Updated July 2010 Page 1 of 4

Club drugs are a pharmacologically 

heterogeneous group of psychoactive drugs 

that tend to be abused by teens and young 

adults at bars, nightclubs, concerts, and 

parties. Gamma hydroxybutyrate (GHB), 

Rohypnol, ketamine, as well as MDMA 

(ecstasy) and methamphetamine (which are 

featured in separate InfoFacts) are some of 

the drugs included in this group. 

GHB (Xyrem) is a central nervous system 

(CNS) depressant that was approved by 

the Food and Drug Administration (FDA) in 

2002 for use in the treatment of narcolepsy 

(a sleep disorder). This approval came 

with severe restrictions, including its use 

only for the treatment of narcolepsy, and 

the requirement for a patient registry 

monitored by the FDA. GHB is also a 

metabolite of the inhibitory neurotransmitter 

gamma-aminobutyric acid (GABA). It exists 

naturally in the brain, but at much lower 

concentrations than those found when GHB 

is abused. 

•	 Rohypnol (flunitrazepam) use began

gaining popularity in the United States in 

the early 1990s. It is a benzodiazepine

(chemically similar to sedative-hypnotic 

drugs such as Valium or Xanax), but it 

is not approved for medical use in this 

country, and its importation is banned. 

•	 Ketamine is a dissociative anesthetic, mostly

used in veterinary practice. 

How Are Club Drugs 

Abused? 

•	 GHB and Rohypnol are available in

odorless, colorless, and tasteless forms 

that are frequently combined with alcohol 

and other beverages. Both drugs have 

been used to commit sexual assaults (also 

known as “date rape,” “drug rape,” 

“acquaintance rape,” or “drug-assisted” 

assault) due to their ability to sedate 

and incapacitate unsuspecting victims, 

preventing them from resisting sexual 

assault. 

•	 GHB is usually ingested orally, either in

liquid or powder form, while Rohypnol 

is typically taken orally in pill form. 

Recent reports, however, have shown that 

Rohypnol is being ground up and snorted. 

•	 Both GHB and Rohypnol are also abused

for their intoxicating effects, similar to other 

CNS depressants. 

•	 GHB also has anabolic effects (it stimulates

protein synthesis) and has been used by 

bodybuilders to aid in fat reduction and 

muscle building. 

•	 Ketamine is usually snorted or injected

intramuscularly.

Club Drugs (GHB, Ketamine, and Rohypnol)
Updated July 2010 Page 2 of 4

How Do Club Drugs Affect 

the Brain?

•	 GHB acts on at least two sites in the

brain: the GABAB receptor and a specific 

GHB binding site. At high doses, GHB’s 

sedative effects may result in sleep, 

coma, or death. 

•	 Rohypnol, like other benzodiazepines,

acts at the GABAA receptor. It can 

produce anterograde amnesia, in which 

individuals may not remember events they 

experienced while under the influence of

the drug. 

•	 Ketamine is a dissociative anesthetic, so

called because it distorts perceptions of 

sight and sound and produces feelings 

of detachment from the environment and 

self. Ketamine acts on a type of glutamate

receptor (NMDA receptor) to produce 

its effects, which are similar to those of 

the drug PCP.1,2, Low-dose intoxication 

results in impaired attention, learning 

ability, and memory. At higher doses, 

ketamine can cause dreamlike states 

and hallucinations; and at higher doses 

still, ketamine can cause delirium and 

amnesia.

Addictive Potential

•	 Repeated use of GHB may lead to

withdrawal effects, including insomnia, 

anxiety, tremors, and sweating. Severe 

withdrawal reactions have been reported 

among patients presenting from an 

overdose of GHB or related compounds, 

especially if other drugs or alcohol are 

involved.3

•	 Like other benzodiazepines, chronic

use of Rohypnol can produce tolerance, 

physical dependence, and addiction.

•	 There have been reports of people

binging on ketamine, a behavior that is 

similar to that seen in some cocaine- or 

amphetamine-dependent individuals. 

Ketamine users can develop signs of

tolerance and cravings for the drug.4

What Other Adverse 

Effects Do Club Drugs Have 

on Health?

Uncertainties about the sources, chemicals, 

and possible contaminants used to 

manufacture many club drugs make it 

extremely difficult to determine toxicity 

and associated medical consequences. 

Nonetheless, we do know that: 

•	 Coma and seizures can occur following

use of GHB. Combined use with other 

drugs such as alcohol can result in nausea 

and breathing difficulties. GHB and two 

of its precursors, gamma butyrolactone 

(GBL) and 1,4 butanediol (BD), have 

been involved in poisonings, overdoses, 

date rapes, and deaths. 
Updated July 2010 Page 3 of 4

•	 Rohypnol may be lethal when mixed with

alcohol and/or other CNS depressants. 

