What is the difference between passing out from GHB (G-sleep) and a coma?

“Don’t worry, he’ll wake up in a minute,” is a response that is sometimes heard when someone has passed out after using too much GHB. One problem with GHB is the dosage; dosing correctly can be difficult. Having a good time can quickly turn into loss of consciousness with the wrong dose, also known as G-nap of G-sleep. But how harmless is this G-nap?

Wake up and keep going

Downers such as GHB but also alcohol have a paradoxical effect. At a low dose, GHB provides a feeling of energy, euphoria, clarity and excitement. At a medium dose, it provides a relaxed feeling. And at high dose you might pass out.

In the case of GHB, this is because at a low dose different types of receptors for signaling substances in the brain are activated than at a high dose.

After this tipping point, when these other receptors are activated, the effect also changes: the user can actually get tired, fall asleep or pass out.

The misleading thing about G-nap is that people often wake up cheerful and energetic. This is because the amount of GHB in your body has fallen again during awakening to such an extent that the effects of a low dose again dominate; feelings of euphoria and excitement take over again.

Passing out is never okay

Unfortunately, the fact that someone feels fine again afterwards says nothing about the possible damage that has occurred in the brain by passing out and is therefore very misleading. Passing out can lead to brain damage. In addition, it is difficult to estimate whether you are only sleeping, or whether you are in a coma.

A coma can be dangerous for several reasons. As just mentioned, it can cause brain damage, you can choke on your own tongue or vomit, and your body can cool off too much (hypothermia). In addition, an overdose can cause respiratory arrest, it increases the risk of epileptic activity in the brain and it can cause movement disorders (not being able to move but wanting to, or moving involuntarily).

Research also shows that people who have been comatose several times due to GHB had poorer long-term memory than people who have never been comatose with GHB. There is also a high addiction risk. And due to the paradoxical effect, users can sometimes feel restless instead of relaxed.

Coma vs sleep

The brain in a coma is not the same as the brain during sleep. There is brain activity in a coma, but it is much lower than during sleep. Normally, brain cells send messages to each other, but during a coma this is so shut down that we can no longer experience consciousness. Although a coma looks like a deep sleep from the outside, these should not be confused with each other; from a sleep one can be awakened, but from a coma one has to awaken oneself. In addition, painful stimuli are still perceived during sleep, but in a coma there is no longer a response.

The G-nap is therefore not as harmless as it may seem. Due to the risk of overdose, falling into a coma is lurking. Although you may feel excited after waking up from G-nap, it is not the same as sleep and so you have not experienced the benefits of sleep.

Unity tips

There is no real safe use of GHB. The risks can be limited with the tips below. Read more tips on the page about GHB:

  • Do not use GHB to fall asleep.
  • The strength of GHB varies widely. Always know the strength of the GHB by testing it at a drug checking service.
  • Measure how many milliliters you take with a milliliter syringe. These can be purchased at pharmacies, pet stores or online.
  • Write down the time and dose, app it to your friends or put it in your phone yourself.
  • Do you feel an effect and do you still want to take it? Then wait at least 1.5 hours and do not take more than half of your first dose.
  • Do you feel NO effect after an hour and do you want to take it? Then never take more than half of your first dose.
  • Never combine GHB with alcohol, benzodiazepines (such as diazepam or Valium), or other downers. The chance of passing out is increased. Your breathing can be severely suppressed and that is life-threatening!
  • If you’re not feeling well or feel like you’re going to pass out, let your friends know. Then they know that you are not ‘just’ sleeping when you lose consciousness. When this happens at a party, it is good to go to the first aid, they can help you and if it goes wrong you are in good hands right away!

By: Lizet Wilken

In collaboration with: Gerard Alderliefste, Layla Deibert, Minni McMaster, Raoul Koning and Sarsani Schenk.