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DRUG HARM REDUCTION — COMPREHENSIVE GUIDE

EMERGENCY: If someone is overdosing, call emergency services IMMEDIATELY. EU: 112 | US: 911 | UK: 999 | AUS: 000. Time is critical in overdose situations. This guide is educational and does not constitute medical advice.

Harm reduction is a public health philosophy that acknowledges drug use as a reality and focuses on minimising associated risks rather than demanding abstinence. The following guide is compiled from organisations including DanceSafe, TripSit, The Loop, and national harm reduction bodies.

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UNIVERSAL SAFETY PRINCIPLES

BEFORE YOU USE
  • Test all substances with reagent kits (Marquis, Mecke, Simon's, Folin)
  • Check drug interaction checker: TripSit combo chart
  • Research dosages at PsychonautWiki or Erowid
  • Start with a very small "allergy test" dose and wait
  • Never use alone — have a sober person present
  • Tell someone trusted what you are taking and when
  • Avoid mixing — especially CNS depressants (opioids + benzos + alcohol)
GENERAL RISK REDUCTION
  • Do not redose too soon — wait for full effects before considering more
  • Stay hydrated — sip water; avoid overhydration on MDMA
  • Avoid using when under significant emotional distress
  • Know your health status — heart conditions, mental health, medications
  • Keep Naloxone available if opioids are present
  • Have a plan for getting home safely
  • Set and setting matter significantly for psychedelics
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[01] OPIOIDS (HEROIN, OXYCODONE, TRAMADOL, MORPHINE, CODEINE)

OVERDOSE SIGNS
  • Slow, shallow, or stopped breathing
  • Blue or grey lips/fingertips (cyanosis)
  • Unconscious and unresponsive
  • Gurgling or choking sounds
  • Pinpoint (very small) pupils
OVERDOSE RESPONSE
  • Call 112/911/999 IMMEDIATELY
  • Administer Naloxone (Narcan) if available — nasal or injection
  • Place in recovery position (on their side)
  • Perform rescue breathing if trained
  • Stay with them — Naloxone wears off in 30–90 min
NEVER LEAVE ALONE. Never inject anything into the heart. Never put in cold water.
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[02] STIMULANTS (COCAINE, METHAMPHETAMINE, AMPHETAMINE, MDMA)

RISKS
  • Cardiac events (arrhythmia, heart attack)
  • Hyperthermia (dangerous overheating)
  • Hyponatremia (overhydration on MDMA)
  • Serotonin syndrome (MDMA + SSRIs/MAOIs)
  • Stimulant psychosis with chronic use
HARM REDUCTION
  • MDMA: max 1–2 uses per 3 months; dose 1–1.5mg/kg
  • Test with Marquis reagent — MDMA should turn purple/black
  • Sip ~500ml water per hour if dancing; no more
  • If overheating: cool environment, wet cloth, stop activity
  • NEVER mix MDMA with MAOIs — potentially lethal
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[03] PSYCHEDELICS (LSD, PSILOCYBIN, DMT, MESCALINE, KETAMINE)

RISKS
  • Acute psychological distress (bad trip)
  • HPPD (persistent perceptual changes) — rare
  • Accidents from impaired judgement
  • Psychosis risk for those with personal/family history
  • Ketamine bladder damage with chronic use
HARM REDUCTION
  • Prepared set (mindset) and setting are critical
  • Have a sober trip-sitter for high doses
  • If bad trip: calm, low-stimulation environment
  • Do not restrain — talk calmly; benzos can reduce intensity
  • Test LSD with Ehrlich reagent (turns purple = indole alkaloid)
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[04] CANNABIS (THC/CBD)

  • Cannabis "green-outs": anxiety, nausea, pale — lay down, breathe, pass
  • Edibles: effects delayed 1–3 hours — do NOT redose early
  • CBD can reduce THC-related anxiety — useful in green-outs
  • Regular heavy use linked to cannabis use disorder and psychosis risk
  • Avoid tobacco mixes — nicotine adds addiction risk
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[05] BENZODIAZEPINES (DIAZEPAM, ALPRAZOLAM, CLONAZEPAM, DESIGNER BENZOS)

Benzo withdrawal can be life-threatening. Never stop long-term benzo use abruptly. Taper under medical supervision.
  • Designer benzos (etizolam, flualprazolam) are far more potent than diazepam — very easy to overdose
  • NEVER mix with opioids, alcohol, or other CNS depressants — respiratory depression risk
  • If person is unconscious but breathing: recovery position, monitor closely, call EMS
  • No reversal agent available for benzos (Flumazenil is short-acting and dangerous)
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