GHB (gamma-hydroxybutyrate) - sometimes called G, juice, Gina or fantasy - is a colourless and odourless drug often used in drink spiking as it can go undetected in drink.
People who take it have similar symptoms to being drunk, but the drug carries a high risk of overdose as the difference between a recreational dose and an overdose is very small.
At low doses, side effects include euphoria, increased libido and lowered inhibitions but it has also been linked to sexual assault and rape.
In NSW, GHB-related emergency department presentations and hospitalisations have increased substantially in the past decade, with young women accounting for a larger proportion of toxicity and overdose cases.
Research by the National Centre for Clinical Research on Emerging Drugs found a demographic shift in GHB use was demonstrated by a rising number of ED presentations in regional and remote NSW.
The study highlighted the need to extend public health education around GHB use, in particular for women and those living in outside major cities, study author Krista Siefried said.
"GHB is most often discussed for its use as a party drug and to facilitate sex, particularly among gay and bisexual men, but our findings suggest we may need to shift our focus to include other groups," Dr Siefried said.
"Women are overlooked in research and public health campaigns when it comes to GHB use, except in the context of it being used as a 'date rape drug'. It's time for that to change."
The study of ED presentations found women accounted for 51 per cent of GHB-related cases among people aged 16 to 24.
GHB-related presentations in regional or remote areas also increased from 3.4 per cent of all cases in 2015-16 to 13.8 per cent in 2023/24.
One in five hospitalisations required intubation and ventilation, and a similar proportion were admitted to intensive care for an average duration of one day.
"Given the short admission times and discharge home from ED, there are limited opportunities to provide harm reduction education in this setting," Dr Siefried said.
"(This) means the focus for such education and interventions is best placed outside the hospital."
Education should include information about harm reduction strategies for safer GHB use, Dr Siefried said.
"(Strategies) such as starting with low doses, avoiding polydrug or alcohol use and monitoring breathing and consciousness of peers, as well as around sexualised drug use in terms of communicating openly about consent and boundaries," she said.
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