Risk tiers below are taken directly from the classification already stated on each substance's own combinations page (its "Use Caution", "High Risk", or "Avoid Entirely" heading) — this matrix does not add any new interaction claims. Click a substance name or "Details" to read the full mechanism, harm-reduction guidance, and emergency-help notes for that combination.
| Substance | Risk Tier | Basis (from substance page) | Details |
|---|---|---|---|
| Lithium | 🚫 Avoid Entirely | Dangerous — avoid entirely | Details → |
| MAOIs | 🚫 Avoid Entirely | Dangerous — serotonin syndrome risk | Details → |
| Tramadol | 🚫 Avoid Entirely | Dangerous — seizure and serotonin syndrome risk | Details → |
| Stimulants | 🚫 High Risk | Cardiovascular stress | Details → |
| MDMA | 🚫 High Risk | Neurotoxicity and overwhelming effects | Details → |
| Cocaine | 🚫 High Risk | Cardiovascular stress | Details → |
| Opioids | 🚫 High Risk | Respiratory depression + impaired judgment | Details → |
| Ketamine | 🚫 High Risk | High complexity — two reality-altering mechanisms stacked | Details → |
| SSRIs | ⚠️ Caution | Blocked effects — do not stop unsupervised | Details → |
| Cannabis | ⚠️ Caution | Unpredictable intensification | Details → |
| Alcohol | ⚠️ Caution | Generally discouraged | Details → |
| Antipsychotics | ⚠️ Caution | Moderate risk — blocked effects, underlying condition matters most | Details → |
| Beta-Blockers | ⚠️ Caution | Situational — generally compatible, discuss with your prescriber | Details → |
| ADHD Medications | ⚠️ Caution | Discuss with your prescriber, don't decide alone | Details → |
| Caffeine | ✅ Lower Risk | Generally well tolerated | Details → |
| CBD | ✅ Lower Risk | Limited data, generally considered mild | Details → |
| Benzodiazepines | ✅ Lower Risk | Sometimes used as a "trip killer" | Details → |
| NSAIDs | ✅ Lower Risk | Mainly a GI-comfort consideration | Details → |
⚠️ Medical Disclaimer
This matrix is for educational and harm-reduction purposes only and does not constitute medical advice. Risk tiers summarize the classification already published on each substance's own combinations page — always read the full page for mechanism, dosing, and emergency guidance before acting, and consult a qualified physician or pharmacist before combining any substance with a prescription or over-the-counter medication.