Harm Reduction Guide — Safety Principles and Substance Information

What Is Harm Reduction?

Harm reduction is a public health approach that acknowledges drug use occurs regardless of legal status and focuses on minimizing associated health risks rather than requiring abstinence. Organizations including DanceSafe, The Loop, Transform Drug Policy Foundation, and national health agencies publish evidence-based harm reduction guidelines.

• Test before use. Fentanyl test strips and reagent kits (Marquis, Mecke, Simon's) identify dangerous adulterants.
• Start low, go slow. Unknown potency is the leading cause of overdose. Begin with a small fraction and wait for full onset.
• Never use alone. Have someone present or call the Never Use Alone hotline (1-800-484-3731).
• Carry naloxone. Naloxone (Narcan) reverses opioid overdose. Available without prescription at most pharmacies in North America.
• Avoid combinations. Polydrug use — especially CNS depressants — exponentially multiplies overdose risk.
• Use clean equipment. Sterile needles, pipes, and surfaces prevent disease transmission.

// OVERDOSE RESPONSE

What to Do If Someone Is Overdosing

Opioid Overdose

Signs: unresponsive, slow or stopped breathing, blue lips or fingertips, gurgling sounds, pinpoint pupils.

1. Call emergency services (911 / 999 / 112)
2. Administer naloxone immediately
3. Place in recovery position if breathing; begin rescue breathing if not
4. Repeat naloxone every 2–3 minutes if no response
5. Stay until emergency services arrive

Stimulant Overdose

Signs: racing heart, high temperature, chest pain, seizures, confusion.

1. Call emergency services immediately
2. Move to a cool environment; remove excess clothing if overheating
3. Do not restrain a seizing person — clear hazards from the area
4. Place in recovery position if unconscious and breathing

Depressant Overdose

Signs: unresponsive, slow breathing, low body temperature. Naloxone does not reverse benzodiazepine or GHB overdose — medical intervention is required.

// FENTANYL TESTING

How to Use Fentanyl Test Strips

1. Dissolve a small sample in water
2. Dip the strip for 15 seconds
3. Wait 2–5 minutes and read the result
4. One line = fentanyl detected · Two lines = not detected · Zero lines = invalid test

• DanceSafe Fentanyl Test Strips
• BTNX Test Strips

// OPIOIDS

Opioid Harm Reduction

Tolerance drops rapidly after breaks in use. Many fatal overdoses occur when someone returns to a previous dose after abstinence. Risk increases sharply when opioids are combined with alcohol or benzodiazepines.

• Test for fentanyl before every use
• Never use alone — call 1-800-484-3731 if no one is present
• Start at a significantly lower dose after any break
• Keep naloxone accessible
• Find supervised consumption sites via EMCDDA

// STIMULANTS

Stimulant Harm Reduction

• Test MDMA with Marquis, Mecke, and Simon's reagents
• Test cocaine with fentanyl strips — adulteration is widespread
• Stay hydrated and cool in hot environments
• Space MDMA use by at least 3 months
• Never combine cocaine with alcohol — produces cocaethylene, a cardiac toxin

• Reagent Testing Kits
• Rollsafe MDMA Guide

// PSYCHEDELICS

Psychedelic Harm Reduction

• Prioritize set and setting — environment strongly affects outcomes
• Use a sober trip-sitter for high doses or first experiences
• Test LSD with Ehrlich reagent before use
• Never combine psychedelics with lithium
• Limit ketamine frequency to reduce bladder damage risk

• Fireside Project — Psychedelic Support
• TripSit Interaction Chart

// CANNABIS

Cannabis Harm Reduction

• Prefer vaporizing over smoking to reduce respiratory harm
• Start with low THC concentrations
• Edibles: wait 1–3 hours before considering another dose
• Avoid synthetic cannabinoids (Spice/K2) — significantly more dangerous

// BENZODIAZEPINES

Benzodiazepine Harm Reduction

• Never combine with alcohol, opioids, or other CNS depressants
• Physical dependence develops quickly — avoid daily use
• Taper under medical supervision rather than stopping abruptly
• Designer benzos have unpredictable potency — use reagent testing

// RESOURCES

Support Organizations

• DanceSafe — Drug checking and education
• The Loop — UK drug checking at events
• TripSit — Interaction database and chat
• SAMHSA — 1-800-662-4357
• Never Use Alone — 1-800-484-3731
• Harm Reduction International

Read the harm reduction FAQ →