How to help someone through a difficult psychedelic experience

Most "bad trips" are not medical emergencies. They are intense emotional experiences in altered states that feel unbearable in the moment but resolve as the substance wears off. The single most important variable is the presence of a calm, kind, non-judgmental person — a "trip sitter." This guide is for that person.

First principles

• The experience will end. Even the strongest LSD or mushroom trip is over in 4–10 hours. Remind the person of this gently.
• They are not dying, going insane, or stuck. It feels like all three. Reassure without dismissing.
• You cannot reason them out of the experience. Don't argue with their interpretation. Just be present.

What to do

1. Get them somewhere quiet, comfortable and dim. Bright lights and loud noises amplify difficult states. A bedroom is usually better than a living room, which is usually better than a kitchen.
2. Reduce input. Turn off the TV. Lower the music or switch to something they chose when sober and trust. Ask others to give space.
3. Speak slowly, calmly, in short sentences. "You're safe. I'm here. This will pass."
4. Sit with them, don't hover over them. Same eye level. Don't pace or fidget visibly.
5. Offer water and a blanket. Cold extremities are common; a warm wrap is grounding.
6. Use grounding techniques if they're open to them: 5-4-3-2-1 (name five things you see, four you can touch, three you hear, two you smell, one you taste), or have them count breaths.
7. Reorient gently if they ask. "We're at my apartment. It's Tuesday evening. You took LSD around 8pm. It's now 11pm. You have maybe 4 hours left."
8. Let them cry, talk, be silent, or rest. Whatever they need. Don't push for explanation.

What NOT to do

• Don't give them benzos, alcohol, or another substance to "calm them down" unless a medical professional advises it. Mixing in alcohol is particularly bad. Vomiting risk is high and the disinhibition makes things worse.
• Don't insist they're "fine" when they clearly aren't. Acknowledge it's hard.
• Don't moralize. "I told you so" or "this is why you shouldn't take this" is the worst possible response in the moment. Save it for next week, if at all.
• Don't take them outside unless absolutely necessary. The disorientation is much worse in unfamiliar surroundings.
• Don't call the police unless there's an immediate danger to life. Police involvement during psychedelic experiences is regularly traumatic, sometimes fatal, and rarely helpful.
• Don't film them. Obvious in hindsight. Less obvious in the moment.

When to call emergency services

Call 911 / 112 / 999 (or local equivalent) immediately if:

• They have lost consciousness and don't respond to firm tapping or voice
• They are having a seizure (rigid limbs, rhythmic shaking, unresponsive)
• Their breathing is severely irregular, very slow (< 8 per minute), or labored
• Their lips, fingertips, or face are turning blue
• Their body temperature is dangerously high (sweating profusely + skin hot + confused → possible serotonin syndrome or hyperthermia)
• They show signs of severe muscle rigidity, especially with hyperthermia
• They've taken or may have taken an unknown combination including opioids
• They are a danger to themselves or others and you cannot keep them safe

Tell the dispatcher what was taken. Many regions have good-samaritan laws specifically for substance-related emergencies. The medical team's job is much easier if they know what they're treating.

After

When they come down, they will be tired, often emotional, sometimes embarrassed. Have water and a light snack ready. Don't push them to talk about what happened, let them bring it up. Most people, with good support, integrate difficult trips into something meaningful within days or weeks.

If the difficulty persists for more than a few weeks (intrusive thoughts, anxiety, depression, persistent visual disturbances), a therapist with experience in psychedelic integration is the right next step. This is uncommon but real.