Taking care of your mate on their first trip or pill

Professor Adam R Winstock

Founder & CEO, Global Drug Survey

A friend tells you they want to try a drug for the first time and asks you to get them some LSD or MDMA for example. What should you do? If you agree to their request, we think you should take responsibility for your decision.

A person’s first drug experience can be particularly risky. The risks are likely to be higher if they are alone, know little about the drug, the dose to take and its effects. First time drug use is also riskier if a person has already drunk alcohol or taken other drugs.

You cannot reduce the risk to zero, but by ensuring someone is informed and in a safe space with good people, you can help your mates avoid some of the harms. Know that there are some people for whom drugs are never a good idea. For others there may be points in their lives when using certain drugs at that time could also be considered unwise.

If you are worried that drugs might be a bad idea for that person, then you should share your concerns with honesty, compassion and gently refuse. Of course, if they still take the drug you can be present and take care of them, but you don’t have be the one to facilitate it.

You should ever encourage anyone to take a drug but if they decide that’s what they want to do, then the more they know about what they are taking, how to take it and with you as their mate knowing what to watch out for, the safer we believe they will be. We hope this information can be used to increase awareness about the potential risks of first time use, in order to reduce negative outcomes.

If you would like to find out about harm reduction strategies most commonly adopted by people who use drugs around the world, check out the Global Drug Survey Highway Code – the guide to safer, more enjoyable drug use.

Your role is to help keep your mate safe. Here’s how.

KNOW STUFF: Make sure your mate knows lots about the drug they are planning on taking. If you don’t know the basics like how it might make you feel, dose, how long it takes for the effect to start, how long before it peaks and how long it will be before you feel back to normal, then don’t bullshit but together do some research and talk to other friends who have used it. Find stuff out and know about your drug.

STICK WITH THEM: People should not try a drug for the first time on their own. Ideally, you’ll be a trusted friend who has tried this drug before and also knows your mate well. It’s far from ideal to take a drug with a bunch of other people who have never tried it either. If something does occur and all of you are intoxicated there’s no one about sort things out. If there’s a group of you, it can be helpful to have least one who will remain sober throughout the session. Be there to keep an eye and to answer questions about the drug experience (e.g. ‘do you know how much I love you man…?’). Just knowing you are there can offer huge reassurance to your friend. You are the best harm reduction your mate has, so stick with them. If you’re at a festival, make sure they te;l you if they want to go for a walk, or better still go with them. If they’re not at home, then know where they’ll be spending the night and how you’ll get them there.

CHECK IN WITH THEM: You’ll probably spot when your mate is coming up or is watching a dancing matchbox, or if they look really ill. You won’t always know what is going on inside their head though, check in with them regularly during the course of the night.

USE SOLO: Advise your friend not to drink alcohol or use any other drugs that day, especially before they try the new drug. Most people who end up seeking Emergency Medical Treatment tend to have been drinking alcohol and using other drugs. When taking MDMA or LSD for the first time we suggest that it is definitely best (and most safely) enjoyed, at least on that first occasion, on its own. Having other drugs in your system – especially alcohol – can make it difficult to assess the effects of a new drug and can sometimes increase the risk of unpleasant effects. Other stimulant drugs can overstress your system leading to anxiety, panic and overheating. And of course, it will confuse your mate’s assessment of what the drug they’re taking itself is actually like.

DRUG QUALITY: Know as much about your drug and as far as possible trust the source. Although most pills and powders sold as MDMA and LSD do contain MDMA and LSD, that’s not always the case. Having your drugs tested is a good idea but know that many forms of testing can’t tell you how much of the drug is in a pill or tab and often don’t detect mixed drugs accurately. Services like The Loop, Energy Control or Checkit! use sophisticated technology and provide robust, personalised information and great advice. In the UK anyone can send their drugs to get tested at WEDINOS. If you can’t get your drugs tested then try to make sure what your friend is taking is from a batch that has previously been used with a positive review by someone you know and trust, who is experienced and knows what they are talking about (not everyone who says they know, does!). But also know that people respond to drugs differently, so just because one person was alright on a particular drug there is no guarantee the next person will be.

