Drug emergency - recognise, act correctly, find help

What is a drug emergency?

A drug emergency occurs when the consumption of substances leads to life-threatening physical or mental conditions. This can be an overdose, but also dangerous interactions, allergic reactions or physical complications such as overheating or circulatory collapse.

Typical emergency situations are

• Overdosing: Especially with opiates, downers or stimulants.
• Mixed consumption: Dangerous combinations such as downer + alcohol or poppers + Viagra.
• Physical reactions: Overheating with MDMA/speed, circulatory problems, seizures.
• Mental health crises: Panic attacks, psychoses, aggression.
• Allergic reactions: Through substances or extenders.

A drug emergency can also affect experienced users - due to contaminated substances, the wrong dose or unpredictable physical reactions.

Drug-related behavioural problems: Recognising warning signs early

There are often warning signs before a real emergency arises. If you recognise them, you can react early and prevent the worst from happening.

Physical warning signs:

• Heavy sweating or freezing
• Dilated or narrow pupils
• Trembling, restlessness, extreme tiredness
• Nausea, vomiting, dizziness
• Palpitations or extremely slow pulse
• Confusion, unclear language
• Coordination problems

Behavioural abnormalities:

• Sudden mood swings
• Aggressiveness, paranoia
• Repetitive movements or speech
• Loss of reality, hallucinations
• Apathy, no reaction
• Panic or extreme fear

If the person is unconscious, breathing heavily or has chest pains, this is a real medical emergency. Then every second counts - call 112 immediately.

Drug poisoning symptoms - how to recognise an emergency

Opiates (heroin, fentanyl, painkillers):
Very slow breathing, bluish lips, unconsciousness, weak pulse, gurgling breath sounds.

Stimulants (cocaine, speed, crystal, MDMA):
Very high pulse, overheating, seizures, chest pain, shortness of breath, collapse.

Downer (benzos, GHB, alcohol):
Slow breathing, unconsciousness, vomiting when lying down, hypothermia, weak pulse.

Hallucinogens (LSD, mushrooms, ketamine):
Extreme panic, self-endangerment, loss of reality, circulatory problems.

Mixed consumption:
Superimposed symptoms - e.g. breathing problems despite high activity, unconsciousness with palpitations.
When in doubt: always call 112.

Drug emergency: What to do?

1. assess the situation:
Is the person responsive? Are they breathing normally (12-20 breaths per minute)? Check pulse.

2. call 112 immediately:
Say „drug emergency“ or „suspected overdose“.
Give address and symptoms, specify substances (if known), stay on the line.

3. provide first aid:

• Unconsciousness → Stable lateral position
• Shortness of breath → open tight clothing, improve air supply
• Overheating → cool with damp cloths
• Seizures → nothing in the mouth, do not hold on, secure surroundings

4. use naloxone (for opiates):
Head slightly backwards, spray into one nostril, press firmly. Repeat after 2-3 minutes if no improvement. Nevertheless, call 112 - naloxone only works for 30-90 minutes.

5. until help arrives:

• Stay with the person
• Check breathing
• Speak reassuringly
• Have substances ready
• Be honest - doctors have a duty of confidentiality.

Do not do this:
No coffee, no cold showers, do not induce vomiting, do not give any other substances, do not leave the person alone.

FAQ - Frequently asked questions about drug emergencies

A drug emergency can happen suddenly - even for experienced users. Here you will find answers to frequently asked questions about symptoms, first aid and legal safety.