Emergency

Overdose signs

• Most difficulty is psychological (intense fear, panic, confusion) and passes with calm support — the signs below mean seek emergency help:
• Very high body temperature; hot, dry skin
• Seizures
• Chest pain; fast or irregular heartbeat
• Severe muscle rigidity, tremor, or twitching (possible serotonin syndrome)
• Cold, pale, or blue fingers/toes — severe vasoconstriction (notably NBOMe / DOx)
• Persistent vomiting; unconsciousness; uncontrollable agitation or risk of self-harm

First response

• Stay calm and reassure — remind them they took a drug and the effect will pass
• Move to a calm, quiet, safe space with low light; reduce noise and sensory input
• Keep them from harm — they may act on fear or confusion; stay with them, don't leave them alone
• Talk them down gently; don't grab or restrain unless they're in danger
• For the medical signs above (overheating, seizure, chest pain, vasoconstriction, unresponsive) call emergency services
• If overheating, cool the body; be ready to give rescue breaths / CPR

For the medical team

Tell the dispatcher what was taken, how much, and when — note if it was a strong or unknown blotter (NBOMe risk) or mixed with stimulants, MAOIs, or antidepressants (serotonin syndrome). Most psychedelic emergencies are psychological, but hyperthermia, seizures, severe vasoconstriction, and serotonin syndrome are genuine medical emergencies.

Resolution

The experience is time-limited and usually resolves with calm reassurance in a safe setting — psychological first aid, not medication. Serious physical harm is uncommon for classic psychedelics (LSD, psilocybin) but real for some potent phenethylamines (NBOMe, DOx), where hyperthermia, seizures, and vasoconstriction warrant emergency care.

Every recorded risk