7-Hydroxymitragynine (7-OH)

If it’s too intense

If an experience becomes overwhelming, the goal is to stay safe and let it pass — most difficult experiences ease as the drug wears off.

• Get to a calm, safe space with someone you trust who is sober and can stay with you.
• Cool down if you’re overheating — move somewhere cool, remove extra layers, rest. Overheating is especially a risk with stimulants and MDMA.
• Sip water to thirst — but don’t over-hydrate. Drinking large amounts of plain water (especially after MDMA) can dangerously dilute your blood sodium (hyponatremia). Electrolytes help more than volume.
• Slow your breathing — long, slow exhales help settle a racing heart and anxiety.
• A sugary drink, fruit juice, or a snack can ease shakiness and the anxiety that comes with low blood sugar.
• Do not take more, and do not add another substance to manage it. Redosing or adding something else (including a sedative like a benzodiazepine) can make things worse, not better.

With opioids, slowed or stopped breathing is the emergency — if available, give naloxone and call 911 immediately; it can be given while you wait for help.

Source: general harm-reduction guidance from SAMHSA, NIH/NIDA, and MedlinePlus, in our own words. Draft — not yet medically reviewed.