•	 Ketamine, in high doses, can cause

impaired motor function, high blood 

pressure, and potentially fatal respiratory 

problems.

What Treatment Options 

Exist?

There is very little information available in 

the scientific literature about treatment for 

persons who abuse or are dependent upon 

club drugs. 

•	 There are no GHB detection tests for

use in emergency rooms, and as many 

clinicians are unfamiliar with the drug, 

many GHB incidents likely go undetected. 

According to case reports, however, 

patients who abuse GHB appear to 

present both a mixed picture of severe 

problems upon admission and a good 

response to treatment, which often 

involves residential services.3

•	 Treatment for Rohypnol follows accepted

protocols for any benzodiazepine, which

may consist of a 3- to 5-day inpatient 

detoxification program with 24-hour 

intensive medical monitoring and 

management of withdrawal symptoms, 

since withdrawal from benzodiazepines

can be life-threatening.3

•	 Patients with a ketamine overdose are

managed through supportive care for 

acute symptoms, with special attention to 

cardiac and respiratory functions.5

How Widespread Is Club 

Drug Abuse?

Monitoring the Future Survey†

MTF has reported consistently low levels of 

abuse of these club drugs since they were 

added to the survey. For GHB and ketamine, this occurred in 2000; for Rohypnol, 

1996. According to results of the 2009 

MTF survey, 0.7 percent of 8th-grade and 

1.1 percent of 12th-grade students reported 

past-year†† use of GHB, a statistically significant decrease from peak-year use of 1.2 

percent in 2000 for 8th-graders and 2.0 

percent for 12th-graders in 2004. GHB use 

among 10th-grade students was reported 

at 1.0 percent, an increase from 2008 (0.5 

percent), and statistically unchanged from 

peak use of 1.4 percent in 2002 and 2003.

Past-year use of ketamine was reported by 

1.0 percent of 8th-graders, 1.3 percent 

of 10th-graders, and 1.7 percent of 12thgraders in 2009. These percentages also 

represent significant decreases from peak 

years: 2000 for 8th-graders (at 1.6 percent) 

and 2002 for 10th- and 12th-graders (at 

2.2 and 2.6 percent, respectively). 
Updated July 2010 Page 4 of 4

For Rohypnol, 0.4 percent of 8th- and 

10th-graders, and 1.0 percent of 12thgraders reported past-year use, also down 

from peak use in 1996 for 8th-graders 

(1.0 percent), 1997 for 10th-graders (1.3 

percent), and 2002 and 2004 for 12thgraders (1.6 percent). 

Other Information Sources

For more information about club drugs, 

visit www.clubdrugs.gov, www.

teens.drugabuse.gov, and www.

backtoschool.drugabuse.gov; or 

call NIDA at 877-643-2644. For street 

terms searchable by drug name, street 

term, cost and quantities, drug trade, 

and drug use, visit http://www.

whitehousedrugpolicy.gov/

streetterms/default.asp.

Data Sources

† These data are from the 2009 Monitoring the Future survey, funded by the National Institute on Drug Abuse, National 

Institutes of Health, Department of Health and Human Services, and conducted annually by the University of Michigan’s 

Institute for Social Research. The survey has tracked 12th-graders’ illicit drug use and related attitudes since 1975; in 

1991, 8th- and 10th-graders were added to the study.

† † “Lifetime” refers to use at least once during a respondent’s lifetime. “Past year” refers to use at least once during 

the year preceding an individual’s response to the survey. “Past month” refers to use at least once during the 30 days 

preceding an individual’s response to the survey.

Resources

1 Anis NA, Berry SC, Burton NR, Lodge D. The dissociative anaesthetics, datamine and phencyclidine, selectively 

reduce excitation of central mammalian neurons by N-methyl-aspartate. Br J Pharmacol 79(2): 565–575, 1983. 

2 Kapur S, Seeman P. NMDA receptor antagonists ketamine and PCP have direct effects on dopamine D2 and serotonin

5-HT2 receptors – Implications for models of schizophrenia. Molecular Psychiatry 7: 837–844, 2002. 

3 Maxwell JC, Spence RT. Profiles of club drug users in treatment. Subst Use Misuse 40(9–10):1409–1426, 2005.

4 Jansen KL, Darracot-Cankovic R. The nonmedical use of ketamine, part two: A review of problem use and

dependence. 

J Psychoactive Drugs 33(2):151–158, 2001.

5 Smith KM, Larive LL, Romanelli F. Club Drugs: Methylenedioxymethamphetamine, flunitrazepam, ketamine

hydrochloride, and γ–hydroxybutyrate. Am J Health-Syst Pharm 59(11):1067–1076, 2002.