THE LAW. Supplying someone with drugs is an offence. Many drugs are illegal to possess and in many countries, an additional law is broken if you supply another person with a drug (and the legal punishment can be costly). If something did go wrong, then you may also may be held liable for any injury they incurred. Anyway, just thought we’d mention it…

DOSE LOW(ER): Start lower and go slower than someone who has used the drug before and discourage redosing (or at least until after they have peaked from the of the first dose). Because this person has no tolerance to the drug and is unware of exactly how it might make them feel, they should probably start off using a lower initial dose that perhaps you as a more experienced drug user would take. If in doubt, aim low. Less than half of first time users reported taking a test dose. We think everyone should. That first small dose may only provide a mild introduction to what the drug effect may be like, but taking it cautiously that first time will help to reduce the risk of unwanted negative effects. Redosing too early or taking too big a dose initially are common mistakes among novice users and redosing too early can lead to worsening negative effects rather than increased pleasure.

GET FED AND WATERED FIRST: Make sure your mate has had a good meal earlier in the day and if it’s a stimulant drug they are planning on taking (for example MDMA) keep them well hydrated and advise them to avoid alcohol. Signs of dehydration include feeling dizzy and faint, but don’t push them to drink too much water either since very rarely (usually in combination with not peeing) this can lead to lowering of salt levels in your body. Do they look like they are getting really hot? Then advise them to take break from dancing, get out of the sun, loosen any tight clothing and chill as appropriate. If you are worried about them look for first aid nearby. And don’t let them drive (or get in the car with someone who is intoxicated).

BE IN A GOOD SPACE INSIDE AND OUT: Ideally your mate will feel physically and emotional well and happy in themselves the first time they take a drug like LSD or MDMA. Most drugs tend to lead a person’s brain in the direction it was pointing before they took the drug. Niggling doubts, worries or fear can become amplified. The time to try a drug like LSD or MDMA for the first time is when a person feels well, settled and happy in themselves (and with the people they are sharing the experience with). Although currently being explored for its therapeutic potential (within clinical settings), MDMA and LSD can worsen many conditions like depression and anxiety. You’re a mate not a therapist. Some people especially those with severe mental health issues would be advised against using any drug. You might want to ask about any medication they take or illnesses they have, so they can think about these issues in advance of trying a drug.

BE FREE: Make sure they don’t have any commitments coming up in the next day or so. Although most people feel pretty much back to normal within 24 hours of taking MDMA, some people do get bad comedowns normally kicking in 1-2 days after the day of use. Let them know that if it’s a stimulant drug then they may have difficulty falling to sleep. Knowing you have nothing to do in the next few days can be reassuring during a person’s first drug experience and can give them a bit more internal comfort space. Remember MDMA can make it difficult to sleep and in the days afterwards it is normal to feel tired and a bit emotional.

TELL ME: Make sure your mate knows that if they feel unwell or are simply just unsure about something then they should let you know. You may well know from your own experience how odd it can feel when a new drug effect starts creeping up on you. What you know as normal may be totally unexpected to someone who has never used that drug before. Feeling a little sick (or even throwing up) can be a normal part of the MDMA experience when you are coming up. It passes quickly and shouldn’t be a cause of worry. Feeling a bit sweaty and noticing your heart racing can also be part of a normal MDMA experience, like feeling more talkative and emotionally attached to those around you. Your body can look distorted on LSD or you ‘see sounds’ – these are all quite typical of the drug’s effect. But feeling anxious, very restless, really hot, confused or being unable to communicate clearly are not normal and might signal that something is up. People can get confused, frightened and sometimes very agitated. Although in many cases these feelings pass, very rarely they can indicate something more serious is up. If in doubt, getting them checked out by first aiders or emergency medical services is the safest thing to do. If someone fits, is acting in way that might place them or others at risk or is unarousable or if you are simply just worried about something, then the safest thing to do is to call the emergency services on 999 (or the equivalent).

NO RUSH: Plan ahead and if in doubt, delay. Although spontaneous initiation into a new drugs experience can be exciting, it appears most people do plan ahead and do their homework (see points 1-9). Before someone takes MDMA or LSD for the first time you should encourage them think about where they will be, who they will be with, what they’ll be doing and check that they are in a good headspace. If on the day it just doesn’t feel right (or if something is troubling them elsewhere) then encourage them to hit the pause button and know that it’s not now or never, and that there’ll be another chance.

GDS is very clear that the only way to avoid drug related risk to zero is not to use drugs. This is the choice that the majority of people take in every population.

Share