Emergencies can happen when using drugs. Safer use helps to make emergencies less likely. However, accidents can never be completely avoided. On this page you will find information and tips on emergency situations that can occur in connection with substance use.
This information is intended as a preliminary guide to help you deal with an emergency. However, they are no substitute for trainings where you can practice first aid.
First aid is always administered according to symptoms. Whether a person has got into an emergency situation due to drug use is not relevant for first aid
In a club or bar, you can always approach the staff or awareness if someone needs help. In private settings, for example at chill-outs, guests are usually dependent on mutual assistance.
Important: Never add more substances to people who are unwell. Additional substances always lead to additional stress on the body, even if they seem to have opposite effects. If you give an overdosed person more substances, in the worst case you risk being held liable for killing them through negligence.
How to act in an emergency
If possible: Ask someone nearby to help you. There may also be awareness or staff you can ask for help.
Is the person conscious?
If they are not awake: Can you wake them? Try to wake the person:
- Address them clearly.
- Grab them by the shoulder and shake them.
- If necessary, pinch their neck muscle (pain stimulus)
Awake / conscious
- Keep the person awake.
- Talk to the them: “How are you feeling? Do you need anything?”
A. Person reacts appropriately
Do they know, who and where they are? Are they in touch with reality? Try to render or organize help according to the situation. Try to make the environment as safe as possible for them.
B. Person is disoriented
Are they out of touch with reality? (psychotic state)
This may be a mental health emergency: if the person is endangering themselves and/or others or is so distressed that they need medical help.
Create a safe environment: Provide a safe, stress-free environment for the person. Anything that makes them feel safer, more relaxed, less watched will help. For example, the presence of friends or familiar people can have a calming effect. It is important to involve the person and offer choices – if someone feels trapped and has no choice, this will only make their condition worse.
Show understanding: Listen to the person and show understanding. If the person expresses threatening impressions that have no connection to reality: Do not argue confrontationally against them (“That’s not true at all”). But say that you do not perceive it that way and do not recognize any threat. Express understanding for the fact that this situation must be frightening and stressful.
Look for their crew: Ask the person which close people could accompany them home. If possible, have one of their friends pick them up and take them home so they can wind down and get a good night’s sleep. Stay with the person until their friend/relative arrives.
4. Emergency / Danger? If the person is very distressed or in danger of hurting themselves or others: Ask someone to call 112. (In the club: ask another person to inform staff/awareness) This may cause or increase anxiety. Stay with the person until help arrives.
More information on psychosis in chemsex settings
Not wakeable / unconscious
1. Ask another person to call 112.
(In the Club: Ask another person to inform staff/awareness)
2. Check whether they are breathing:
- Hold your cheek close to the person’s mouth and nose.
- Watch the person’s chest and stomach area for movement.
- Place your hand on the person’s chest.Lege deine Hand auf den Brustkorb der Person.
A. Breathing normally
- 1. Place them in the recovery position.
- 2. Stay with the person and observe their breathing until the emergency services arrive.
B. Not breathing or breathing abnormally*
*Hard and noisy breathing (gasping or snoring) / slow breathing (less than 10 breaths per minute) / shallow breathing (no movement in the chest, breaths only faintly palpable)
- Start CPR (cardiopulmonary resuscitation: 30x chest compressions, 2x artificial respiration). You can be accompanied by the emergency services (112) by telephone. Note: Continuous chest compressions are sufficient if you are unable to give the person artificial respiration – e.g. if the person has vomited or you feel very nauseated.
- Ask another person to support you by taking turns.
- If available: Use a defibrillator.
- Continue providing CPR until the emergency services arrive.
Calling 112
Important: 112 should always be called for an unconscious person. As soon as a person is unconscious, they are a “black box”. This means that you cannot know what is happening in their body (e.g. heart attack or stroke) without medical equipment.
Wenn du die 112 rufst, reicht es, am Telefon den Zustand der Person zu beschreiben. Emergency responders don’t care whether the drugs that have been used are legal or not. They are there to provide medical assistance in an emergency. As a rule, the police are only called if the person poses a danger to others or themselves. If you are worried that the police might come along, you can inform the emergency services in person about the drug use after they have arrived on the scene.
If the situation does not turn out to be an emergency after all, you will not have to bear any consequences for the operation.
After the emergency
Substance mixup?
Are you suspecting that something is off with the drugs you or your friends have taken? At Drugchecking Berlin, you can have your substances analyzed anonymously and free of charge and also receive advice.
Spiking?
Do you think you may have been a victim of spiking or sexual assault?
- You can have your injuries examined and documented by a forensic doctor free of charge and without having to report them to the police at the violence protection outpatient clinic.
- You can get help at specialized counselling centres. The counselors will listen to you and work with you to see what you can do in your situation. LGBTI counseling centers on violence in Berlin:
Further support services for (sexual) violence in Berlin
Risk of infection?
Was there sexual contact before or during the emergency situation that could have resulted in HIV infection?
If you suspect that HIV may have been transmitted, you can get post-exposure prophylaxis (PEP). This is an emergency medication that you can use to prevent HIV infection after sex. You need a doctor’s prescription for PEP. The PEP takes effect within the first 72 hours after the risk contact and is taken daily over a longer period of time. The sooner you take it, the better it works. You can find an overview of PEP centers in Berlin here.
Possible pregnancy?
If the possibility of pregnancy applies, you can buy the morning-after pill at the pharmacy. The morning-after pill is an emergency medication that you can use to prevent pregnancy. You can get it without a prescription. The pill works within the first 72 hours after sex. The sooner you take it, the better it works.
Drüber reden?
Are you looking for someone to talk to about what happened?
https://sidekicks.berlin/beratung-drogen-chemsex/
Further information
This information is an initial guide for emergencies. It is not a substitute for a first aid training course where you have the chance to practice.
Further information on first aid for drug emergencies (e.g. bad trip, seizure, heat stroke,…) can be found here (german).