I had taken the medication shipment); sometimes I would delay ordering my shipment for a few days, but in the end, I would break down and order it again. I would even start out trying to take only the dose prescribed, but quickly found myself having to dose around the clock again to keep withdrawal symptoms at bay. I would have to use the Xanax that I normally took to help with sleeping in between shipments to get through the first few days of withdrawal. This would minimize the symptoms. One of the first times I quit the Xyrem (without using the Xanax) my blood pressure went up to 180/120 and I shook so hard I could not write my name. After this episode, I would dose myself with a higher dose of Xanax (1-2 mg) daily until my withdrawal symptoms went away and then would taper back on the Xanax.

The main withdrawal symptoms (sweating, hot flashes, elevated blood pressure, muscle aches, tremors, etc.) actually dissipate fairly quickly – within day or so. The inability to sleep and the anxiety last a lot longer. I definitely think that significant doses of a benzodiazepines (like Xanax or Klonopin) are necessary to totally get off this medication and prevent very serious withdrawal effects. The first two days off the medication are the worst. Without the use of other medications to sleep, I would basically not sleep at all for 48-72 hours and would feel extreme anxiety at times (even with using Xanax). I tried drinking large doses of alcohol at bedtime with a couple of my early attempts off GHB in the hopes that I would just “pass out” but it is almost like one becomes immune to alcohol when first withdrawing. All it would do was make me sick, but I would not really sleep. After the first 2 days, I would get to the point where I could sleep some. At first, it was in 1-2 hour stretches of very poor quality sleep and it would progress to longer and longer spans of sleep.

I finally decided that this cycle of binging and withdrawing had to be terrible for me and decided to never order the medication again. I also decided to quit all the other medications I used “in between” shipments. I used the last few Xanax doses to get through the major, acute withdrawal symptoms and then weaned off of the Xanax. I also stopped the Trazodone and the OTC Benadryl I had used at night to get at least an inkling of sleep without the Xyrem. (I never told my physician the real reason for quitting Xyrem. I just blamed the “side effects”.)

The long lasting problems after GHB addiction include difficulty sleeping for 6 or more weeks. Even with narcolepsy, I could initially only sleep a couple of hours at a time. I experienced significant anxiety symptoms that lasted 1-2 weeks. I also experienced some depression and significant irritability about 4 weeks after quitting that lasted about 2-3 weeks. I have been off the Xyrem for over 3 months now and am just beginning to feel “normal” again. Other than the benzodiazepine taper, I did not use any other medications when stopping the Xyrem (nor did I go through any treatment program). I no longer have the depressive episodes and can now sleep 6 or more hours at a time at night.

Although it is said in some literature that GHB is not addictive, this is not true. I am in the medical field and was much attuned to what was going on in my body. I knew my body had become addicted to this substance, but did what most people do and tried to convince myself that the symptoms were something else or I was prescribed the medicine so it was 'okay'. Even at full-blown addiction, I would tell myself that I could continue the pattern since I would “clean up” every couple of weeks for 2-3 weeks at a time. I know that if I ever order it again, I will only progress quickly to the round-the-clock dosing until it is all gone. What is weird is that no one ever accused or suspected me of having an addiction – not even my close family members or co-workers. I would test negative on the random and annual drug screens at work (since GHB does NOT show up on a routine drug screen); I never had difficulty functioning at work or public as long as I took the small doses to keep withdrawal symptoms away; and my close friends and family members knew that at night it was not unusual for me to be “passed” out on GHB or nod off while on the phone due to the medicine (they just did not know how MUCH I was having to take to get there).

I do want to make a note – this addiction to GHB has not caused me to crave other substances or have problems with other substances such as alcohol or opiates. Other than my attempts at TRYING to drink a lot of alcohol to get to sleep, my regular alcohol intake has not changed from prior to GHB use. I currently only drink alcohol occasionally (a couple of times a month) and find no “need” or “craving” for it. I have also taken a prescription of Oxycodone for an injury recently and had no problems with it (albeit, I admit that neither oxycodone nor hydrocodone has ever held much draw for me anyway). I only took a few pills of this prescription, and rest still sits in my medicine cabinet.

I hope this experience will help others to consider how dangerous abuse of this medication can be. I did not start it for recreational purposes, but for a diagnosed medical condition. In the end, I abused it and then became physically addicted to it. Other than the Xanax taper, I did not use any other medications to get off GHB nor did I go though any support program or treatment program. I don’t think this is advisable for most people. I have a medical background and I think I essentially treated myself through the withdrawal period with the Xanax and Atenolol. I had access to the equipment to monitor the physical reactions going on in my body and stay on top of the elevations in blood pressure with extra doses of the beta blocker and/or diuretics. None of this was optimal and could have resulted in very serious problems or even death. I just did not want to risk anyone finding out.

[Reported Dose: 5-30 grams per day (over time)]

Exp Year: 2010ExpID: 86922
Gender: Not Specified 
Age at time of experience: 40
Published: Sep 23, 2010Views: 43,774
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GHB (25) : Medical Use (47), Post Trip Problems (8), Addiction & Habituation (10), Alone (16)

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