Session Companion
For when you’re sitting with someone, or on your own: how long it has been, where the session is in its arc, when not to take more, and who to call.
Start the clock when it’s taken.
Pick what was taken, then tap “Taken just now” as soon as it’s taken. Everything after that is worked out from the time.
DMT needs a sober sitter in the room. For several minutes the person who took it can’t move, speak or keep themselves safe.
5-MeO-DMT needs a sober, experienced sitter. Alone, nobody can turn the person onto their side or keep their airway clear.
Ibogaine belongs in a clinic with continuous cardiac monitoring and someone able to treat an arrhythmia. Without that, nobody is there if their heart goes wrong.
Salvia needs a sober sitter within arm’s reach. People stand up and walk without knowing they took anything.
These go into the summary to read out if you call for help.
Pick what was taken first.Pick how it was taken first.
A time later than now counts as yesterday, unless it’s within the next hour.
That time hasn’t come yet.Check that time.
An educational tool, not medical advice. If anything looks like an emergency, call emergency services first, then come back to this.
Get help fast
Get help fast if: severe overheating, confusion, or muscle rigidity.
Get help fast if: high fever, rigidity, or racing heart — possible serotonin syndrome.
Get help fast if: unresponsive or vomiting while sedated — recovery position, then call.
Get help fast if: any chest pain, fainting, or irregular heartbeat.
- Is unresponsive, or you can't wake them
- Is having a seizure
- Has chest pain, difficulty breathing, or a dangerously fast or irregular heartbeat
- Is severely overheating (hot dry skin, confusion, collapse), common with MDMA
- Shows signs of serotonin syndrome: agitation, muscle rigidity or twitching, high fever, racing heart
- Is a danger to themselves or others and cannot be de-escalated
Tell them exactly what was taken, how much, and when.
(), amount not noted, taken at , ago. Other drugs or medication: none entered. Took more: noyes, at .
Their job is treatment, not enforcement, and knowing the substance can change what treatment is safe. Most US states and all of Canada have Good Samaritan laws that protect people who call for help during a drug-related emergency from simple possession charges.
Hard, but not an emergency
Fireside Project, Psychedelic Support Line
62-FIRESIDE (623) 473-7433 Text insteadFree, confidential peer support by phone or text, daily 11am–11pm PT. Fireside supports sitters too. Not an emergency service.
If it gets hard
Most difficult psychedelic experiences are not medical emergencies. They are intense psychological states, and they resolve with time, reassurance, and a safe container. If the person is physically stable, the goal is not to stop the experience but to help them move through it.
For MDMA
- Heat is the danger. Take breaks somewhere cool before they feel needed.
- Water: roughly 500 ml an hour if they are active and dancing, much less sitting still. Drinking large amounts out of fear has killed people.
For DMT
- Take the pipe out of their hands as soon as they’ve inhaled, and say nothing unless something is wrong. A dropped lit pipe is the most common way DMT causes an injury.
- They need to be sitting on the floor or lying down before they inhale. People stand up during onset, and they fall.
- Clear anything hard they could roll into.
For 5-MeO-DMT
- They need to be lying down on a floor or mat before taking it, not on furniture.
- Stay where you can turn them onto their side and keep their airway clear. The physical danger is vomiting while unresponsive and on their back.
For Ketamine
- They should be lying down before it comes on. The injuries to plan for are falls and vomiting while dissociated.
- Never alongside alcohol, opioids or benzodiazepines: together they can stop someone breathing properly.
For Ibogaine
- A flood dose means a day or more of being unable to stand, with vomiting. Walking unaided isn’t safe.
- The heart risk runs through most of it, well after the visions. Chest pain, fainting or an irregular heartbeat is an emergency at any point.
For Salvia
- Stay within arm’s reach. Take the pipe, keep them seated, and stop them going anywhere.
- Don’t talk to them during the peak. They won’t be able to make sense of it, and the attempt is often distressing.
- Stay calm and stay present. Your nervous system is the intervention. Speak slowly, softly, and simply.
- Reassure without arguing. Use the words below. Don’t debate the content of the experience.
- Change the setting, not the person. Lower the lights, change the music or turn it off, move somewhere quieter, offer water or a blanket.
- Don't restrain or corner them. Keep pathways clear and hazards away. Physical restraint escalates panic.
- Encourage surrender, not resistance. Breathe slowly, and let them match you.
Words that help
After the peak
“You took a psychedelic. This is temporary. You are safe. I’m staying with you.”
“You don’t have to fight it. Let it move through you. Breathe with me.”