When should I call emergency services during a difficult psychedelic experience?

Call 911 immediately if the person loses consciousness, has a seizure, develops chest pain, stops breathing, has a temperature above 104°F, or becomes violent. For psychological distress without physical symptoms, use grounding techniques and contact the Fireside Project (62-FIRESIDE) for peer support before escalating to emergency services.

What if the person in crisis refuses help?

If the person's capacity for judgment is clearly impaired and the risk to their safety is high, their welfare takes priority. Stay with them, call the Fireside Project for guidance, and contact emergency services if physical danger is present. Do not leave someone alone in a severe psychological crisis.

Can I text for crisis support during a psychedelic emergency?

Yes. The Fireside Project Psychedelic Support Line accepts texts at 1-415-658-5883. The Crisis Text Line (text HOME to 741741) also provides confidential support via text. These options are useful when calling is difficult or when the person in distress needs quiet support.

How do I support someone after a difficult psychedelic experience?

After the acute phase, encourage integration support: journaling, talking with a trusted person, or working with an integration therapist. Allow rest, avoid stimulants, and check in regularly in the days following. Normalize the experience without minimizing it — many difficult trips carry meaningful content that benefits from reflection.

Is sedation with benzodiazepines appropriate for a crisis?

Benzodiazepines (such as diazepam or lorazepam) can reduce the intensity of a psychedelic experience and should be reserved as a last resort — when someone is at risk of harming themselves or others, or after grounding techniques have failed over an extended period. Premature sedation can interrupt potentially meaningful experiences and may leave unresolved distress.

Crisis Support Resources

Crisis Hotlines

24/7 crisis hotlines, support lines, and immediate help resources for mental health emergencies.

Emergency Procedures

Step-by-step emergency procedures for various crisis situations and when to seek immediate help.

Support Resources

Comprehensive list of support resources, organizations, and services available for crisis situations.

Mental Health Crisis

Specific information about mental health crises, recognizing warning signs, and getting appropriate help.

Get Help Fast

Use this directory when minutes matter. Each linked page contains country-specific numbers, de-escalation scripts, and guidance for supporting someone until professionals arrive.

What to Do First

Assess immediate safety: remove hazards, check for self-harm risks
Call appropriate hotline or emergency services; stay on the line
Use calm tone, simple questions, and grounding prompts
Do not leave the person alone during acute crisis

Key Info to Gather

Location, contact number, and any nearby landmarks
Substances taken, timing, and current symptoms
Medical conditions, medications, and allergies if known
Trusted contact who can help coordinate or meet responders

Hotlines Emergency steps Support resources Mental health

Recognising a Genuine Crisis vs. a Difficult Experience

Not every intense or frightening psychedelic experience constitutes a clinical crisis. The vast majority of difficult trips — fear, grief, confusion, ego dissolution — resolve safely with grounded sitter support. A genuine crisis requiring immediate intervention has one or more of these features:

Loss of consciousness, seizures, or irregular breathing
Chest pain, extreme hyperthermia (above 39°C / 102°F), or signs of serotonin syndrome (muscle rigidity, clonus, confusion together)
Violent behaviour toward self or others
Persistent psychotic symptoms continuing more than 24 hours after the experience has ended
Suicidal ideation with plan or intent, not just passive existential thoughts

Immediate Response Priorities

Physical safety first: Remove tripping hazards, lock away sharp objects, ensure the person cannot access vehicle keys or heights
Stay present: A calm, grounded sitter reduces crisis severity significantly — do not leave the person alone
Speak slowly and simply: Short sentences, reassuring tone. Avoid arguing about the reality of their experience
Grounding anchors: Offer cold water, suggest slow breathing, use a familiar scent or texture, place feet flat on the floor
Know when to escalate: If physical symptoms appear or verbal de-escalation fails after 30–45 minutes, call emergency services

De-escalation Phrases That Help

"You’re safe. I’m here and not going anywhere."
"This is temporary. The substance will metabolise and this will pass."
"You don’t have to talk — just breathe with me."
"Can you feel your feet on the floor? Press them down."
"Let’s step outside for some air" (if the environment is triggering)

Avoid: "Calm down," "It’s just a drug," detailed questions about the content of their visions, or expressing your own anxiety about the situation.

Aftercare (24–72 Hours)

After the acute phase: prioritise sleep and hydration. Avoid alcohol, cannabis, and stimulants for at least 48 hours. Schedule a follow-up check-in. If the experience was severe, connect with an integration therapist or the Fireside Project for peer support. Normalise processing time — some people need days to weeks to integrate a difficult trip.

Privacy & Disclosure

When contacting emergency services about a psychedelic crisis, share only medically relevant information (substance ingested, timing, current symptoms). In most jurisdictions Good Samaritan laws protect callers from prosecution when seeking help for a drug-related emergency — check your local law, but do not let fear prevent you from calling for help.

Peer & Specialist Support

Fireside Project (US, 623-473-7433): psychedelic-specific peer support, free and confidential. Zendo Project: harm reduction presence at events. TripSit online chat: real-time drug information and peer support. These specialists understand the psychedelic context and will not escalate unnecessarily.

FAQ

When do I call emergency services? If there is self-harm risk, violent behaviour, loss of consciousness, signs of cardiac or neurological distress, or if psychological symptoms persist beyond 24 hours after the experience ends.
What if they refuse help? Stay present and keep the environment safe. If the person is clearly unable to make safe decisions and physical danger is present, their welfare takes priority over their preferences. Contact emergency services if you cannot safely manage the situation.
Can I text instead of call? Yes — the Fireside Project accepts texts at 1-415-658-5883, and the Crisis Text Line (text HOME to 741741) is available in the US. UK options include text 85258 (Shout). Texting is useful when a voice call is disruptive to the experience.
Is benzodiazepine sedation ever appropriate? Only under medical supervision, as a last resort when verbal de-escalation has failed and the person is at risk of harming themselves or others. Premature sedation can leave difficult psychological content unresolved and impair integration.
How do I support someone after a difficult experience? Allow rest without forcing conversation. Offer food, warmth, and quiet. Check in daily for the first 72 hours. Encourage professional integration support if the experience was significantly distressing. Avoid minimising — acknowledge that it was hard, and that processing takes time.