NARCØDEX
◈HARM REDUCTION PRINCIPLES/ HR-00
UNIVERSAL

Harm reduction accepts that people use drugs, and focuses on reducing the harm that use can cause. The principles below apply across almost every psychoactive substance. They are not permission to use. They are a floor of safety for the people who will use anyway, and a way to recognise a medical emergency early.

Evidence-basedNon-judgementalNot medical advice
◈START LOW · GO SLOW/ 01
  • · Take a small test dose first, especially with a new substance, new supply, or after a break.
  • · Wait for the full onset before redosing. Many overdoses happen when someone assumes "nothing is happening" and doubles up.
  • · Tolerance drops fast after a break. A previous "normal" dose can become an overdose after two to three weeks off.
  • · Potency between batches is unpredictable in unregulated markets. Milligram-scale substances need a milligram-scale scale.
◈TEST YOUR SUPPLY/ 02
  • · Reagent kits (Marquis, Mecke, Mandelin, Ehrlich, Simon's, Froehde) confirm or rule out common substances.
  • · Fentanyl test strips can detect fentanyl and many analogues in a small dissolved sample. They do not detect nitazenes reliably.
  • · Where available, drug checking services (spectrometry) give the most accurate picture of what a sample contains.
  • · A single test does not prove purity or dose. It only rules out the most dangerous adulterants it can detect.
Open reagent guide →
◈DO NOT MIX/ 03

The most predictable driver of overdose deaths is combining substances. Especially:

  • · Opioid + benzodiazepine · leading cause of respiratory arrest.
  • · Opioid + alcohol · same mechanism, same outcome.
  • · Depressant + depressant · alcohol, GHB, benzos and pregabalin stack unpredictably.
  • · MAOI + serotonergic drug · MDMA, tramadol, SSRIs, DXM, 5-MeO-DMT can trigger fatal serotonin syndrome.
  • · Stimulant + stimulant · massive cardiovascular strain, hyperthermia, seizure risk.
Open interaction checker →
◈DO NOT USE ALONE/ 04
  • · Someone sober should know what you took, when, and be able to check on you.
  • · For opioid use, the Never Use Alone line (US: 1-800-484-3731) stays on the phone with you.
  • · If you must use alone, tell a trusted person, unlock the door, and set a check-in time.
  • · A friend who can call emergency services and start rescue breathing is the single strongest predictor of surviving an opioid overdose.
◈CARRY NALOXONE/ 05
  • · Naloxone (Narcan) reverses opioid overdose in minutes. It is safe, has no effect on people not taking opioids, and is available free or low-cost in most regions.
  • · Carry it if you use opioids, if you use any street powder or pressed pill (fentanyl contamination is now near-universal), or if someone you love does.
  • · Give one dose, call emergency services, start rescue breathing. Give a second dose if there is no response in 2 to 3 minutes.
  • · Nitazenes and other potent synthetic opioids can need multiple doses. Do not stop at one.
◈HYDRATION AND HEAT/ 06
  • · Stimulants and empathogens (MDMA, methamphetamine, cathinones) impair thermoregulation. Overheating kills faster than the drug itself.
  • · Aim for about 500 ml water per hour if dancing or exerting; less if sitting still. Overhydration on MDMA can trigger hyponatraemia (fatal brain swelling), so do not chug water without sweating.
  • · Take breaks in a cool space. Notice if you have stopped sweating · that is a medical emergency.
◈SET AND SETTING/ 07
  • · Psychedelics and dissociatives are heavily shaped by mindset and environment. Anxiety, sleep deprivation and unresolved trauma amplify difficult experiences.
  • · Be somewhere physically safe. Sitters help. A phone with a trusted contact reduces panic.
  • · Family history of psychosis, bipolar disorder or schizophrenia is a strong reason to avoid classic psychedelics and cannabis.
◈DO NOT DRIVE/ 08
  • · Almost every psychoactive impairs driving, even those that feel "clear-headed" (stimulants, cannabis, benzodiazepines).
  • · Effects can outlast the subjective high, especially after-effects and residual effects listed on each substance page.
  • · Blood, saliva and hair testing detects use for hours to months. Consult local roadside testing law.
◈SPACE OUT USE/ 09
  • · Frequent redosing drives dependence, tolerance and neurotoxicity risk (especially with amphetamines, MDMA and dissociatives).
  • · MDMA is best kept to a maximum of once every 6 to 8 weeks to reduce neurotoxicity risk.
  • · Daily benzodiazepine or opioid use produces physical dependence in days to weeks and unsupervised cold-turkey withdrawal from benzos or alcohol can be fatal.
◈RECOGNISE AN EMERGENCY/ 10

Call emergency services if you see:

  • · Slow, shallow or stopped breathing · blue lips · unresponsive to a sternal rub (opioid overdose).
  • · Seizure lasting more than 5 minutes, or repeated seizures.
  • · Body temperature over 40 °C, dry hot skin, confusion (heat stroke).
  • · Sudden severe chest pain, one-sided weakness, slurred speech (cardiac or stroke event).
  • · Rigidity, tremor, fever and confusion after serotonergic drugs (serotonin syndrome).
  • · Uncontrolled agitation, hyperthermia and paranoia after stimulants (excited delirium).
  • · Persistent vomiting with inability to keep fluids down, or vomiting while unconscious.

In most jurisdictions, good-samaritan laws protect the caller and the person overdosing from drug possession charges. Call.

◈THIS PAGE IS NOT MEDICAL ADVICE/ END

NARCØDEX is an educational reference. If you are worried about your own use or someone else's, please talk to a doctor, a licensed harm reduction service, or a drug helpline. For per-substance detail (dose, duration, interactions, first aid), open that substance's page from the database.