What to do if someone is having a difficult experience — practical guide
88 replies · Harm Reduction
One of the most important harm reduction topics: what do you actually DO if you're sober and someone in your group is having a crisis experience? Not theoretical — what are the practical steps, what do you say, what do you avoid doing, and when do you call emergency services?
Core principles from trained trip sitting: (1) Stay calm — your state is contagious. (2) Reduce stimulation — quiet space, dim lights, remove other people if possible. (3) Ground them with gentle physical contact if they consent — hand on shoulder or hand. (4) Use simple, present-tense language: 'You are safe. I am here. This will pass.' Don't try to talk them out of the experience, argue with their perceptions, or tell them what they're feeling is wrong. (5) Don't leave them alone. (6) The experience has a biological end — maximum intensity rarely exceeds 2–3 hours.
When to call emergency services: (1) Physical danger to self or others that you cannot manage. (2) Loss of consciousness. (3) Seizure. (4) You believe they consumed something other than psilocybin (especially if behavior is erratic in a way inconsistent with psychedelics). For psychological crisis only — difficult experience, fear, confusion — EMS is usually not warranted and can escalate the situation. Fireside Project (62-FIRESIDE) provides real-time phone support for trip crisis situations and is specifically trained for this.
Benzodiazepines (Valium, Xanax, Ativan) will significantly reduce or end a psilocybin experience by a GABA-A mechanism. If someone consented to having a 'trip kill' available, this is the appropriate use. Don't administer benzos to someone without their prior explicit consent and knowledge. Antipsychotics are not appropriate for uncomplicated psychedelic crisis — they can worsen the physical experience.
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