Health & Safety

Harm Reduction
Drug Safety Guide

Harm reduction is a public health approach that accepts the reality of drug use and seeks to minimise the associated harms without necessarily requiring abstinence. This evidence-based guide draws from organisations including DanceSafe, Erowid, The Loop, and national health services.

🚨 Emergency: If you suspect someone is overdosing, call emergency services immediately. Do not leave them alone. If naloxone (Narcan) is available for opioid overdose, administer it without delay. Time is critical.

Core Principles

Harm Reduction Principles

Harm reduction does not endorse drug use. It acknowledges that some people will use substances regardless of legal status, and that providing accurate, evidence-based information saves lives. The alternative — abstinence-only messaging that leaves users without safety information — demonstrably leads to more deaths and injuries.

  • Test what you take. Drug testing kits are inexpensive, legal in most countries, and can identify dangerous adulterants including fentanyl, research chemicals, and toxic cutting agents.
  • Start with a very low dose. Never assume purity or strength. Street drugs frequently vary dramatically in concentration. Tasting a tiny amount first is standard harm reduction practice.
  • Never use alone. Have a sober friend present who knows what you've taken and has emergency contacts ready. If you must use alone, use a "drug checking" phone service (available in some countries).
  • Know the interactions. Drug-drug interactions cause many preventable deaths. Particularly dangerous: alcohol + CNS depressants, MDMA + SSRIs (serotonin syndrome), stimulants + cardiovascular conditions.
  • Have naloxone available. Naloxone (Narcan) reverses opioid overdose and is available over-the-counter in many countries. Everyone who may encounter opioids — including bystanders — should carry it.
Emergency Information

Recognising & Responding to Overdose

Opioid Overdose (Heroin, Fentanyl, Oxycodone, etc.)

Signs: Unresponsive or unconscious, slow/shallow/stopped breathing (fewer than 1 breath per 5 seconds), blue or purple lips/fingertips (cyanosis), choking or gurgling sounds, pinpoint pupils, limp body, pale and clammy skin.

Response:

  1. Call emergency services immediately (112/999/911)
  2. Administer naloxone (Narcan) — 1 spray in one nostril or intramuscular injection
  3. Place in recovery position if breathing; perform rescue breathing if not
  4. Repeat naloxone every 2-3 minutes if no response (fentanyl may require multiple doses)
  5. Stay with the person — naloxone wears off in 30-90 minutes, opioids may outlast it

Resources: overdoselifeline.org | harmreduction.org

Stimulant Crisis (MDMA, Cocaine, Methamphetamine, Amphetamine)

Serotonin Syndrome Signs: Rapid heartbeat, high body temperature (hyperthermia), agitation, confusion, muscle twitching, dilated pupils. Severe: seizures, high fever (>40°C/104°F), organ failure.

Stimulant Overdose Signs: Chest pain, severe headache, difficulty breathing, seizure, loss of consciousness, irregular/rapid heartbeat.

Response:

  1. Call emergency services
  2. Move to a cool environment — cool the person down with damp cloths, fans, ice packs to neck/armpits/groin
  3. Keep them calm, avoid restraining if possible
  4. Do NOT give benzodiazepines unless directed by medical professionals
  5. Monitor breathing and consciousness

Resource: dancesafe.org

Psychedelic Crisis (LSD, Psilocybin, DMT, Mescaline)

Note: Pure psychedelics (LSD, psilocybin) have extremely low physiological toxicity — most "bad trips" are psychological, not medical emergencies. However, adulterants like NBOMe compounds (not classical psychedelics) can cause physical overdose. NBOMe overdose mimics stimulant toxicity.

Response for psychological crisis:

  1. Move to a calm, safe, quiet environment — "set and setting" matters enormously
  2. Reassure: "You took a substance, it will pass" — grounding language helps
  3. Stay with the person, maintain calm and non-threatening presence
  4. Do not leave them in a position where they could harm themselves
  5. Call Zendo Project or Fireside Project crisis lines for psychedelic support

Resources: Fireside Project (855-FIRESID) | Zendo Project | Erowid Vaults

Depressant Overdose (Benzodiazepines, GHB/GBL, Alcohol)

Signs: Unconsciousness or extreme sedation, slow breathing, confusion, loss of coordination, vomiting while unconscious (choking risk), very low heart rate.

GHB specific: GHB has a very narrow therapeutic window. Combining with alcohol dramatically increases overdose risk. Loss of consciousness from GHB typically occurs rapidly and with little warning.

Response:

  1. Call emergency services — do not wait to see if they "sleep it off"
  2. Place in recovery position to prevent choking on vomit
  3. Ensure airway is clear; monitor breathing
  4. Do NOT try to wake with cold water or stimulants — this can cause shock
  5. Stay until emergency services arrive

Resource: Global Drug Survey

Cannabis Overconsumption (Edibles, Concentrates)

Signs: Severe anxiety/panic, racing heartbeat (tachycardia), paranoia, nausea/vomiting, disorientation, in rare cases temporary psychosis.

Note: Cannabis overconsumption is rarely life-threatening but can be extremely distressing. Edibles have delayed onset (30 mins–2 hours) making it easy to accidentally overconsume.

Response:

  1. Move to a calm, safe environment
  2. Lie down, breathe slowly and deeply
  3. Black pepper (sniffed or chewed) may reduce anxiety — contains beta-caryophyllene
  4. CBD can reduce THC-induced anxiety if available
  5. Seek medical attention if symptoms are severe or prolonged beyond a few hours

Ketamine / Dissociative Crisis

Signs: Unresponsive to speech but eyes open, inability to move, cardiac stress at high doses, respiratory depression at very high doses.

Response:

  1. If breathing is adequate, place in recovery position and monitor closely
  2. Call emergency services if breathing is compromised or person is completely unresponsive
  3. Do not leave alone — aspiration risk if they vomit while incapacitated
  4. Keep the environment quiet and non-stimulating until the person recovers
Test Your Substances

Drug Testing Kits

Drug testing kits use chemical reagents that produce distinctive colour reactions when mixed with a small sample. They can identify the primary compound and detect certain dangerous adulterants — particularly fentanyl, which has caused thousands of overdose deaths due to its presence in non-opioid drug supplies.

Essential Test Kits

  • Fentanyl Test Strips (BTNX): Simple paper strips that detect fentanyl in samples dissolved in water. Should be used for every opioid supply and any supply where opioid contamination is possible (including counterfeit pills, MDMA, and cocaine). Resource: DanceSafe Testing Strips
  • Reagent Testing Kits (Marquis, Mecke, Mandelin, Simon's): Identify MDMA, amphetamines, opioids, and research chemicals. A full reagent kit set costs under $50 and provides dozens of tests. Resource: Bunk Police
  • Cocaine Testing Kits: Detect levamisole (a common cocaine adulterant linked to immune system damage) and other dangerous cutting agents.

Limitations of Testing

Reagent tests identify the presence or absence of certain compounds but cannot determine purity or exact concentration. A negative fentanyl test does not guarantee safety — very low concentrations may not trigger a positive result. Testing reduces risk; it does not eliminate it.

Drug Checking Services: In some jurisdictions, free drug checking services operate at festivals and via mail. The Loop (UK) and DanceSafe (US) provide on-site spectrometry testing at events.

Get Help

Harm Reduction Resources & Crisis Lines