What is GHB?

GHB is a central nervous system (CNS) depressant that naturally occurs in small amounts in the human brain but is also manufactured synthetically for illicit use. Commonly referred to as the “date rape” drug, it produces sedative, euphoric, and anesthetic effects and has a rapid onset, especially when taken orally. In appearance, GHB is typically found as a clear, oily liquid, though it may also appear as a white powder or crystalline substance. It is often mixed into small containers or disguised in beverages due to its colorless and sometimes slightly salty taste.

Medically, a pharmaceutical form of GHB known as sodium oxybate is FDA-approved for the treatment of narcolepsy with cataplexy and excessive daytime sleepiness. This prescription form is highly regulated and dispensed only through a restricted distribution program. Recreationally, illicit GHB is used for its euphoric and disinhibiting effects, particularly in nightlife settings. It is also known for its role in drug-facilitated sexual assault due to its strong sedative properties, fast absorption, and difficulty to detect without specialized testing.

Effects:

• Euphoria and increased sociability

• Relaxation and reduced anxiety

• Sedation and drowsiness

• Impaired coordination and slowed reaction time

• Dizziness or lightheadedness

• Nausea and vomiting

• Confusion or disorientation

• Respiratory depression

• Memory loss or blackouts

• Risk of coma or overdose, especially when mixed with alcohol or other depressants

What is Gabapentin?

Gabapentin is a prescription medication classified as an anticonvulsant and neuropathic pain agent. It works by modulating certain neurotransmitters to reduce nerve-related pain and stabilize electrical activity in the brain. Medically, it is FDA-approved for treating seizures and postherpetic neuralgia, and is widely prescribed off-label for conditions such as anxiety, fibromyalgia, restless leg syndrome, and general nerve pain.

Gabapentin typically comes in capsules, tablets, or oral solutions. Capsules may be white, yellow, or multicolored depending on strength and manufacturer. Tablets may be scored or film-coated and usually display the dose or manufacturer imprint.

Medically, gabapentin is taken orally in controlled doses. Recreational misuse has increased in recent years, often combined with opioids, sedatives, or alcohol to enhance sedating or euphoric effects. On its own, gabapentin may produce relaxation, mild dissociation, or sedation in high doses. Misuse is most common in populations with substance use disorders due to its ability to potentiate other depressants, despite being traditionally viewed as a low-risk medication.

Effects:

• Sedation and drowsiness

• Dizziness or lightheadedness

• Relaxation and reduced anxiety

• Mild euphoria in high doses

• Impaired coordination or slowed motor skills

• Blurry or double vision

• Confusion or slowed cognition

• Swelling in extremities (edema)

• Nausea or gastrointestinal discomfort

• Increased risk of respiratory depression when combined with opioids or alcohol

What is Fentanyl?

Fentanyl is a potent synthetic opioid originally developed for medical use in severe pain management, such as post-surgical care, cancer pain, and end-of-life treatment. In clinical settings, fentanyl is administered in forms like transdermal patches, lozenges, injections, and nasal sprays. Even in its legitimate pharmaceutical form, fentanyl is 50–100 times more potent than morphine, making dosage control critical and misuse extremely dangerous.

Illicit fentanyl, now widespread in the drug supply, is produced unlawfully in powder, tablet, or counterfeit pill form. It is often mixed with heroin, cocaine, or methamphetamine—or pressed into pills made to resemble legitimate medications—without the user’s knowledge. This extreme potency and unpredictable contamination make illicit fentanyl a leading cause of overdose deaths. It can be snorted, smoked, ingested, or injected, and even tiny dosing errors can be fatal due to rapid respiratory depression.

Because fentanyl appears in so many adulterated street drugs, its detection is a major priority for workplaces (particularly safety-sensitive roles), courts, treatment programs, and community health initiatives. Rapid toxicology tests are increasingly incorporating fentanyl-specific assays to identify exposure early and support life-saving interventions.

Effects:

• Extreme pain relief

• Profound sedation or drowsiness

• Euphoria followed by heavy “nodding”

• Slowed breathing (respiratory depression)

• Constricted “pinpoint” pupils

• Nausea or vomiting

• Confusion or disorientation

• Severe drowsiness leading to unconsciousness

• High risk of dependence and withdrawal

• Overdose that can rapidly lead to respiratory arrest and death

What is Buprenorphine?

Buprenorphine is a semi-synthetic opioid medication used primarily in the treatment of opioid use disorder (OUD). It works as a partial opioid agonist, meaning it activates opioid receptors enough to prevent withdrawal and reduce cravings but not enough to produce the intense euphoria associated with full opioids like heroin or oxycodone. This unique pharmacology allows buprenorphine to stabilize individuals in recovery and reduce the risk of overdose. Medically, it is prescribed in formulations such as Suboxone® (buprenorphine/naloxone), Subutex® (buprenorphine alone), Bunavail®, and Sublocade® (a long-acting injectable). These come as sublingual tablets, films, or monthly injections.

Illicit or non-prescribed buprenorphine can also appear on the street, typically as diverted prescription tablets or films. Recreational misuse is less common than with other opioids due to buprenorphine’s “ceiling effect,” which limits the level of euphoria it can produce. However, some individuals misuse buprenorphine to self-treat withdrawal, maintain opioid dependence without medical supervision, or combine it with other substances. Because of its role in treatment programs, monitoring appropriate use vs. misuse is often necessary.

Effects:

• Reduced opioid cravings and withdrawal symptoms

• Mild euphoria at low doses (less than full opioids)

• Sedation or drowsiness

• Constipation

• Headache and nausea

• Sweating or flushed skin

• Reduced respiratory depression compared to full opioids

• Potential for dependence if misused

• Precipitated withdrawal if taken too soon after other opioids

• Impaired coordination or slowed reaction time

What is MDVP?

Methylenedioxypyrovalerone (MDPV) is a powerful synthetic stimulant belonging to the class of drugs known as synthetic cathinones. It acts on the central nervous system by sharply increasing dopamine and norepinephrine levels, leading to intense stimulation, euphoria, and, at higher doses, severe behavioral disturbances. MDPV is not approved for any medical use, and all versions found in the U.S. are illicit. It often appears as a crystalline powder that can be white, off-white, brownish, or even tan. Products have historically been falsely marketed as “bath salts,” “plant food,” or “research chemicals” to evade regulation.

MDPV is typically sold in small packets or baggies and may be ingested, snorted, smoked, or injected. Because it is produced in clandestine labs, purity and potency vary dramatically, increasing the risk of unpredictable and dangerous effects. Recreational users may seek MDPV for its intense stimulant and euphoric properties, but the drug is well-known for triggering severe agitation, paranoia, hallucinations, violent behavior, and medical emergencies. Its unpredictable pharmacology and highly addictive nature make it one of the more dangerous synthetic stimulants encountered in emergency and toxicology settings.

Effects:

• Intense euphoria and extreme stimulation

• Rapid heart rate and dangerously elevated blood pressure

• Severe agitation, anxiety, and restlessness

• Extreme paranoia or delusional thinking

• Hallucinations (visual or auditory)

• Hyperthermia (dangerously high body temperature)

• Muscle tension, tremors, or seizures

• Insomnia and prolonged wakefulness

• Compulsive redosing and high addiction potential

• Violent behavior or psychosis requiring medical intervention