Alcohol & Xyrem/GHB
Alcohol enhances the effect of the neurotransmitter gamma-aminobutyric acid (GABA) at GABA_A receptors, causing sedative, anxiolytic, and muscle-relaxant effects. Also alcohol inhibits the function of glutamate at NMDA receptors, reducing excitatory neurotransmission, and increases dopamine release in the brain's reward pathways, contributing to its addictive properties.
Xyrem (sodium oxybate) or its illicit counterpart, GHB (gamma-hydroxybutyrate) acts primarily on GABA_B receptors, leading to sedative, anxiolytic, and muscle-relaxant effects. It also binds to specific GHB receptors, whose functions are not entirely understood but are thought to play a role in the sedative and euphoric effects. GHB has a biphasic effect on dopamine: low doses inhibit dopamine release, while higher doses increase it after an initial suppression.
Combining alcohol with Xyrem\GHB, poses significant risks due to their synergistic effects on the central nervous system (CNS). Both substances are CNS depressants, and their interaction can lead to severe and potentially life-threatening consequences.
- Enhanced Sedation and CNS Depression: Both alcohol and GHB/Xyrem induce sedation, and their combination can lead to excessive drowsiness or deep sedation. The combined depressive effect on the CNS can severely slow or stop breathing, increasing the risk of fatal respiratory failure. High doses of either substance alone can cause coma; together, the risk is significantly elevated.
- Impaired Cognitive and Motor Functions: Both substances impair motor skills; combined use can result in significant ataxia, making activities like driving extremely dangerous. Alcohol and GHB/Xyrem can cause anterograde amnesia, leading to complete memory blackouts where the user cannot recall events that occurred while intoxicated.
- Cardiovascular Effects: Both substances can cause a drop in blood pressure, which can lead to dizziness, fainting, and in severe cases, shock. A slowed heart rate is common with both substances, and combined use can exacerbate this effect, potentially leading to cardiac arrest.
- Psychological and Behavioral Changes: Alcohol lowers inhibitions, and GHB/Xyrem can enhance this effect, leading to dangerous behaviors and poor decision-making. Some users may experience heightened aggression or agitation, which can be dangerous to themselves and others.
- Gastrointestinal Distress: Both substances can cause nausea and vomiting, which can be severe when combined, increasing the risk of aspiration and choking.
- Risk of Overdose: The depressant effects of alcohol and GHB/Xyrem can significantly lower the threshold for overdose, meaning smaller amounts of each can result in life-threatening toxicity. The synergistic effects greatly increase the risk of fatal overdose due to compounded respiratory and cardiovascular depression.
- Neurological Effects: Both alcohol and GHB/Xyrem can lower the seizure threshold. Their combination increases the risk of convulsions. Confusion and delirium are more likely with combined use, especially in higher doses or with chronic use.
- Withdrawal Complications: Withdrawal from GHB/Xyrem is already severe and can include anxiety, tremors, and seizures. Combined with alcohol dependence, withdrawal symptoms can be more intense and complex to manage. This severe form of alcohol withdrawal can be exacerbated by concurrent GHB/Xyrem use, increasing the risk of hallucinations, severe agitation, and cardiovascular collapse
Combining alcohol with GHB/Xyrem significantly increases the risk of severe, life-threatening effects. The synergistic depressant impact on the CNS can lead to critical outcomes such as respiratory failure, coma, and death. It is crucial to understand these risks and avoid concurrent use to ensure safety and well-being.
All things considered, we recommend avoiding this combination under any conditions.
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